Psychosocial influences on coronary heart disease

Abstract

A variety of types of scientific evidence supports the hypothesis that stress and related psychosocial processes contribute to the development and course of coronary hean disease (CHD). In animal models, stress can accelerate the development of coronary artery disease and precipitate acute cardiac events. In human epidemiological studies, social isolation and low social support, Type A behaviour, and hostility predict the development of CHD. In clinical studies of patients with CHD, psychological stress is associated with transient myocardial ischemia, suggesting that psychosocial factors can increase vulnerability to acute coronary events. Finally, intervention research suggests that modification of these psychosocial risk factors may prevent recurrence of cardiac events in patients with CHD. This paper reviews each of these topics and discusses the implications for prevention and management of CHD.