The association between psychological distress and angina pectoris: A population-based study

Abstract

BackgroundPsychological distress is an undifferentiated combination of symptoms that may be related to the occurrence of angina pectoris (AP). However, few studies have investigated the relationship between psychological distress and AP, particularly in Asian populations. The purpose of this study was to examine the relationship between psychological distress and AP in Taiwanese adults.MethodsWe adopted a cross-sectional design to explore the data of the 2005–2008 Nutrition and Health Survey in Taiwan. In total, 2080 subjects (aged ≥ 19 years) responded to questionnaire interviews and underwent physical examinations. Each of the five dimensions of psychological distress (sleep disturbance, anxiety, hostility, depression, and feelings of inferiority) were scored (from 0–20) according to the Five-Item Brief Symptom Rating Scale (BSRS-5). A score ≥ 6 points indicated psychological distress. AP was evaluated using a modified Rose questionnaire.FindingsIn total, 102 subjects (3.6%) had AP, and 231 subjects (8.8%) had symptoms of psychological distress. After adjusting for the basic data, metabolism, and lifestyle covariates, the BSRS-5 total score was associated with AP (odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.13–1.26, p < 0.001). Subjects with psychological distress had a higher risk of AP (OR = 2.97, 95% CI = 1.76–4.99, p < 0.001).ConclusionsThe presence of AP is associated with psychological distress. Health care providers should therefore be aware of the impact of psychological distress on AP. Our study findings can serve as a reference for AP assessments. Large scale longitudinal studies are needed to confirm a causal relationship between psychological distress and AP.

Prevalence of Angina Pectoris and Associated Factors in the Adult Population of Brazil: National Survey of Health, 2019

“…This study identified an association of grade I angina with self-declared black and mixed race/color and with living in rural areas, reinforcing the relationship of social characteristics and poorer access to health promotion and preventive measures 16 . Among the study's limitations, we highlight a strong association between "positive" responses to the questionnaire and the presence of common mental disorders 4,19,20 . Thus, the positive response could be due to somatization or increased sensitivity to pain in depressed or anxious people, and not exactly to a manifestation of coronary ischemia 4,19 .…”

“…Among the study's limitations, we highlight a strong association between "positive" responses to the questionnaire and the presence of common mental disorders 4,19,20 . Thus, the positive response could be due to somatization or increased sensitivity to pain in depressed or anxious people, and not exactly to a manifestation of coronary ischemia 4,19 . Also, the study had a cross-sectional design and cannot define the direction of causality.…”

“…Chronic angina, from the Latin Angina Pectoris (AP), is a common symptom of coronary artery disease (CAD) that impacts an individual's quality of life 3 . It typically expresses as a chest discomfort usually triggered by physical activity or emotional stress, which gets better after rest or use of nitroglycerin and is mostly caused by myocardial hypoxia resulting from obstructive or non-obstructive CAD 4 . Associated with age and gender, the characterization of angina helps to predict the probability of coronary ischemic disease, although in some cases it may result from conditions other than CAD, such as anemia, hyperthyroidism, respiratory diseases and valvular diseases 4 .…”

“…self-reported angina experience. In order to characterize angina and chest pain during infarction in a reproducible way, Geoffrey Rose 8 developed a questionnaire in 1962, which was later adopted by the WHO as a general instrument for determining the prevalence of angina 4 .…”

Anxiety disturbs the blood plasma metabolome in acute coronary syndrome patients

“…CHD is the result of a complex metabolic disorder caused by various environmental and genetic factors 2 , and is often accompanied by psychological disease, such as anxiety 3 , 4 , throughout the patients’ lifelong time. Activation of the hypothalamus–pituitary–adrenal axis in CHD patients with comorbid anxiety 5 can lead to increased blood pressure, dyslipidemia, decreased sleep quality, and increased frequency and degree of angina pectoris 6 . Increasing data from clinics has identified anxiety is an independent risk factor for the adverse cardiovascular events and mortality in patients with acute coronary syndrome (ACS) 7 .…”