Psychosociální rizikové faktory kardiovaskulárních onemocnění

Cor Vasa 2005, 46(10):385-390

Psychosocial risk factors of cardiovascular disease

Alexandra Pilipčincová: Katedra psychologie, Filozofická fakulta Univerzity Karlovy, Praha, Česká republika

The paper presents an overview of psychosocial factors of cardiovascular disease (CVD), such as type A behavior pattern, depression, anxiety, vital exhaustion, social support and pessimism/optimism. Long-term observation of the above predictors of CVD among healthy participants and patients with overt disease has clearly confirmed these individual are at risk of morbidity, mortality, CVD prognosis and decreased quality of life. Intensive investigation of the type A behavior pattern (TABP), commenced in the 1950s and providing many controversial results, resulted in the development of more accurate diagnostic methods in the late 1980s, methods which do not focus on TABP in general, but on its particular components. The early 1950s were also a period of exploring the relationship among depression, depressive patients and CVD; this relationship has remained a major topic of research to date. Depression, anxiety and a status termed vital exhaustion have been confirmed by long-term studies to be CVD predictors. The role of optimism/pessimism in the development of somatic diseases is a relatively new hypothesis, but the relationship of the so-called dispositional pessimism has been documented with regard to coronary heart disease, development of postpartum depression, prognosis of cancer, prognosis among pa-tients after myocardial infarction or after coronary artery bypass graft surgery. The risk of absence of social support has been likened to the well-known risk factors of coronary heart disease; i. e., increased levels of serum cholesterol, smoking, and hypertension. To summarize, psychosocial factors have a long history of intensive research and despite the fact that the mechanism of relationship between them and CVD is still unknown, their origin cannot be explained by the severity of the somatic disease.