11.6. The Association of Psychological Distress with Cardiovascular risk, the Metabolic Syndrome and Mortality

Public examination of a doctoral dissertation in the field of medicine

Doctoral candidate: Lic Med, MPH Pekka Puustinen

Time and venue: 11.6.2011 at 14.30, Central Finland Central Hospital, Lecture Hall 1, Jyväskylä

The 12-item General Health Questionnaire (GHQ-12) is one of the most studied indicators of psychological distress.

The relationship between various psychological factors and cardiovascular disease (CVD) is well documented, but whether there is a significant association in both men and women, is currently unknown. Because atherosclerosis is nowadays seen as an inflammatory process, also the role of C-reactive protein (CRP) in this association is currently studied vigorously. Psychological factors have been associated also with the metabolic syndrome and all-cause mortality, but there are no prospective studies examining the relationship between GHQ-12 and the risk of developing MetS. Furthermore, the association between GHQ-12 and mortality has been studied only in British population.

This study was done to evaluate the association of general psychological distress, measured by the GHQ-12, with cardiovascular risk, C-reactive protein, metabolic syndrome and all-cause mortality in a community-based population sample in Pieksämäki, Finland.

The study showed a gender-specific association between psychological distress and cardiovascular risk: men with high psychological distress had 28-44% higher cardiovascular risk scores compared to men with low distress. Among women, no significant association was observed.    In addition, subjects with high psychological distress had a 1.79-fold risk for elevated CRP level representing high relative cardiovascular risk, compared to subjects with no distress, although age, gender, body-mass index and health behaviours were accounted for.

High psychological distress was also associated with a two-fold relative risk for the development of metabolic syndrome during a 7-year follow-up, even after adjusting for age, gender, socio-economic status and health behaviours, as well as with a 2.4-fold all-cause mortality risk during an 11-year observation time, mainly due the excess mortality among distressed men.

In conclusion, these results support a direct, independent association of psychological distress with metabolic syndrome and premature mortality. In addition, psychological distress is associated with inflammation among both genders and significantly elevated cardiovascular risk scores among men.

The doctoral dissertation of Licenciate of Medicine , Master of Public Health Pekka Puustinen, entitled The Association of Psychological Distress with Cardiovascular risk, the Metabolic Syndrome and Mortality: The Role of C-reactive Protein will be examined at the Faculty of Health Sciences. The opponent in the public examination will be Professor Kaisu Pitkälä of the University of Helsinki and the custos will be Professor Mauno Vanhala of the University of Eastern Finland.

Photo available for download at http://uef.fi/vaitoskuvat .

Contact: Pekka Puustinen, pekka.puustinen@kuopio.fi, GSM 044 3510 338 

Publishing year: 2011

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