Henry Ford Study Finds That Denial May Kill Cardiac Patients

March 19, 1997

DETROIT -- We've all heard that anger can kill. Yet for cardiac patients, perhaps denial of anger is even more deadly.

Denial of anger emerged as a stronger predictor for death and other cardiac incidents, such as new heart attacks or additional cardiac procedures, than traditional cardiac risk factors, according to a Henry Ford Hospital study conducted by Mark Ketterer, Ph.D.

Results of this study were presented at the American Psychosomatic Society Annual Meeting, held March 19-22 in Santa Fe, N.M.

"The results of this study make a strong case for doctors to routinely ask a spouse or friend about the patient's emotional well-being," Dr. Ketterer said. "Patients tend to minimize what is really happening."

Researchers discovered that patients routinely under-reported anger. In fact, it was more likely to be minimized than depression or anxiety. This makes it difficult for physicians to accurately assess patients' emotional risk factors and direct them to appropriate therapy.

The study evaluated measures of emotional distress, in addition to standard cardiovascular risk factors, to determine which are the most potent predictors of additional cardiac incidents or death. It also examined how to determine which patients will benefit from evaluation and intervention for emotional distress.

"It is striking that standard cardiovascular risk factors largely failed to predict cardiac events or chest pain," Dr. Ketterer said. "This study shows that denial of emotional distress is a powerful predictor of long-term outcomes and points out that patient distress is not likely to be apparent to the physician."

The study involved 144 men who underwent coronary catherization between 1989 - 1991, had no history of previous cardiac procedures or mental disorders, and whose baseline coronary artery disease was determined by angiography, a procedure which provides an image of the blood vessels to the heart. Each patient and a spouse/friend completed parallel versions of the Ketterer Stress Symptom Frequency Checklist at that time, which evaluated the patient's emotional well-being.

Patients or surviving family were followed up by phone an average of five years after their catherization. Patients who had experienced one or more cardiac events or death were compared with those not experiencing events on traditional risk factors and a number of measures of psychosocial/emotional distress.

Of the traditional cardiac risk factors, only the number of hours of exercise per week and a history of hypertension were found to predict cardiac events.

Denial scores, which are the difference between what the patient and the spouse reported, proved to be the strongest predictor of cardiac events. Denial of anger had the strongest association observed for cardiac events or death, even over traditional cardiac risk factors.

Dr. Ketterer believes that more support groups are needed for cardiac patients to address the emotional and psychological issues of their disease.

In addition, Dr. Ketterer believes that future research and clinical care need to take reports of emotional status from the spouse/friend into account to effectively evaluate and treat patients.

Henry Ford Health System

Related Heart Attacks Articles from Brightsurf:

Additional heart imaging valuable for women with unexplained heart attacks
Combining diagnostic imaging methods can detect the underlying cause of heart attack in women who did not have blocked arteries.

How to treat the most common heart attacks
One in five patients die within a year after the most common type of heart attack.

Slow release of two chemicals protects the heart after experimental heart attacks
A novel treatment reduces heart damage after serious heart attacks in two animal models.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Declines in heart attacks greater among men than women
In a study published in the American Heart Association scientific journal Circulation, Kaiser Permanente research scientists report a steady decline in heart attacks for both men and women enrolled in the health system from 2000 to 2014, although that rate of decline slowed among women in the last 5 years of the study.

AI helps predict heart attacks and stroke
Artificial intelligence has been used for the first time to instantly and accurately measure blood flow, in a study led by UCL and Barts Health NHS Trust published in Circulation.

Nanoparticle chomps away plaques that cause heart attacks
Michigan State University and Stanford University scientists have invented a nanoparticle that eats away -- from the inside out -- portions of plaques that cause heart attacks.

Additional heart artery stenting reduces risk of future heart attacks
Research has shown that patients who have had emergency heart attack treatment with heart artery stenting -- and have significant narrowings in their other untreated arteries -- can benefit from additional stenting to help prevent future heart attacks.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Since 1990s, heart attacks have become less deadly, frequent for Americans
Heart attack prevention and outcomes have dramatically improved for American adults in the past two decades, according to a Yale study in JAMA Network Open.

Read More: Heart Attacks News and Heart Attacks Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.