CORONARY heart disease and hypertension.

Coronary heart disease (CHD) is the leading cause of death in the United States, and hypertension (HTN) is a common chronic health condition. Studies confirm that psychological stress is associated with increased incidence of CHD, increased recurrence of cardiac events, and higher risk of HTN. Stress appears to influence disease onset and progression via both direct physiological pathways and indirect behavioral pathways. Social support and dispositional attributes such as optimism may moderate the effects of stress and provide beneficial effects. Studies of psychosocial interventions to reduce disease risk and improve health outcomes among patients with CHD have produced inconsistent results. In general, studies indicate that psychosocial interventions enhance psychosocial functioning and quality of life but may not lead to reduced incidence of recurrent cardiac events. Symptoms of depression and anxiety have been associated with increased risk of CHD and HTN. Poor adherence to medications and lifestyle changes is associated with poorer health outcomes among patients with CHD and HTN. Keywords: coronary heart disease; hypertension; stress; adherence