The stressful impact of news of risk for premature heart disease

Efforts at prevention of disease include case-finding of individuals at high risk and offering to these identified people an intervention to reduce their risk. Although the intention of intervention is to reduce risk, the impact of discovering that one is at high risk may also lead to intrusive ideas and feelings that characterize psychological stress response syndromes. The present study examined these issues with a sample of 1,447 men who were advised of their risk for coronary heart disease in the collaborative Multiple Risk Factor Intervention Trial. Comparisons over three yearly data collections between a usual care and special intervention group showed that the special intervention group reported a far greater level of coping and mastery efforts regarding their risk status. This was accompanied by a much smaller tendency to be bothered by intrusive thoughts, but amount of reported upset did not differ. Finally, a small group of men in both groups indicated continuing high levels of upset across the three years. Clinicians are advised to be watchful for these persons for whom mastery of the news appears to be difficult.