ABSTRACT
Cardiovascular disease remains the largest contributor to morbidity and mortality in developed countries. Given the complex nature of human behavior, it is likely that the relationship between psychosocial factors and cardiovascular disease are mediated at multiple levels along the pathophysiologic mechanisms responsible for cardiovascular disease events. While the methodology and measurement tools in the previous studies are quite variable, there is a consensus of evidence that depressive symptomology is associated with increased cardiovascular morbidity and mortality. Traditional cardiovascular risk factors, as outlined in the Framingham Study, include cigarette smoking, hypertension, diabetes mellitus, dyslipidemia, family history of premature coronary disease, and sedentary lifestyle. Myocardial ischemia results in the setting of atherosclerotic cardiovascular disease when myocardial blood flow demand outstrips the supply. Multiple studies have demonstrated that psychosocial factors are risk factors for cardiovascular disease in both patients with established disease and non-diseased subjects.
