Greater Social Support Linked to More Cardiac Events in Women. (Counters Observations in Men)

Article excerpt

CHICAGO -- The long-held notion that a strong social support network provides a buffer against ill health doesn't seem to apply to women with coronary heart disease, Karma Davidson, Ph.D., said at the annual scientific sessions of the American Heart Association.

Indeed, the opposite appears to be true. Among women who have had an acute MI, those who report high levels of perceived social support--a feeling of being loved and needed, of belonging--have a markedly higher rate of recurrent coronary events and increased mortality compared with women who score lower on measures of social support, said Dr. Davidson, director of intervention research at the Kravis Center for Cardiovascular Health, Mount Sinai School of Medicine, New York.

This surprising new finding from a sub-analysis of the National Heart, Lung, and Blood Institute-sponsored Nova Scotia Health Survey 1995 raises the possibility that interventions aimed at enhancing social support in women with coronary disease--interventions now being studied in randomized trials--may not be the best ways to improve prognosis, she added.

The Nova Scotia Health Survey 1995 was a 4-year prospective observational study of 3,227 randomly selected adults. Among the 88 women and 139 men with documented coronary heart disease (CHD) at baseline, 32 women and 67 men had one or more recurrent coronary events during 4 years of follow-up.

In a logistic regression analysis that controlled for all the cardiovascular risk factors used in the Framingham Heart Study, higher perceived social support at baseline was independently associated with a 3.1-fold increased risk of recurrent events in women. No such link was seen in men.

Conventional wisdom has held that social support protects against CHD, cancer, and other chronic illnesses. But closer examination of the CHD data shows that this idea is based on many observational studies in which few women were enrolled. …