Psychosocial Risk Factors and Ischemic Heart Disease: A New Perspective

Author(s): Adriana Roncella*.

Journal Name: Reviews on Recent Clinical Trials

Volume 14 , Issue 2 , 2019

Become EABM
Become Reviewer

Graphical Abstract:


Abstract:

Background: Cardiovascular disease is the most common cause of morbidity and mortality worldwide, with ischemic heart disease (IHD) accounting for roughly 50% of these events in industrialized nations.

In recent years, the relative importance of IHD in less industrialized countries is also rising at an alarming and steadily-increasing rate.

Objectives: Many experimental, observational and epidemiological studies have demonstrated the importance of psychosocial risk factors in the development and clinical manifestations of IHD. They act both indirectly, associated with an unhealthy lifestyle; and directly, through the activation of inflammatory cascades and the sympathetic nervous system. They also cluster with biological risk factors to increase the incidence and clinical manifestations of IHD. From these assumptions, there emerges the potential that an integrated approach that incorporates psychological therapy in various forms might reduce IHD patients’ symptoms and maladaptive behaviors, and thereby enhance their prognosis.

Methods: To date, three psychotherapeutic approaches have been utilized within cardiac psychology practice: (1) cognitive-behavioral psychotherapy; (2) psychodynamic psychotherapy; and (3) ontopsychological psychotherapy. The current article briefly describes these three approaches and how their use might enhance the care of IHD patients.

Results: A range of psychological characteristics influence the development, course and management of cardiac patients’ IHD. Among others, these include patients’ emotions, attitudes, behaviors, relationships, and stressors. State-of- the-art literature suggests that psychological interventions should be considered in much the same way as medical interventions, in terms of their relevance to both patient management and outcomes.

Conclusion: For this reason, it is essential that professional psychological and psychotherapeutic support be rendered available to cardiology patients, as a means to enhance both the effectiveness and efficiency of care.

Keywords: Cardiac psychology, cognitive-behavioral psychotherapy, ischemic heart disease, ontopsychology, psychodynamic psychotherapy, psychosocial risk factors.

