ABSTRACT
In this chapter, the authors focus on the more recent literature and important developments in their understanding of psychopathology, pharmacological interventions, and behavioral interventions. Reviews confirm that anger and hostility remain important psychosocial factors for prognosis in primary and secondary prevention of cardiovascular disease. Several psychosocial risk factors have been identified, including social isolation, anger/hostility, depression, and anxiety. Anxiety worsens prognosis in secondary prevention of cardiovascular disease. The relationship between depression and heart disease is complex, as depression is also a risk factor for the development of cardiovascular disease. Given the disappointing effectiveness of both antidepressants and psychotherapy for addressing psychosocial factors that moderate risk in secondary prevention, alternative approaches are needed. The authors argue that addressing psychosocial factors in the context of cardiac rehabilitation is a promising approach. A meta-analysis found that antidepressants increase cardiovascular risk for a general population sample, while not affecting the risk for the sample of cardiovascular disease patients.
