"Stress" and coronary heart disease: psychosocial risk factors.
An Expert Working Group of the National Heart Foundation of Australia undertook a review of systematic reviews of the evidence relating to major psychosocial risk factors to assess whether there are independent associations between any of the factors and the development and progression of coronary heart disease (CHD), or the occurrence of acute cardiac events. The expert group concluded that (i) there is strong and consistent evidence of an independent causal association between depression, social isolation and lack of quality social support and the causes and prognosis of CHD; and (ii) there is no strong or consistent evidence for a causal association between chronic life events, work-related stressors (job control, demands and strain), Type A behaviour patterns, hostility, anxiety disorders or panic disorders and CHD. The increased risk contributed by these psychosocial factors is of similar order to the more conventional CHD risk factors such as smoking, dyslipidaemia and hypertension. The identified psychosocial risk factors should be taken into account during individual CHD risk assessment and management, and have implications for public health policy and research.
Bunker
Stephen J
SJ
National Heart Foundation, 411 King Street, West Melbourne, VIC 3003, Australia. steve.bunker@heartfoundation.com.au
Colquhoun
David M
DM
Esler
Murray D
MD
Hickie
Ian B
IB
Hunt
David
D
Jelinek
V Michael
VM
Oldenburg
Brian F
BF
Peach
Hedley G
HG
Ruth
Denise
D
Tennant
Christopher C
CC
Tonkin
Andrew M
AM
D001008:Anxiety Disorders / Q000150:complications; D003327:Coronary Disease / Q000209:etiology*; D003863:Depression / Q000150:complications*; D006791:Hostility; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008016:Life Change Events; D016584:Panic Disorder / Q000150:complications; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012934:Social Isolation; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications*; D014434:Type A Personality; D014937:Work