Patients who are active in their health care may lower their risk of heart disease

Middle-aged women who take an active role in their health care may be less likely to develop cardiovascular disease as they transition through menopause, according to research done at the University of Pittsburgh.

The results, presented today at the American Psychosomatic Society Annual Meeting, suggest women who believe they should take charge of their health, rather than rely solely on treatment by doctors, have fewer signs of pre-clinical atherosclerosis. “Our findings provide evidence that women who believe they should be engaged in the maintenance of their health, rather than women who would rather put the responsibility for their health into someone else’s hands, somehow translate those attitudes into better health through behavioral and psychological mechanisms,” said Wendy Troxel, M.S., predoctoral fellow in psychology at the University of Pittsburgh, and the study’s lead author.

The research team followed 370 middle-aged women from the Healthy Women Study, a prospective investigation of health during and following the critical menopausal transition led by Lewis H. Kuller, M.D., Dr.Ph., professor of public health at the University of Pittsburgh Graduate School of Public Health.

Participants’ involvement in their health care was measured using the Krantz Health Opinion Survey. Active participants would tend to agree with a statement such as “Except for serious illness, it is generally better to take care of your own health rather than to seek professional help,” while less active participants would agree with the statement “If it costs the same, I would rather have a doctor or nurse give me treatments than to do the same treatments myself.”

Then, using a type of imaging called B-mode ultrasound, the researchers took measures of two reliable signs of pre-clinical cardiovascular disease, intima-media thickness (IMT) and plaque buildup. IMT is a measurement of the thickness of the artery wall and may be a factor in the later formation of plaques. Increased IMT has been shown to be a risk factor for heart attack and stroke.

Women who scored as active participants in the opinion survey had lower IMT and plaques in their arteries compared to non-active participants, which translates into a lower risk of developing heart disease or suffering a heart attack or stroke.

The results showing lower IMT in women who reported greater involvement in their health care persisted after statistically controlling for education, age during follow-up, pulse pressure, smoking history and triglycerides, and were independent of a general personality measure. “This study supports the present trend in health care to encourage patients to take an active role in their health and well-being,” said Ms. Troxel.

Other authors are Dr. Kuller and Karen A. Matthews, Ph.D., professor of psychiatry and psychology at the University of Pittsburgh School of Medicine.