Psychosomatic factors in ischemic heart disease in women: Perceptions of health-related quality of life, psychosocial stress, and functional capacity

Purpose: Ischemic heart disease (IHD) is a leading threat to women and a major public health problem. While psychosomatic variables have been associated with IHD, the relationship of specific psychosomatic factors and the extent of myocardial ischemia in women is unknown. We examined psychosomatic variables relative to severity of IHD in women with signs and symptoms of ischemia but without obstructive coronary artery disease. Methods: In this secondary data analysis on 168 data records from Microvascular, we evaluated psychosocial stress, perceived health-related quality of life (HRQOL), self-reported physical functional capacity and related these psychosomatic variables to severity of IHD as measured by cardiac MRI. Statistical analysis was performed using multiple linear regression modeling. Results: HRQOL in perceived physical limitation, angina stability, treatment satisfaction, and perception of disease was not a statistically significant predictor of severity of IHD. However, HRQOL in perceived angina frequency, which included frequency of chest pain, chest tightness, angina, and taking nitroglycerin, significantly predicted severity of IHD (R2=0.103, p=0.018). Psychosocial stress, including stress at work, stress at home, life events stress, and financial stress, did not significantly predict severity of IHD. We did not observe any relationship between self-reported physical functional capacity and severity of IHD. Conclusions: Perception of HRQOL in angina frequency is an independent predictor of severity of IHD. The relationship between perception of HRQOL in angina frequency and severity of IHD may contribute to an improved understanding of psychosomatic contributors to IHD. Improved understanding of psychosomatic contributors to IHD may help optimize IHD interventions.