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- Koertge, J C, et al.
(författare)
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Vital exhaustion in relation to lifestyle and lipid profile in healthy women
- 2003
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Ingår i: International Journal of Behavioral Medicine. - : LAWRENCE ERLBAUM ASSOC INC. - 1070-5503 .- 1532-7558. ; 10:1, s. 44-55
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Tidskriftsartikel (refereegranskat)abstract
- "Vital exhaustion," characterized by fatigue, irritability, and demoralization, precedes new and recurrent coronary events. Biological mechanisms explaining this association are not fully understood. The objective was to investigate the relationship between vital exhaustion, lifestyle, and lipid profile. Vital exhaustion, smoking, body mass index (BMI), alcohol consumption, exercise capacity, and serum lipids were determined in 300 healthy women, aged 56.4 +/- 7.1 years. No statistically significant associations were found between vital exhaustion and lifestyle variables. Divided into quartiles, vital exhaustion was inversely related to high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A1 in a linear fashion after adjustment for age, BMI, exercise capacity, and alcohol consumption. A multivariate-adjusted vital exhaustion-score in the top quartile, as compared to one in the lowest, was associated with 12% lower HDL-C and 8% lower apolipoprotein A1 (p < .05). In conclusion, alterations in lipid metabolism may be a possible mediating mechanism between vital exhaustion and coronary heart disease. The impact of lifestyle variables was weak.
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- Koertge, J, et al.
(författare)
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Effects of a cognitive-behavioral stress management program on vital exhaustion and depression in women with coronary heart disease - a randomized intervention study
- 2008
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 263:3, s. 281-293
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Psychosocial factors, including depression and vital exhaustion (VE) are associated with adverse outcome in coronary heart disease (CHD). Women with CHD are poor responders to psychosocial treatment and knowledge regarding which treatment modality works in them is limited. This randomized controlled clinical study evaluated the effect of a 1-year stress management program, aimed at reducing symptoms of depression and VE in CHD women. Design. Patients were 247 women, ≤75 years, recruited consecutively after a cardiac event and randomly assigned to either stress management (20 2-h sessions) and medical care by a cardiologist, or to obtaining usual health care as controls. Measurements at; baseline (6–8 weeks after randomization), 10 weeks (after 10 intervention sessions), 1 year (end of intervention) and 1–2 years follow-up. Results. For VE, intention to treat analysis showed effects for time (P < 0.001) and time × treatment interaction (P = 0.005), reflecting that both groups improved over time, and that the decrease of VE was more pronounced in the intervention group. However, the level of VE was higher in the intervention group than amongst controls at baseline, 22.7 vs. 19.4 (P = 0.036) but it did not differ later. The change in depressive symptoms did not differ between the groups. Conclusions. CHD women attending our program experienced a more pronounced decrease in VE than controls. However, as they had higher baseline levels, due to regression towards the mean we cannot attribute the decrease in VE to the intervention. Whether the program has long-term beneficial effects needs to be evaluated.
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- Koertge, J., et al.
(författare)
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Vital exhaustion and recurrence of CHD in women with acute myocardial infarction
- 2002
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Ingår i: Psychology, Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 7:2, s. 117-126
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to investigate the prospective impact of vital exhaustion on recurrence after acute myocardial infarction (AMI) in women. Women ≤ 65 years, mean age = 55.30, SD = 7. 63, N = 110, consecutively admitted to a coronary care unit with AMI were examined after three-six months, and followed for five years. Vital exhaustion was assessed using an early version of the Maastricht Questionnaire. A recurrent event was defined as cardiac death, AMI or a revascularization procedure. Forty-five recurrent events were found (in 41% of the study group). One standard deviation (8.4 points) increase of vital exhaustion scores was associated with a 53 % increased risk of a new event and a score above the median was associated with a hazard ratio of 2.24 (95% CI 1.21-4.14). These results remained after adjusting severity of chest pain and significant coronary stenosis. In conclusion, it was found that vital exhaustion is a marker of poor prognosis in women with AMI. The relationship appears to be independent of signs of underlying disease, including severity of chest pain and significant coronary stenosis.
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