[1]
Pristipino C, Roncella A. Preface. In: Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach. Springer: Berlin 2016; pp. 1-2.
[2]
Global Burden of Disease Study 2010 (GBD 2010) Mortality Results 1970-2010. Seattle, United States: Institute for Health Metrics and Evaluation (IHME).
[3]
Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med 2007; 356(23): 2388-98.
[4]
World Health Organization (2014) Projections of mortality and causes of death, 2015 and 2030. (Accessed on January 20, 2016). http://www.who.int/healthinfo/global_burden_disease/projections/en/
[5]
World Health Organization (2013) Health statistics and information systems. Disease burden. Estimates for 2000-2012 by region. (Accessed on January 20, 2016). http: //www.who.int/healthinfo/ global_burden_disease/estimates/en/index2.html
[6]
Shah AJ, Vaccarino V. Psychosocial Risk Factors and Coronary Artery Disease. In: Roncella A, Pristipino C, Eds. Psychotherapy for ischemic heart disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 29-44.
[7]
Manuck SB, Kaplan JR, Clarkson TB. Social instability and coronary artery atherosclerosis in cynomolgus monkeys. Neurosci Biobehav Rev 1983; 7(4): 485-91.
[8]
Manuck SB, Kaplan JR, Clarkson TB. Behaviorally induced heart rate reactivity and atherosclerosis in cynomolgus monkeys. Psychosom Med 1983; 45(2): 95-108.
[9]
Kaplan JR, Manuck SB, Adams MR, et al. Inhibition of coronary atherosclerosis by propranolol in behaviorally predisposed monkeys fed an atherogenic diet. Circulation 1987; 76(6): 1364-72.
[10]
Chida Y, Steptoe A. Greater cardiovascular responses to laboratory mental stress are associated with poor subsequent cardiovascular risk status: A meta-analysis of prospective evidence. Hypertension 2010; 55(4): 1026-32.
[11]
Steptoe A, Brydon L. Emotional triggering of cardiac events. Neurosci Biobehav Rev 2009; 33(2): 63-70.
[12]
Kloner RA. Natural and unnatural triggers of myocardial infarction. Prog Cardiovasc Dis 2006; 48(4): 285-300.
[13]
Leor J, Poole WK, Kloner RA. Sudden cardiac death triggered by an earthquake. N Engl J Med 1996; 334(7): 413-9.
[14]
Vaccarino V, Goldberg J, Rooks C, et al. Post-traumatic stress disorder and incidence of coronary heart disease: A twin study. JACC 2013; 62(11): 970-8.
[http://dx.doi.org/10.1016/j.jacc.2013.04.085]
[15]
Backe EM, Seidler A, Latza U, et al. The role of psychosocial stress at work for the development of cardiovascular diseases: A systematic review. Int Arch Occup Environ Health 2012; 85(1): 67-79.
[16]
Laszlo KD, Ahnve S, Hallqvist J, et al. Job strain predicts recurrent events after a first acute myocardial infarction: The Stockholm Heart Epidemiology Program. J Intern Med 2010; 267(6): 599-611.
[17]
Orth-Gomer K. Psychosocial and behavioral aspects of cardiovascular disease prevention in men and women. Curr Opin Psychiatry 2007; 20(2): 147-51.
[18]
Wang HX, Leineweber C, Kirkeeide R, et al. Psychosocial stress and atherosclerosis: Family and work stress accelerate progression of coronary disease in women. The stockholm female coronary angiography study. J Intern Med 2007; 261(3): 245-54.
[19]
Rabi DM, Edwards AL, Svenson LW, et al. Association of median household income with burden of coronary artery disease among individuals with diabetes. Circ Cardiovasc Qual Outcomes 2010; 3(1): 48-53.
[20]
Skala JA, Freedland KE, Carney RM. Coronary heart disease and depression: A review of recent mechanistic research. Can J Psychiatry 2006; 51(12): 738-45.
[21]
Whooley MA, de Jonge P, Vittinghoff E, et al. Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA 2008; 300(20): 2379-88.
[22]
Kent LK, Shapiro PA. Depression and related psychological factors in heart disease. Harv Rev Psychiatry 2009; 17(6): 377-88.
[23]
Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Cleve Clin J Med 2009; 76(2): S13-7.
[24]
Sherwood A, Hinderliter AL, Watkins LL, et al. Impaired endothelial function in coronary heart disease patients with depressive symptomatology. J Am Coll Cardiol 2005; 46(4): 656-9.
[25]
Vaccarino V, Johnson BD, Sheps DS, et al. Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: The National Heart, Lung, and Blood Institute-sponsored WISE study. J Am Coll Cardiol 2007; 50(21): 2044-50.
[26]
Roest AM, Martens EJ, de Jonge P, et al. Anxiety and risk of incident coronary heart disease: A meta-analysis. J Am Coll Cardiol 2010; 56(1): 38-46.
[27]
Chida Y, Steptoe A. The association of anger and hostility with future coronary heart disease: A meta-analytic review of prospective evidence. J Am Coll Cardiol 2009; 53(11): 936-46.
[28]
Rosengren A, Hawken S, Ôunpuu S, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study. Lancet 2004; 364(9438): 953-62.
[29]
Kent LK, Shapiro PA. Depression and related psychological factors in heart disease. Harv Rev Psychiatry 2009; 17(6): 377-88.
[30]
