Going to the heart of the matter

Kubzansky, Laura D; Kawachi, Ichiro

doi:10.1016/s0022-3999(99)00091-4

Cited by 442Cardiac Health and Mental HealthPsychosomatic Disorders and Their TreatmentsHeart Rate Variability and Autonomic Control

Going to the heart of the matter

Kubzansky, Laura D, Kawachi, Ichiro·2000·Journal of Psychosomatic Research

DOI 10.1016/s0022-3999(99)00091-4

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Abstract

Objective Negative emotions, such as anger, anxiety, and depression, have emerged as potentially important risk factors for coronary heart disease. The purpose of this article is to consider the nature and function of emotions, to review epidemiological evidence for an association between the three negative emotions and coronary heart disease (CHD), to discuss briefly the mechanisms by which emotions may be linked to CHD, and to consider this evidence in light of theoretical insights provided by mainstream psychological research on emotions.Methods We collected articles published between 1980 and 1998 on the relationship between each negative emotion and CHD. We also collected review articles or chapters published during the same time period that considered mechanisms by which emotions may increase CHD risk. We used a qualitative approach to review the published literature.Results Evidence that anxiety is involved in the onset of CHD is strongest, whereas evidence for an association between anger and CHD is limited but suggestive. Although depression has consistently been linked to mortality following a myocardial infarction, evidence for its role in the onset of coronary disease is quite mixed. Numerous unresolved issues leave our current understanding of the emotion-health relationship incomplete. Psychological theories of emotion are considered to help address gaps in our knowledge.Conclusion Growing evidence indicates that negative emotions may influence the development of CHD. The focused and specific consideration of negative emotions and their possible role in the etiology of CHD gives insight into current knowledge and suggests important directions for future research.

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Anxiety can be involved in the onset of coronary heart disease.
“and anxiety can be involved in the onset of CHD [3].”
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Psychosocial stress, including chronic anxiety, is a major risk factor for somatic disease, including cardiovascular disease.
“Psychosocial stress, including chronic anxiety, is a major risk factor for somatic disease, including cardiovascular disease”
From Exposed to events that never happen: generalized unsafety, the default stress response, and prolonged autonomic activity (2017) · cites this paper as Kubzansky and Kawachi, 2000

