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[Importance of personality traits and psychosocial factors for the development of coronary heart disease].

BACKGROUND/AIM
Numerous studies have provided clear and convincing evidence that psychosocial factors contribute to the pathogenesis and expression of coronary heart disease (CHD). These factors have been related to the following psychosocial domains: personality factors and character traits, depression, anxiety, social isolation and chronic life stress. The aim of this study was to estimate the influence of personality traits and psychosocial risk factors for the development of coronary heart disease.


METHODS
The investigation was conducted as observational cross-sectional (case-control) study. Based on medical records all subjects were divided into two groups: the group of patients with CHD (61 participants), and the control group of 41 healthy participants. All participants fulfilled the Eysenck Inventory Questionnaire, Paykel stress scale and Bortner scale of A-B self-estimation.


RESULTS
The participants with CHD were shown to have lower education than healthy participants, but were comparable by gender, age and place of residence. According to the Bortner scale, most participants with CHD expressed type A personality, whereas most healthy participants expressed types B and AB. The patients with CHD achieved higher scores on the Paykel stress scale of life events, and they had the higher level of neurotic and psychotic tendencies, as well as the lower level of extroversion compared to the healthy participants. Multivariate logistic regression model identified chronic stress (odds ratio 1.018; 95% confidence interval 1.007-1.028) as an important predictor for the occurrence of coronary heart disease, when adjusted for age, gender, nourishment and blood pressure. On the other side, the lower risk for the occurrence of CHD was observed among the participants who had the higher level of extroversion (odds ratio 0.859; 95% confidence interval 0.636-0.902).


CONCLUSION
Chronic stress and introversion can be considered important risk factors for the development of coronary heart disease, independent of other predictors such as obesity and hypertension, supporting the biopsychosocial model of the occurrence of coronary heart disease.