Psychological Factors in Cardiovascular Disease
Summary
Psychological factors such as depression, anxiety, chronic stress and maladaptive personality traits play a critical role in the development, progression and prognosis of cardiovascular disease. Depression and anxiety contribute to behavioural patterns—poor medication adherence, physical inactivity, smoking—that accelerate atherosclerosis and impair recovery after an acute cardiac event. Biologically, these states activate the hypothalamic–pituitary–adrenal axis and sympathetic nervous system, leading to dysregulated cortisol release, heightened inflammatory cytokine production and autonomic imbalance. Personality constructs characterised by negative affectivity and social inhibition have been linked to adverse cardiac outcomes, while robust social support and effective coping strategies serve as protective buffers. Integrating psychological assessment and targeted interventions into cardiac rehabilitation programmes can reduce morbidity, improve quality of life and lower healthcare costs, underscoring the necessity of a holistic approach in global cardiovascular care.
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Psychological Factors in Cardiovascular Disease publication trend
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Technical terms
Metacognitive therapy (MCT): A psychological intervention targeting the modification of unhelpful beliefs about thinking patterns to alleviate anxiety and depression.
Polygenic risk score (PRS): A composite measure of genetic susceptibility to a disease calculated from the aggregate effect of numerous genetic variants.
Cardiac rehabilitation (CR): A multidisciplinary programme combining exercise training, education and psychosocial support to improve recovery and prevent recurrence in cardiovascular patients.
Type D personality: A distressed personality profile marked by high negative affectivity and social inhibition, associated with poorer cardiac outcomes.
References
- Metacognitive therapy home-based self-help for anxiety and depression in cardiovascular disease patients in the UK: A single-blind randomised controlled trial. PLOS Medicine (2023).
- Association of Depression With All-Cause and Cardiovascular Disease Mortality Among Adults in China. JAMA Network Open (2020).
- Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLOS ONE (2016).
- Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with heart failure: a longitudinal observational study. Health and Quality of Life Outcomes (2015).
- Depression and the Link with Cardiovascular Disease. Frontiers in Psychiatry (2016).
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