Education, psychosocial stress and sudden cardiac death.

To explore the hypothesis that low education, associated with high 5-yr sudden-death risk among myocardial infarction survivors demonstrating ventricular arrhythmia, might be a marker for relatively high levels of psychosocial stress, we did telephone interviews with the patients' wives. Analysis of the information obtained on life circumstances and personality attributes resulted in four psychosocial factors that were found to be independent of the patients' educational level. The difference in sudden-death risk in relation to education, given the presence of complex ventricular premature beats in one hour of ECG monitoring, was large and could not be accounted for in multivariate analyses by one or more of these psychosocial factors. Nevertheless, life-table analyses in relation to categorized levels of scores for some of the factors did suggest some modest influences on risk of sudden cardiac death, with severity of disease controlled.