Psychosocial factors and venous thromboembolism: a long-term follow-up study of Swedish men

• BACKGROUND: The link between psychosocial factors and coronary heart disease is well established, but although effects on coagulation and fibrinolysis variables may be implicated, no population-based study has sought to determine whether venous thromboembolism is similarly related to psychosocial factors. OBJECTIVE: To determine whether venous thromboembolism (deep vein thrombosis or pulmonary embolism) is related to psychosocial factors. PATIENTS/METHODS: A stress questionnaire was filled in by 6958 men at baseline from 1970 to 1973, participants in a cardiovascular intervention trial. Their occupation was used to determine socio-economic status. RESULTS: After a maximum follow-up of 28.8 years, 358 cases of deep vein thrombosis and/or pulmonary embolism were identified through the Swedish hospital discharge and cause-specific death registries. In comparison with men who, at baseline, had no or moderate stress, men with persistent stress had increased risk of pulmonary embolism [hazard ratio (HR)=1.80, 95% CI: 1.21-2.67]. After multivariable adjustment, the HR decreased slightly to 1.66 (95% CI: 1.12-2.48). When compared with manual workers, men with white-collar jobs at intermediate or high level and professionals showed an inverse relationship between occupational class and pulmonary embolism (multiple-adjusted HR=0.57, 95% CI: 0.39-0.83). Deep vein thrombosis was not significantly related to either stress or occupational class. CONCLUSION: Both persistent stress and low occupational class were independently related to future pulmonary embolism. The mechanisms are unknown, but effects on coagulation and fibrinolytic factors are likely.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Aged

80 and over

Alcoholism/epidemiology

Body Mass Index

Cardiovascular Diseases/mortality

Confounding Factors (Epidemiology)

Diabetes Mellitus/epidemiology

Follow-Up Studies

Humans

Hyperlipidemias/epidemiology

Hypertension/epidemiology

Intervention Studies

Leisure Activities

Male

Neoplasms/mortality

Occupations/statistics & numerical data

Proportional Hazards Models

Pulmonary Embolism/*epidemiology/etiology/psychology

Questionnaires

Risk Factors

Smoking/epidemiology

Social Class

Stress

Psychological/*epidemiology

Sweden/epidemiology

Thrombophlebitis/*epidemiology/etiology/psychology

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)