Religion, spirituality and cardiovascular disease: research, clinical implications, and opportunities in Brazil

Abstract

In this paper we comprehensively review published quantitative research on the relationship between religion, spirituality (R/S), and cardiovascular (CV) disease, discuss mechanisms that help explain the associations reported, examine the clinical implications of those findings, and explore future research needed in Brazil on this topic. First, we define the terms religion, spirituality, and secular humanism. Next, we review research examining the relationships between R/S and CV risk factors (smoking, alcohol/drug use, physical inactivity, poor diet, cholesterol, obesity, diabetes, blood pressure, and psychosocial stress). We then review research on R/S, cardiovascular functions (CV reactivity, heart rate variability, etc.), and inflammatory markers (IL-6, IFN-γ, CRP, fibrinogen, IL-4, IL-10). Next we examine research on R/S and coronary artery disease, hypertension, stroke, dementia, cardiac surgery outcomes, and mortality (CV mortality in particular). We then discuss mechanisms that help explain these relationships (focusing on psychological, social, and behavioral pathways) and present a theoretical causal model based on a Western religious perspective. Next we discuss the clinical applications of the research, and make practical suggestions on how cardiologists and cardiac surgeons can sensitively and sensibly address spiritual issues in clinical practice. Finally, we explore opportunities for future research. No research on R/S and cardiovascular disease has yet been published from Brazil, despite the tremendous interest and involvement of the population in R/S, making this an area of almost unlimited possibilities for researchers in Brazil.

Are religiosity and prayer use related with multiple behavioural risk factors for chronic diseases in European adults aged 50+ years?

“…10,14,15 Although the explanatory mechanisms of this relationship are many and complex, these have mainly been attributed to the positive influence religiosity has on physical health via psychological, social and behavioural pathways. 10,14,15,20 Religiosity can also favourably affect mental health through lower stress, general well-being, less anxiety, less depression and more positive emotions, since it allegedly facilitates coping with negative events, and is associated with greater social capital, marital stability and social support. 14,15 In addition, religiosity might promote healthier behaviours, such as less cigarette smoking, more physical activity and exercise, low or no consumption of alcohol and higher nutritional quality.…”

The comparison of cardiovascular risk factors prevalence among Catholics and Seventh-day Adventists living in southern Poland

“…A review literature concerning the religious affiliation and that of cardiovascular disease did not show any clear correlations between these variables [12][13][14]. Some studies, especially among Adventists, showed the influence of taking up religious practices on a reduction in mortality [15][16][17][18].…”

Implications for public health of the religiosity-longevity relation

“…To move forward in this direction, some approaches are needed in future studies: 28 • Prospective observational studies, especially those that examine the interaction between R/S and better response to pharmaceutical, biological and surgical treatments.…”