Carney RM, Freedland KE. Depression and heart rate variability in patients with coronary heart disease. Cleve Clin J Med 2009; 76(2): S13-7.
[31]
Sherwood A, Hinderliter AL, Watkins LL, et al. Impaired endothelial function in coronary heart disease patients with depressive symptomatology. J Am Coll Cardiol 2005; 46(4): 656-9.
[32]
Vaccarino V, Johnson BD, Sheps DS, et al. Depression, inflammation, and incident cardiovascular disease in women with suspected coronary ischemia: The National Heart, Lung, and Blood Institute-sponsored WISE study. J Am Coll Cardiol 2007; 50(21): 2044-50.
[33]
Pristipino C. Psychological Stress, Inflammation, Immunity and Coagulation Intertwining in Ischemic Heart Disease. In: Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp 45- 58.
[34]
Whooley MA, de Jonge P, Vittinghoff E, et al. Depressive symptoms, health behaviors, and risk of cardiovascular events in patients with coronary heart disease. JAMA 2008; 300(20): 2379-88.
[35]
Lazzari D, Lazzari L. Integrated Approach for Cardiac Patients and Psychological Interventions In: Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 95-106.
[36]
Biondi-Zoccai G, Mazza M, Roever L, et al. Evidence-Based Psychotherapy in Ischemic Heart Disease: Umbrella Review and Updated Meta-Analysis. In: Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 131-58.
[37]
Sommaruga M. Cognitive and Behavioral Psychotherapy in Coronary Artery Disease In: Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 159-72.
[38]
Beck AT. Cognitive therapy Nature and relation to behavior therapy. Behav Ther 1970; 1(2): 1184-200.
[39]
Ellis A. Reason and emotion in psychotherapy. New York: Lyle Stuart 1962.
[40]
Young JE, Weinberger AD, Beck ET. Clinical handbook of psychological disorders: A step-by-step treatment manual. 3rd ed. New York: Guilford 2001; pp. 264-308.
[41]
van Dixhoorn J, White A. Relaxation therapy for rehabilitation and prevention in ischaemic heart disease: A systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2005; 12(3): 193-202.
[42]
Kabat-Zinn J. Full catastrophe living: How to cope with stress, pain and illness using mindfulness meditation. New York: Bantam Dell, A Division of Random House 1990.
[43]
Fisher P, Wells A. Metacognitive Therapy. New York: Routledge Taylor and Francis Group 2009.
[44]
Pierobon A, Sommaruga M. An integrative model of psychotherapy in medical practice according to GICR-IACPR*. In: Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 159- 72.
[45]
Di Carlo O, Sommaruga M, Bonadies M, Roncella A. Verbal Communication and Effective Communication: Communication in the Psychotherapeutic Setting In Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 225-39.
[46]
Dazzi N, De Coro A. Psicologia dinamica. Bari: Editori La Terza. 2001.
[47]
Winnicott DW. Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development. London: Hogarth Press 1965.
[48]
Jordan J, Bardè B. Psychodynamic Hypotheses on the Etiology, Course, and Psychotherapy of Coronary Heart Disease: 100 Years of Psychoanalytic Research. In: Jordan J, Bardé B, Zeiher AM Eds. Contributions toward evidence-based psychocardiology. A systematic review of the literature. American Psychological Association: Washington DS 2007.
[49]
Lantz J, Gregoire T. Couples, existential psychotherapy, and myocardial infarction: A ten year evaluation study. Contemp Fam Ther 2003; 25(4): 367-79.
[50]
Meneghetti A. Ontopsychology Handbook. Roma: Psicologica Editrice (now Ontopsicologia Editrice). 2004.
[51]
Freud S. (1915-17) Introductory Lectures on Psycho-Analysis. London: Hogart Press 1963.
[52]
Jung CG. (1935) Practice of Psychotherapy. Collected Works of CG Jung, Volume 16. Princeton, NJ: Princeton University Press. 1966.
[53]
Maslow AH. (1962, 1968) Toward a Psychology of Being. New York: D Van Nostrand Company Inc 1968.
[54]
Roncella A, Giornetti A, Cianfrocca C. Rationale and trial design of a randomized, controlled study on short-term psychotherapy after acute myocardial infarction: the STEP-IN-AMI trial (Short Term Psychotherapy in Acute Myocardial Infarction). J Cardiovasc Med (Hagerstown) 2009; 10(12): 947-52.
[55]
Roncella A, Pristipino C, Cianfrocca C, et al. One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial. Int J Cardiol 2013; 170(2): 132-9.
[56]
Roncella A. Short-Term Psychotherapy in Patients with Acute Myocardial Infarction In Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 187-201.
[57]
Roncella A, Pristipino C, Pasceri V, et al. A Model Integrating Psychotherapy into Medical Practices at San Filippo Neri Hospital in Rome, Italy In Roncella A, Pristipino C, Eds. Psychotherapy for Ischemic Heart Disease. An evidence-based clinical approach Springer: Berlin 2016; pp. 281-6.


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 14
ISSUE: 2
Year: 2019
Page: [80 - 85]
Pages: 6
DOI: 10.2174/1574887114666190301141628
Price: $58

Article Metrics

PDF: 49
HTML: 2