‘Chronic Workload’, ‘Need for Control’ and ‘Vital Exhaustion’ in Patients With Myocardial Infarction and Controls: A Comparative Test of Cardiovascular Risk Profiles

In view of a growing number of different psychosocial cardiovascular risk profiles which have been developed and tested over the past 30 years, it is now timely to assess their interrelationship in terms of convergent validity and differential predictive power. Three such profiles, ‘chronic workload’, ‘need for control’ and ‘vital exhaustion’, are analysed using data from a case-control study of 79 hospitalized male patients following a first acute myocardial infarction (AMI) (mean age 52.9) and of 132 controls hospitalized for surgical (mean age 52.0). As predicted by theory, all three concepts significantly discriminated between AMI patients and controls both in univariate analyses and after adjusting for important confounders (age, anginal pain, cigarette smoking). However, when controlling for ‘vital exhaustion’ (OR=3.80, p=0.02), the effect of the critical factor ‘immersion’ of the concept ‘need for control’ lost its statistical significance (OR=2.11, p=0.24), whereas the powerful independent effect of ‘chronic workload’ (OR=8.98, p=0.01) was maintained. No interaction effects on the criterion produced by the three concepts were observed. The data confirm the validity of selected elements of the effort–reward imbalance model and contribute to the specification of the coronary-prone coping career. Therefore, they encourage more intense comparative testing of related concepts in research on psychosocial cardiovascular risk profiles.