Distinct psychosocial differences between women with coronary heart disease and cardiac syndrome X

Eur Heart J. 2004 Oct;25(19):1695-701. doi: 10.1016/j.ehj.2004.07.035.


Aims: To compare the impact of oestrogen, gynaecological history, social support, life events and family history of CHD on psychosocial morbidity in syndrome X, CHD patients and healthy controls.

Methods and results: 100 female syndrome X (60 +/- 9 years), 100 female CHD (65 +/- 9 years) and 100 healthy female volunteers (61 +/- 10 years) completed the hospital anxiety and depression scale (HADS), health anxiety questionnaire (HAQ), a demographic information scale, life events scale, family history of CHD, menopausal, menstrual and gynaecological history. A 17beta-oestradiol sample was taken. Syndrome X patients had higher levels of life interference (p < 0.05) and HADS anxiety (p < 0.05) than CHD patients, and higher levels of all HADS and HAQ scales than controls (p < 0.01). Syndrome X patients with a large social network had lower HADS anxiety (p < 0.05), health worry (p < 0.05), life interference (p < 0.01) and total HAQ (p < 0.01). Social network (p = 0.003), divorced/separated or widowed status (p = 0.005), HRT (p = 0.008) and HADS anxiety score (p < 0.001) accounted for 41.9% of the variance in HAQ scores in syndrome X. Oestrogen was unrelated to the HADS or HAQ for any group.

Conclusion: Syndrome X patients suffered higher levels of psychological morbidity in comparison to CHD patients and controls. Life events and social network size were related to health anxiety, general anxiety and depression in women with syndrome X.

Publication types

  • Comparative Study

MeSH terms

  • Anxiety / etiology*
  • Coronary Disease / genetics
  • Coronary Disease / psychology*
  • Cross-Sectional Studies
  • Depressive Disorder / etiology*
  • Estrogen Replacement Therapy / adverse effects
  • Female
  • Hospitalization
  • Humans
  • Hysterectomy / adverse effects
  • Interpersonal Relations
  • Life Change Events
  • Male
  • Microvascular Angina / genetics
  • Microvascular Angina / psychology*
  • Middle Aged
  • Multivariate Analysis
  • Pedigree