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PSYCHOSOCIAL RISK FACTORS IN CARDIOVASCULAR DISEASE
Introduction: according to the literature, psychosocial factors significantly contributeto both pathogenesis and expression of coronary artery disease (CAD). Depression, anxiety, anger and hostility, social isolation and stressful lifestyle represent the main contributing factors both to higher prevalence of unhealthy behaviors (poor diet, physical inactivity, alcohol use or smoking) and adverse pathophysiological mechanisms, such as neuroendocrine and platelet activation. Material and method: over the past few decades, there has been an increasing interest in investigating the relationship between psychosocial risk factors and cardiovascular disease, leading to a growing pool of clinical and epidemiological data on the subject. Specifically, a large casecontrol trial, involving 52 countries, has identified nine potentially modifiable risk factors for CAD, among which psychosocial factors have been included and divided into two general categories: chronic stressors and emotional factors. These are believed to exacerbate the development of cardiovascular disease by two mechanisms: 1) encouraging unhealthy behaviors and increasing the noncompliance to treatments; and 2) eliciting physiological responses that may lead to insufficient oxygen delivery to the heart muscle, threatening heart rhythms, more vulnerable plaque, and the potential for blood clotting. Etiological controlled studies also confirmed this relationship. In this work, we outline the psychosocial domains significantly considered associated with increased risk of cardiovascular morbidity and mortality. We also discuss critical pathophysiological mechanisms and pathways that, operating in a synergistic and integrative way, promote related clinical manifestations. Also, the impact of cardiac rehabilitation programs on psychological-related cardiovascular events is discussed. Discussion: the importance of psychosocial variables in the development, clinical manifestations, and prognosis of patients with heart disease received increased attention in recent years. However, the influence of psychosocial risk factors in cardiovascular disease remains underestimated when compared with the conventional ones. To recognize this relationship and to offers an important target for cardiovascular education, counseling and behavioral interventions, even after controlling for major risk factors. Cardiac rehabilitation programs considering amultidisciplinary approach are then widely recommended for the management of risk factors, nutritional, psychological, behavioral and social aspects potentially affecting patient outcomes.
DESCRIPTION Type 2 diabetes (T2D) and cardiovascular disease (CVD) are lifestyle related chronic illnesses and both are associated with an increased prevalence of co-morbid depression, which is detrimental to prognosis. Coping resources are protective against depression. The prevalence of these illnesses is higher in regional areas of Australia. This study examined the relationship among T2D, CVD, depression, lifestyle behaviour and coping resources in a regional sample. There were 80 females and 69 males (5 unknown, M = 51.09, SD = 17.15 years). 35 had T2D (M = 60.21, SD = 11.61 years), 51 had CVD (M = 58.44, SD = 10.20 years), 26 had both T2D and CVD (M = 61.64, SD = 7.94 years), and 42 had no illness (M = 29.24, SD = 10.31 years). 29 participates were classified as having depression. Participants with a chronic illness were overwhelmingly more likely to have depression, had higher rates of smoking, exercised less often, had a larger waist circumference and had less physical copin...
Psychosocial Factors in Coronary Heart Disease
Behavioral Medicine, 2021
The chapter begins by a hypothetical case and an introduction to biomedical risk factors and the etiology of coronary heart disease (CHD). We then review psychosocial etiological risk factors and psychosocial prognostic factors of CHD (e.g., hostility, depression, Type-D personality). The chapter then presents in depth the PNI of the acute coronary syndrome with an emphasis on the vagal nerve and inflammation. We then discuss behavioral mediators between psychological factors and CHD prognosis and the evidence for the effects of various psychological interventions on CHD prognosis. These are done via meta-analyses and specific studies. The chapter ends with returning to the hypothetical case, vis-a-vis the presented studies.
International Journal of Behavioral Medicine, 2005
The International Society of Behavioral Medicine (ISBM) was one of eight societies that comprised the Third Task Force of European and Other Societies on Prevention of Cardiovascular Disease in Clinical Practice (2003-2004). This task force considered published knowledge from diverse fields related to preventive cardiology including behavioral medicine to improve risk estimation and risk factor management. The scientific evidence supporting the guidelines included findings on low socioeconomic status, social isolation, psychosocial stress, hostility, depression and negative affect, the clustering of psychosocial and lifestyle risk factors, and lifestyle psychosocial interventions. Recommendations for promoting behavior change and management of psychosocial and lifestyle factors in clinical practice include strategies for promoting healthy lifestyle, improving health care provider—patient interactions, implementing multimodal interventions, and managing psychosocial risk factors.