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Behavioral cardiology: Recognizing and addressing the profound impact of psychosocial stress on cardiovascular health

Current Atherosclerosis Reports volume 8, pages 111–118 (2006)Cite this article

Abstract

Psychosocial stress exerts independent adverse effects on cardiovascular health. The recent INTERHEART study reported that psychosocial stress accounted for approximately 30% of the attributable risk of acute myocardial infarction. Prospective studies consistently indicate that hostility, depression, and anxiety are all related to increased risk of coronary heart disease and cardiovascular death. A sense of hopelessness, in particular, appears to be strongly correlated with adverse cardiovascular outcomes. Time urgency and impatience have not been consistently related to risk of coronary disease, but do increase the likelihood of developing hypertension. Psychosocial stress appears to adversely affect autonomic and hormonal homeostasis, resulting in metabolic abnormalities, inflammation, insulin resistance, and endothelial dysfunction. Additionally, stress is often associated with self-destructive behavior and non-compliance with medications. Psychosocial stress is a highly modifiable risk and many factors have been shown to be protective. These include psychosocial support, regular exercise, stress reduction training, sense of humor, optimism, altruism, faith, and pet ownership. Simple screening questions are available to reliably indicate a patient at risk for psychosocial stress-related health problems.

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Authors and Affiliations

  1. Mid America Heart Institute, 4330 Wornall Road, Suite 2000, 64111, Kansas City, MO, USA

    James H. O’Keefe MD

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  1. Sajal Das MD
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  2. James H. O’Keefe MD
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Correspondence to James H. O’Keefe MD.

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Das, S., O’Keefe, J.H. Behavioral cardiology: Recognizing and addressing the profound impact of psychosocial stress on cardiovascular health. Curr Atheroscler Rep 8, 111–118 (2006). https://doi.org/10.1007/s11883-006-0048-2

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  • DOI: https://doi.org/10.1007/s11883-006-0048-2

Keywords

  • Coronary Heart Disease
  • Heart Rate Variability
  • Psychosocial Stress
  • Rimonabant
  • Psychosocial Risk Factor