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The benefits of frequent positive affect: Does happiness lead to success?
Lyubomirsky, S., King, L., & Diener, E. (2005) · Psychological Bulletin · doi:10.1037/0033-2909.131.6.803 · Cited by 7,143 · see citing works
The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors
Thayer, J. F., Yamamoto, S. S., & Brosschot, J. F. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2009.09.543 · Cited by 2,276 · see citing works
Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.7.757 · Cited by 2,025 · see citing works
Social Determinants of Risk and Outcomes for Cardiovascular Disease: A Scientific Statement From the American Heart Association
Havranek, E. P., Mujahid, M. S., Barr, D. A., Blair, I. V., Cohen, M. S., Cruz-Flores, S., Davey-Smith, G., Dennison-Himmelfarb, C. R., Lauer, M. S., Lockwood, D. W., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000228 · Cited by 1,472 · see citing works
Depression and Coronary Heart Disease: Recommendations for Screening, Referral, and Treatment: A Science Advisory From the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: <i>Endorsed by the American Psychiatric Association</i>
Lichtman, J. H., Bigger, J. T., Blumenthal, J. A., Frasure-Smith, N., Kaufmann, P. G., Lespérance, F., Mark, D. B., Sheps, D. S., Taylor, C. B., & Froelicher, E. S. (2008) · Circulation · doi:10.1161/circulationaha.108.190769 · Cited by 1,482 · see citing works
Depression as a predictor for coronary heart disease
Rugulies, R. (2002) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(02)00439-7 · Cited by 1,110 · see citing works
The role of vagal function in the risk for cardiovascular disease and mortality
Thayer, J. F., & Lane, R. D. (2007) · Biological Psychology · doi:10.1016/j.biopsycho.2005.11.013 · Cited by 1,033 · see citing works
Anger, Anxiety, and Depression as Risk Factors for Cardiovascular Disease: The Problems and Implications of Overlapping Affective Dispositions.
Suls, J., & Bunde, J. (2005) · Psychological Bulletin · doi:10.1037/0033-2909.131.2.260 · Cited by 878 · see citing works
Depression as a Risk Factor for Coronary Artery Disease: Evidence, Mechanisms, and Treatment
Lett, H. S., Blumenthal, J. A., Babyak, M. A., Sherwood, A., Strauman, T., Robins, C., & Newman, M. F. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000126207.43307.c0 · Cited by 849 · see citing works
Is job strain a major source of cardiovascular disease risk?
Belkic, K. L., Landsbergis, P. A., Schnall, P. L., & Baker, D. B. (2004) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.769 · Cited by 746 · see citing works
Health benefits: Meta-analytically determining the impact of well-being on objective health outcomes
Howell, R. T., Kern, M. L., & Lyubomirsky, S. (2007) · Health Psychology Review · doi:10.1080/17437190701492486 · Cited by 627 · see citing works
“Stress” and coronary heart disease: psychosocial risk factors
Bunker, S. J., Colquhoun, D. M., Esler, M. D., Hickie, I. B., Hunt, D., Jelinek, V. M., Oldenburg, B. F., Peach, H. G., Ruth, D., Tennant, C. C., et al. (2003) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2003.tb05193.x · Cited by 560 · see citing works
Epidemiology of comorbid coronary artery disease and depression
Rudisch, B. E., & Nemeroff, C. B. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00587-0 · Cited by 549 · see citing works
The Health Effects of Economic Decline
Catalano, R. A., Goldman-Mellor, S. J., Saxton, K. B., Margerison-Zilko, C. E., Subbaraman, M. S., LeWinn, K. Z., & Anderson, E. (2011) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031210-101146 · Cited by 536 · see citing works
A Dark Side of Happiness? How, When, and Why Happiness Is Not Always Good
Gruber, J., Mauss, I. B., & Tamir, M. (2011) · Perspectives on Psychological Science · doi:10.1177/1745691611406927 · Cited by 515 · see citing works
Daily worry is related to low heart rate variability during waking and the subsequent nocturnal sleep period
Brosschot, J. F., Van Dijk, E., & Thayer, J. F. (2007) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2006.07.016 · Cited by 474 · see citing works
Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study
Kubzansky, L. D., Sparrow, D., Vokonas, P., & Kawachi, I. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200111000-00009 · Cited by 400 · see citing works
Self-citation
Positive Emotion and Health: Going Beyond the Negative.
Richman, L. S., Kubzansky, L. D., Maselko, J., Kawachi, I. I., Choo, P. W., & Bauer, M. (2005) · Health Psychology · doi:10.1037/0278-6133.24.4.422 · Cited by 374 · see citing works
Self-citation
A mind-brain-body dataset of MRI, EEG, cognition, emotion, and peripheral physiology in young and old adults
Babayan, A., Erbey, M., Kumral, D., Reinelt, J. D., Reiter, A. M. F., Röbbig, J., Schaare, H. L., Uhlig, M., Anwander, A., Bazin, P., et al. (2019) · Scientific Data · doi:10.1038/sdata.2018.308 · Cited by 361 · see citing works
Comparing symptoms of depression and anxiety as predictors of cardiac events and increased health care consumption after myocardial infarction
Strik, J. J. M. H., Denollet, J., Lousberg, R. L., & Honig, A. (2003) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.07.007 · Cited by 356 · see citing works
