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2011-06-16 16:14:01
Med psych CVD cardiovascular disease

Med psych and CVD
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  1. __% of men and __% of women who died suddenly of CHD had no previous symptoms. (majority, minority, 50/50)
    50% men, 64% women
  2. Strokes are the ___ leading cause of death in the US.
  3. What is the leading cause of death in the US, considering all age groups?
    CVD. Almost 60% of total mortality in 2002.
  4. Prevalence...who is more likely to get it?
    Men or women?
    Socioeconomic status?
    • Men > women (although CVD deaths are greater for women; and CVD prevalence is greater for women after age 54)
    • After menopause > before menopause (for women of the same age)
    • Old > young
    • African americans 50% higher than whites
    • Prevalence of having 2+ risk factors greatest in blacks and american indians/alaskans and lowest among asians
    • Multiple risk factors greater in those with less than a high school degree
    • Earning more money = decreased risk
  5. Which disease subtype is more common in men? In women?
    • Men: coronary heart disease
    • Women: essential hypertension
  6. What is the only major CVD whose prevalence is rising, due to the medical advances that have helped more people survive MI and prevent deaths caused by CH?
    Congestive Heart Failure
  7. What are the gender differences in clinical presentation and testing?
    • Women have a greater tendency to have atypical chest pain or to complain of abdominal pain, difficulty breathing, nausea and unexplained fatigue.
    • Women may avoid or delay seeking medical care
    • Women have heart attacks later in life than men do, so other diseases may mask heart attack symptoms. This can also help explain women's greater mortality after heart attacks.
  8. Who is most likely to be recommended for cardiac catheterization? (men/women, black/white)
    Whites and men
  9. Risk factors for CVD
    • Stress
    • Cigarette smoking
    • Obesity
    • Lack of physical activity
    • Dietary intake of saturated fats (monounsaturated fats reduce risk)
    • Elevated serum cholesterol and/or TGs
    • Hostility/anger
    • Personality Traits
    • Depression
    • Hypertension
    • Presence of certain inflammatory factors
    • Age
    • Sex (males at greater risk)
    • Family history of heart disease, diabets
  10. Describe the job strain model of stress.
    • Little control = increased stress
    • Low control + high demand = increased heart disease
  11. (T/F) A CAD diagnosis is often accompanied by symptoms of depression, anxiety and psychosocial impairment. These symptoms often go undetected due to lack of primary care provider awareness of psychological co-morbidities with CAD, in addition to patient denial and the stigma of psychiatric illness in the military.
  12. In the military, what has been the most common CAD risk factor among those under the age of 40?
    Increased incidence of smoking
  13. Which personality type (A, B or D) is linked to increased mortality, poorer prognosis after MI, recurrent MI and increased risk of sudden cardiac death?
    Type D
  14. Does having a Type A personality increased your risk of CVD?
    Conflicting data; only certain components of Type A personality may confer risk. (i.e. hostility and anger)
  15. Assuming all other relevant psychosocial and disease risk factors are the same, which of the following individuals would be MOST likely to suffer an MI?
    A. 63-yo African american male
    B. 37-yo african american male
    C. 42-yo caucasian female
    D. 64-yo african american female
    E. 60-yo caucasian male