The Journal of

Introduction: Coronary Heart Disease can be mentioned as one of the main causes of death in the world. In recent years, the role of psychological factors has been taken into account in the onset and exacerbation of cardiovascular diseases, particularly coronary artery disease. Thus, this study aimed to determine the level of perceived stress in patients with coronary heart disease as a step toward solving some problems of heart patients as well as reducing their additional costs.

Methods: In this case-control study, 250 patients with coronary artery disease, hospitalized in Afshar and Shahid Sadoughi Hospitals, were compared with 250 healthy individuals whose heart have been diagnosed to be healthy by a heart specialist. The two groups, matched in regard with their age and sex, were compared in terms of stress and stressors using the Holmes-Rahe stress scale. T-test, chi-square, Mann-Whitney and logistic regression were applied to compare the two groups in terms of variables and stress score using SPSS software (ver,16).

Results: The study results showed that patients with myocardial infarction experienced higher psychological stressors within one year prior to the heart attack. 16.4% of cases and 1.6% of the controls demonstrated stress levels of more than 300 units (P <0.001,). The risk of coronary artery disease in these groups was 20 times as much as the control group. Moreover, the most stressful events that were perceived by the subjects consisted of changes in economic conditions, changes in sleep duration and a wound or illness within the previous year.

Conclusions: In this study, heart patients were exposed to more stressors compared with the healthy subjects. In addition to the Stressor' direct effect on increasing the risk of heart disease and  its aggravation, they can lead to the vicious cycle in the patients'  improvement. As a result, the role of stress in cardiac rehabilitation can be further emphasized.