Gender-specific association of psychological distress with cardiovascular risk scores

Abstract

Objective. To examine the gender differences in the association of psychological distress with cardiovascular disease (CVD) risk scores using two different CVD risk assessment models. Design and setting. A cross-sectional, population-based study from 1997 to 1998 in Pieksämäki, Finland. Subjects. A population sample of 899 (399 male and 500 female) middle-aged subjects. Main outcome measures. The 10-year risk for CVD events was calculated using the European SCORE model and the Framingham CVD risk prediction model. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). Study subjects were allocated into three groups according to their global GHQ-12 -scores: 0 points, 1–2 points, and 3–12 points. Results. Psychological distress was associated with higher mean CVD risk scores in men. Men in the highest GHQ group (3–12 points) had significantly higher mean European CVD risk score (3.6 [SD 3.3]) compared with men in the lowest group (0 points) (2.5 [SD 2.6]), the difference being 1.1 (95% CI 0.4 to 1.9). The p-value for linearity between the three GHQ groups was 0.003. The Framingham CVD risk prediction model yielded similar results: 15.7 (SD 10.2) vs. 12.3 (SD 9.6), the difference 3.4 (95% CI 1.0 to 6.0) and p-value for linearity 0.008. No significant association was observed in women. Conclusion. A gender-specific association was found betwen psychological distress and cardiovascular risk scores. These results highlight the importance of identifying men with psychological distress when assessing CVD risk.