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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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  • Authors+Show Affiliations

    ,

    Brain and Mind Research Institute, University of Sydney, Sydney, NSW.

    , , , , , , , , ,

    Source

    The Medical journal of Australia 199:3 2013 Aug 05 pg 179-80

    MeSH

    Adult
    Age Distribution
    Australia
    Consensus
    Coronary Disease
    Depression
    Evidence-Based Medicine
    Female
    Humans
    Incidence
    Male
    Middle Aged
    Occupations
    Practice Guidelines as Topic
    Psychology
    Risk Factors
    Severity of Illness Index
    Sex Distribution
    Societies, Medical
    Stress, Psychological
    Work Schedule Tolerance
    Workplace
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article
    Review

    Language

    eng

    PubMed ID

    23909539

    Citation

    Glozier, Nick, et al. "Psychosocial Risk Factors for Coronary Heart Disease." The Medical Journal of Australia, vol. 199, no. 3, 2013, pp. 179-80.
    Glozier N, Tofler GH, Colquhoun DM, et al. Psychosocial risk factors for coronary heart disease. Med J Aust. 2013;199(3):179-80.
    Glozier, N., Tofler, G. H., Colquhoun, D. M., Bunker, S. J., Clarke, D. M., Hare, D. L., ... Branagan, M. G. (2013). Psychosocial risk factors for coronary heart disease. The Medical Journal of Australia, 199(3), pp. 179-80.
    Glozier N, et al. Psychosocial Risk Factors for Coronary Heart Disease. Med J Aust. 2013 Aug 5;199(3):179-80. PubMed PMID: 23909539.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Psychosocial risk factors for coronary heart disease. AU - Glozier,Nick, AU - Tofler,Geoffrey H, AU - Colquhoun,David M, AU - Bunker,Stephen J, AU - Clarke,David M, AU - Hare,David L, AU - Hickie,Ian B, AU - Tatoulis,James, AU - Thompson,David R, AU - Wilson,Alison, AU - Branagan,Maree G, PY - 2013/04/05/received PY - 2013/07/07/accepted PY - 2013/8/6/entrez PY - 2013/8/6/pubmed PY - 2013/10/30/medline SP - 179 EP - 80 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 199 IS - 3 N2 - 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. SN - 1326-5377 UR - https://www.unboundmedicine.com/medline/citation/23909539/Psychosocial_risk_factors_for_coronary_heart_disease_ L2 - https://www.mja.com.au/doi/10.5694/mja13.10440 DB - PRIME DP - Unbound Medicine ER -