The association between burnout, depression, anxiety, and inflammation biomarkers: C-reactive protein and fibrinogen in men and women
Toker, S., Shirom, A., Shapira, I., Berliner, S., & Melamed, S. (2005) · Journal of Occupational Health Psychology · doi:10.1037/1076-8998.10.4.344 · Cited by 340 · see citing works
Phobic Anxiety and Risk of Coronary Heart Disease and Sudden Cardiac Death Among Women
Albert, C. M., Chae, C. U., Rexrode, K. M., Manson, J. E., & Kawachi, I. I. (2005) · Circulation · doi:10.1161/01.cir.0000153813.64165.5d · Cited by 330 · see citing works
Self-citation
Comorbid Mental Disorders Account for the Role Impairment of Commonly Occurring Chronic Physical Disorders: Results From the National Comorbidity Survey
Kessler, R. C., Ormel, J., Demler, O., & Stang, P. (2003) · Journal of Occupational and Environmental Medicine · doi:10.1097/01.jom.0000100000.70011.bb · Cited by 330 · see citing works
The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis
Lamers, S. M. A., Bolier, L., Westerhof, G. J., Smit, F., & Bohlmeijer, E. T. (2012) · Journal of Behavioral Medicine · doi:10.1007/s10865-011-9379-8 · Cited by 306 · see citing works
“…coronary heart disease (Glassman & Shapiro, 1998), diabetes complications (De Groot et al., 2001), cancer incidence, progression (Spiegel & Giese-Davis, 2003) and cancer mortality (Satin et al., 2009), and anxiety may influence the development of coronary heart disease (Kubzansky & Kawachi, 2000).”
Background
Clinical anxiety, cortisol and interleukin-6: Evidence for specificity in emotion–biology relationships
O’Donovan, A., Hughes, B. M., Slavich, G. M., Lynch, L., Cronin, M.-T., O’Farrelly, C., & Malone, K. M. (2010) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2010.03.003 · Cited by 296 · see citing works
Purpose in life and reduced incidence of stroke in older adults: 'The Health and Retirement Study'
Kim, E. S., Sun, J. K., Park, N., & Peterson, C. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.01.013 · Cited by 274 · see citing works
Personality traits as risk factors for stroke and coronary heart disease mortality: pooled analysis of three cohort studies
Jokela, M., Pulkki-Råback, L., Elovainio, M., & Kivimäki, M. (2014) · Journal of Behavioral Medicine · doi:10.1007/s10865-013-9548-z · Cited by 269 · see citing works
Emotional Vitality and Incident Coronary Heart Disease: Benefits of Healthy Psychological Functioning
Kubzansky, L. D., & Thurston, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.12.1393 · Cited by 252 · see citing works
Self-citation
Purpose in life and reduced risk of myocardial infarction among older U.S. adults with coronary heart disease: a two-year follow-up
Kim, E. S., Sun, J. K., Park, N., Kubzansky, L. D., & Peterson, C. (2013) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9406-4 · Cited by 244 · see citing works
Self-citation
The default response to uncertainty and the importance of perceived safety in anxiety and stress: An evolution-theoretical perspective.
Brosschot, J., Verkuil, B., & Thayer, J. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.04.012 · Cited by 226 · see citing works
Generalized unsafety theory of stress: unsafe environments and conditions, and the default stress response
Brosschot, J., Verkuil, B., & Thayer, J. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15030464 · Cited by 244 · see citing works
Stress, Coping, and Health
Carver, C. S., & Vargas, S. E. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195342819.013.0008 · Cited by 228 · see citing works
Depression and Anxiety in Heart Failure
Konstam, V., Moser, D. K., & Jong, M. J. D. (2005) · Journal of Cardiac Failure · doi:10.1016/j.cardfail.2005.03.006 · Cited by 219 · see citing works
Depression and coronary heart disease: A review of the epidemiological evidence, explanatory mechanisms and management approaches
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Opening lectures, 18.06.00, 16:00–17:00
(2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(00)90108-9
Symposium 4. Cancer, 19.06.00, 14:00–15:45
(2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(00)90113-2
Symposium 12. Psychosomatic research in children, adolescents and families, 20.06.00, 14:00–15:45
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Authors: Kubzansky, L. D., & Kawachi, I.
Affiliations: Harvard University (US)
Corresponding author: Kubzansky, Laura D
ORCID: Kubzansky, Laura D
Kawachi, Ichiro
Venue: Journal of Psychosomatic Research
Publisher: Elsevier BV
Published: 2000-04
Volume: 48
Issue: 4-5
Pages: 323-337
ISSN: 0022-3999 (ISSN-L)
DOI: 10.1016/s0022-3999(99)00091-4
OpenAlex: W2144555034
Cited by: 442
References: 168
Citations by year: 2026: 2 · 2025: 7 · 2024: 8 · 2023: 8 · 2022: 15 · 2021: 16 · 2020: 15 · 2019: 16 · 2018: 13 · 2017: 13 · 2016: 19 · 2015: 27 · 2014: 23 · 2013: 16 · 2012: 23
FWCI: 3.35
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Psychosomatic Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords: negative emotions, coronary artery disease, anger, anxiety, depression, emotions and health, myocardial infarction mortality, psychosocial risk factors
MeSH terms: Affect, Anger, Anxiety, Coronary Disease, Depressive Disorder, Female, Humans, Male, Risk Factors, Epidemiologic Studies

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