Mental Stress and the Cardiovascular System Part VI. Chronic Mental Stress and Cardiovascular Disease: Psychosocial Factors

This paper extends our review of mental stress and the cardiovascular system. We focus on the psychosocial factors of life events, socioeconomic status (SES), and social isolation or disruption. Life events (positive or negative) bring changes in baseline emotional state. Change, in and of itself, may adversely affect the cardiovascular system. Thus, subjects exposed to an increased number of life events over a short time may develop clinical manifestations of coronary artery disease independent of the nature of the life events. SES incorporates many lifestyle issues. Subjects with low SES may have many cardiac risk factors because of their location within the SES hierarchy and are more likely to suffer adverse cardiovascular events than subjects with high SES. Therefore, this psychosocial risk factor should be assessed in any investigation of the relationship between mental stress and cardiovascular disease. Social isolation or disruption may adversely affect the origin, course, and outcome of coronary artery disease. Also, this psychosocial factor may act synergistically with other cardiac risk factors such as high cholesterol diet to accelerate the course of coronary atherosclerosis.