Rafia Rafique, Naumana Amjad, Lubna Amer, Sabrina Afzal.
Evidence Based Psychosocial and Behavioral Model for Primary and Secondary Prevention of Ischemic Heart Disease for Pakistani Population.
J Cardiovascular Dis Jan ;12(3):61-6.

BACKGROUND: The present study intended to suggest a model for primary and secondary prevention of IHD by exploring behavioral, psychological, social and self-reported family history of IHD, disease history and anthropometric factors for the possible early onset of IHD in Pakistan. The behavioral factors of the participants were evaluated by inquiring about smoking, number of cigarettes smoked daily and ex-smoking status and physical activity. Monthly family income, education, perceived social support and social dominance; psychological features investigated in this regard were the following: anxiety, stressful life events, perceived stress, depression, hostility, anger, locus of control and optimism. Regarding self-reported disease history, family history of IHD, diabetes and hypertension were incorporated; and anthropometric variables encompassed waist circumference, Body Mass Index (BMI) and Waist-Hip Ratio (WHR). METHODS: Case-control research design was utilized, comprising 190 cases and 380 gender and age matched controls, aged from 35 to 55 years. Measures were translated in Urdu language following the forward –backward translation procedure, the translated Urdu version of all the measures was validated. RESULTS: Binary logistic regression analyses showed that two or more traumatic life events, internal locus of control, family history of IHD, diabetes and BMI ≥ 25 kg/m2 are linked with risk of IHD; and optimism, 12 to 14 years of education and 4 or more hours of physical activity per week are protective factors of IHD. In men, occurrence of diabetes, physical activity of less than 4 hours a day, two or more stressful life events, being a smoker or an ex-smoker and smoking one pack or more cigarettes were risk factors for IHD. For men, optimism and external locus of control turned out to be significant protective factors of IHD. In women, trait anger was found to be concomitant with IHD. Social support played a protective role. CONCLUSION: A model for primary and secondary prevention of IHD is hereby recommended in the light of present research findings. KEY WORDS: Multivariate Odds Ratios, Primary prevention, Secondary prevention, Ischemic Heart Disease.

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