Social support and coronary heart disease: epidemiologic evidence and implications for treatment.
OBJECTIVE
The present paper reviews theories of social support and evidence for the role of social support in the development and progression of coronary heart disease (CHD).


METHODS
Articles for the primary review of social support as a risk factor were identified with MEDLINE (1966-2004) and PsychINFO (1872-2004). Reviews of bibliographies also were used to identify relevant articles.


RESULTS
In general, evidence suggests that low social support confers a risk of 1.5 to 2.0 in both healthy populations and in patients with established CHD. However, there is substantial variability in the manner in which social support is conceptualized and measured. In addition, few studies have simultaneously compared differing types of support.


CONCLUSIONS
Although low levels of support are associated with increased risk for CHD events, it is not clear what types of support are most associated with clinical outcomes in healthy persons and CHD patients. The development of a consensus in the conceptualization and measurement of social support is needed to examine which types of support are most likely to be associated with adverse CHD outcomes. There also is little evidence that improving low social support reduces CHD events.
Lett
Heather S
HS
Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, North Carolina 27710, USA. heather.lett@alumni.duke.edu
Blumenthal
James A
JA
Babyak
Michael A
MA
Strauman
Timothy J
TJ
Robins
Clive
C
Sherwood
Andrew
A
D015897:Comorbidity; D003327:Coronary Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011446:Prospective Studies; D011582:Psychological Theory; D012307:Risk Factors; D012923:Social Class; D012944:Social Support; D009626:Terminology as Topic