Gender-specific association of psychological distress with cardiovascular risk scores

OBJECTIVE: To examine the gender differences in the association of psychological distress with cardiovascular disease (CVD) risk scores using two different CVD risk assessment models. DESIGN AND SETTING: A cross-sectional, population-based study from 1997 to 1998 in Pieksämäki, Finland. SUBJECTS: A population sample of 899 (399 male and 500 female) middle-aged subjects. MAIN OUTCOME MEASURES: The 10-year risk for CVD events was calculated using the European SCORE model and the Framingham CVD risk prediction model. Psychological distress was measured using the 12-item General Health Questionnaire (GHQ-12). Study subjects were allocated into three groups according to their global GHQ-12 -scores: 0 points, 1-2 points, and 3-12 points. RESULTS: Psychological distress was associated with higher mean CVD risk scores in men. Men in the highest GHQ group (3-12 points) had significantly higher mean European CVD risk score (3.6 [SD 3.3]) compared with men in the lowest group (0 points) (2.5 [SD 2.6]), the difference being 1.1 (95% CI 0.4 to 1.9). The p-value for linearity between the three GHQ groups was 0.003. The Framingham CVD risk prediction model yielded similar results: 15.7 (SD 10.2) vs. 12.3 (SD 9.6), the difference 3.4 (95% CI 1.0 to 6.0) and p-value for linearity 0.008. No significant association was observed in women. CONCLUSION: A gender-specific association was found between psychological distress and cardiovascular risk scores. These results highlight the importance of identifying men with psychological distress when assessing CVD risk.