Considerable epidemiologic evidence suggests that a variety of behavioral, psychosocial, and socioeconomic factors are associated with ischemic heart disease. However, little is available concerning the pathophysiologic pathways that link these factors with clinically important events, on the impact of changes in these factors on morbidity or mortality, or subclinical manifestations of atherosclerotic disease. Little is also known about the contributions which these factors make to explaining cardiovascular disease in women or sex differences in CVD in later life. The Kuopio Ischemic Heart Disease Risk Factor Study (KIHD) is the most comprehensive, population-based study to prospectively assess the association between behavioral, psychosocial, and socioeconomic factors and the extent and progression of atherosclerosis, and the incidence of ischemic heart disease. Data from a baseline examination, a 4-year re-examination, and a proposed 1-year re-examination of ultrasonographically assessed carotid and femoral atherosclerosis, and surveillance for myocardial infarctions and other outcomes, will be used to examine the progression or incidence of these outcomes in relation to changes in behavioral, psychosocial and socioeconomic factors. It will also be possible to see to what extent the input of these behavioral, psychosocial and socioeconomic factors on CVD in men and women is mediated by lipid peroxidation, hemostatic factors, and cardiovascular reactivity. Finally, the investigators state that this will be the first population-based epidemiologic study to examine the association between a carefully developed set of measures of cardiovascular reactivity to stress and the progression of carotid atherosclerosis, risk of myocardial infarction and death, and development of hypertension.
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