Impact of psychosocial risk factors on the heart: changing paradigms and perceptions.

Abstract

To combat cardiovascular disease (CVD), physicians and allied health care professionals often focus on modifying conventional risk factors such as cigarette smoking, hypertension, hypercholesterolemia, and diabetes. However, a recent review of published research demonstrated that 75% to 90% of coronary artery disease (CAD) incidence is explained by these risk factors, either alone or in combination. This has stimulated a vigorous search for other correctable risk factors (ie, to explain the remaining incidence [10%-25%]), including genetic anomalies, markers of inflammation (C-reactive protein, lipoprotein-associated phospholipase A2), and specific lipid/lipoprotein particles to enhance risk stratification. Nevertheless, an escalating body of research provides strong evidence for the adverse effects of psychosocial factors in the development of CVD and in the prognosis of patients with CAD.