Psychosocial risk factors for coronary heart disease

Abstract

In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD. Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive. Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD. Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study. Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.

Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology

“…Likewise, and as will be further detailed below, PSRFs may adversely impact the prognosis of patients with clinically established CHD. 3,4,15,16 The INTERHEART case-control study, performed in 52 countries throughout Africa, Asia, Australia, Europe, the Middle East and North and South America, is one of the seminal studies that has been instrumental in increasing attention towards PSRFs in CVD. 17 The study reported that perceived stress (due to work, home, finances or life events), and depression accounted for approximately 30% of the attributable risk of acute myocardial infarction (MI).…”

The relationship of work-related psychosocial risk factors with depressive symptoms among Hungarian workers.Preliminary results of the Hungarian Work Stress Survey

“…A nagyfokú munkahelyi stressz pszichés és szomatikus megbetegedések rizikótényezője. A nemzetközi vizsgálatok azt mutatják, hogy a cardiovascularis megbetegedések kockázatát másfélszeresétől akár közel hét-szereséig növelheti a magas munkahelyi stressz [2,3]. Különböző kutatási eredmények alapján a magas pszichoszociális stressz a depresszió kialakulásának kockáza-tát másfélszeresétől akár közel ötszöröséig is növelheti [4,5,6,7,8,9,10].…”

Effects of cardiac biological activities on low-intensity physical training in doxorubicin-induced cardiotoxicity rat models

“…Heart disease has a high mortality rate and serious physical consequences; thus, maintaining a healthy heart is as important as early diagnosis and treatment [1]. Heart disease is well known to be associated with an individual's physical activity level, and it is important that cardiac rehabilitation from heart disease is managed appropriately.…”