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BACKGROUND: Past and recent research suggests that psychological and biological factors may increase women's risk of coronary heart disease (CHD). This study examined the prevalence and correlates of self-reported heart disease among Jewish women from the Negev, a socio-economically and culturally unique region in south of Israel. METHOD: A cross-sectional design was used. We interviewed over the phone 526 randomly-selected women (mean age: 44.3+/-14.2 years) about background variables (e.g., education), biomedical risk factors (e.g., body mass index or BMI), self-reported inflammatory diseases (rheumatoid arthritis or RA, urinary infections), psychosocial factors (depression, hopelessness, self-esteem, social-support) and self-rated health and heart disease. RESULTS: Prior physician diagnosis of heart disease was reported by 8.2% of women. Age, economic difficulties, diabetes, hypertension, BMI, physical exercise, RA and urinary infections were significantly associated with reported heart disease. Of all psychosocial factors considered, hopelessness and self-esteem significantly distinguished heart disease cases from non-cases. In a multiple logistic regression, poor self-esteem, RA and hypertension were significant independent correlates of self-reported heart disease. CONCLUSIONS: Pending replication with objective measures of heart disease and a prospective design, poor self-esteem and RA may prove to be new CHD risk factors in women.

The authors evaluated hospitalization cost offset of hostility management group therapy for patients with coronary heart disease (CHD) from a previously published randomized controlled trial (Y. Gidron, K. Davidson, & I. Bata, 1999). Twenty-six male patients with myocardial infarction or unstable angina were randomized to either 2 months of cognitive-behavioral group therapy or an information (control) session. Therapy patients had a shorter average length of hospital stay (n = 13, M = 0.38 days, SD = 0.96) than did control patients (n = 13, M = 2.15 days, SD = 2.6), t(15.2) = -2.29, p = .04, over 6 months following therapy. The average hospitalization costs were significantly lower for therapy patients (M = 245(dollars), SD = 627(dollars)) than for control patients (M = 1,333(dollars), SD = 1,609(dollars)), t(15.6) = -2.27, p = .04. The cost-offset ratio is calculated by dividing the 1,088(dollars) of hospitalization savings by the 560(dollars) of therapy expense (1.00:1.94(dollars)), indicating that for every 1.00(dollars) spent on therapy, there is an approximate savings of 2.00(dollars) in hospitalization costs in the following 6 months. These findings support the hospitalization cost offset of hostility-reduction in CHD patients.

Family interaction is a basic factor in determining the quality of life of patients undergoing heart surgery. The present study investigates the emotional attitudes in the relatives of 10 heart-operated patients. The results indicate that a high amount of relatives' emotional overinvolvement and warmth tends toward a correlation with lower anxiety and depression scores, and with a better 12-month outcome of the illness. © 1991 S. Karger AG, Basel.