Psychosocial risk factors for coronary heart disease
Abstract
In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD. Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive. Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD. Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study. Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.
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Stress and trauma are risk factors for cardiovascular disease.
“Stress and trauma are also risk factors for a range of non-communicable diseases, including cardiovascular disease [5,6], diabetes [7], and cognitive impairment [8,9], and can contribute to cancer incidence and survival [10].”
Individuals with stronger social relationships have a 50% increased likelihood of survival, with no variation between gender.
“with individuals with stronger social relationships having a 50% increased likelihood of survival, with no variation between gender 41”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [41]
Adults with social isolation have an increased likelihood of post-myocardial infarction mortality (PMIM).
“Two other systematic reviews suggested that adults with social isolation have an increased likelihood of PMIM”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [41]
The overview found an association (++) between social isolation and cardiovascular disease, supported by one or more higher quality reviews.
“| Cardiovascular disease (Bunker et al 2003, Cuffee et al 2015, Glozier et al 2013, Mookadam et al 2004, Steptoe et al 2013) | ++ | | |”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as Glozier et al 2013
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“Stress and trauma are also risk factors for a range of non-communicable diseases, including cardiovascular disease [5,6], diabetes [7], and cognitive impairment [8,9], and can contribute to cancer incidence and survival [10].”
Background
- Authors
- Glozier, N., Tofler, G. H., Colquhoun, D. M., Bunker, S. J., Clarke, D. M., Hare, D. L., Hickie, I. B., Tatoulis, J., Thompson, D. R., Wilson, A., & Branagan, M. G.
- Affiliations
- The University of Sydney (AU)
- The University of Queensland (AU)
- Deakin University (AU)
- Monash University (AU)
- The University of Melbourne (AU)
- National Heart Foundation of Australia (AU)
- Australian Catholic University (AU)
- Corresponding author
- Branagan, Maree G
- ORCID
- Venue
- Medical Journal of Australia
- Publisher
- AMPCo
- Published
- 2013-08
- Volume
- 199
- Issue
- 3
- Pages
- 179-180
- ISSN
- 0025-729X (ISSN-L)
- 1326-5377
- OpenAlex
- W1981950242
- Cited by
- 103
- References
- 70
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 4 · 2019: 10 · 2018: 8 · 2017: 11 · 2016: 12 · 2015: 13 · 2014: 13 · 2013: 2
- FWCI
- 9.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Medical Journal of Australia (publishedVersion)
- PubMed (publishedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- coronary artery disease, psychosocial risk factors, psychosocial stress, occupational stress, job strain, shift work, job insecurity, job satisfaction, working hours, effort-reward imbalance, job loss, workplace health programs, social isolation, myocardial infarction, takotsubo cardiomyopathy, acute emotional stress, natural disasters, public access defibrillators, cardiovascular risk
- MeSH terms
- Adult, Australia, Coronary Disease, Depression, Female, Humans, Male, Middle Aged, Occupations, Psychology, Risk Factors, Severity of Illness Index, Societies, Medical, Stress, Psychological, Work Schedule Tolerance, Incidence, Workplace, Practice Guidelines as Topic, Age Distribution, Sex Distribution, Evidence-Based Medicine, Consensus, Young Adult
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