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Psychological Factors Surrounding Cardiovascular Disease

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Cardiovascular disease is the disease of the heart (heart disease), and of the circulatory system (such as chronic obstructive pulmonary disease or COPD) and can cause strokes.

A 2017 study revealed that, on average, one person dies from a cardiovascular disease every 37 seconds in the US; which is around 2,353 deaths per day while one person has a stroke every 40 seconds. 

Most people think that cardiovascular diseases are purely physical problems and psychology has nothing to do with it but there have been many research studies that have pointed out the connection between heart diseases and psychology.

There are a number of clinical areas that explore the link between cardiovascular diseases and behaviour, such as behaviour cardiology, psychocardiology, and cardiac psychology because many of the risk factors surrounding cardiac health have behavioural components.

Here are psychological factors surrounding cardiovascular disease:

Anxiety and depression

Anxiety is a negative affective state resulting from an individual’s perception of threat and characterised by a perceived inability to predict, control, or gain the preferred results in given situations. In simple terms, it is a feeling of fear and worry about the future. 

Depression, on the other hand, is a mood disorder that causes persistent feelings of sadness and loss of interest. A person with depression may have different emotional and physical problems because it affects how they feel, think, and behave.

Both anxiety and depression can be factors in having or developing cardiovascular disease. Several studies have found out that anxiety is an independent risk factor for chronic heart disease and cardiac mortality which may suggest a relationship between anxiety disorders and increased cardiac outcomes.

There are also several studies that have found that depression is associated with poorer outcomes of chronic heart disease. Depression and stress are risk factors in the development and prognosis of cardiovascular diseases.

Lifestyle and personality traits

Lifestyle and personality traits also play a major role in the onset of cardiovascular diseases. Personality traits are the traits that reflect people’s characteristic patterns of thoughts, feelings, and behaviour. There are several studies that suggest that there are certain personality traits that may be common to certain forms of heart disease. 

Personality traits such as optimism, openness, conscientiousness, and curiosity have been found to be associated with positive health outcomes in people with cardiovascular diseases while a person with a Type D personality or the ‘distressed’ personality, with traits such as neuroticism and introversion, have been found to experience more cardiac symptoms.

Another example is the Type A personality or the high-achieving workaholics which is more susceptible to burnout especially when they feel like a career martyr – underpaid and overworked – which can eventually lead to the development of heart disease. 

There are also other theories that explain the relationship between personality and the way of life of an individual with cardiovascular diseases. These theories are the Personality-Induced Hyperactivity Model, Dangerous Behaviour Model, Transactional Stress Model, and Constitutional Predisposition Model.

Personality-Induced Model means that a person with exaggerated neuroendocrine and sympathetic responses towards perceived stressors can be more susceptible to cardiovascular diseases. These are the persons that tend to overreact when confronted with danger.

Another model is the Dangerous Behavior Model which suggests that personality indirectly affects health through excessive health degrading behaviours and lack of health-promoting behaviours. For example, a person with a type D personality most of the time has negative emotions and is pessimistic in general. This type of person doesn’t share his emotions or thoughts also. Since this person is often sad and pessimistic, this person may be engaged with drinking problems which, in the long run, can lead to heart disease.

The Transactional Stress Model, on the other hand, suggests that certain personality dispositions may have tendencies toward using particular coping strategies when stressed.

These people may have different behaviour patterns in coping with stress that may lead to the development of heart disease.

Lastly, the Constitutional Predisposition Model suggests that there is an underlying genetic or constitutional factor that produces both vulnerabilities in the physiological aspect and in the behavioural, emotional, and cognitive phenotype of personality. For example, chronic anger problems are often a risk factor for poor physical health that can also lead to heart disease.

Prevention and treatment

Psychological techniques and therapy can be used to prevent and treat cardiovascular diseases. These are behaviour modification (cognitive behavioural therapy) and interpersonal therapy.

Cognitive behavioural therapy is a short-term, goal-oriented psychotherapy that takes a hands-on, practical approach to problem-solving. Its goal is to change patterns of thinking or behaviour that are behind people’s difficulties, and so change the way they feel.

One of its famous techniques is behaviour modification which is a therapeutic approach designed to change a particular undesirable negative behaviour. For example, smoking. Modifying a behaviour pattern like smoking can have a beneficial impact on major cardiovascular risk factors.

Interpersonal therapy, on the other hand, is a time-limited, focused, evidence-based approach particularly designed to treat mood disorders. The main goal of this psychotherapy is to improve the quality of a person’s interpersonal relationships and social functioning to help reduce stress.

Interpersonal therapy intervenes in symptom formation and social dysfunction and it is based on the presumption that interpersonal issues affect mood, and mood impairs interpersonal functioning. 

This type of therapy is often used with persons with mood and personality disorders or those persons under the Dangerous Behaviour Model and has a significant relationship  Transactional Stress Model – it can be offered to those with Type D Personality and those with depression.

Final thoughts

Psychology does have a relation to the development, prevention, and treatment of cardiovascular diseases. Personality types and lifestyles are one of the factors in the development of cardiovascular diseases.

In order to prevent the development of cardiovascular diseases, one should be mindful of the health-degrading behaviours that can cause the onset of heart disease. One major factor to prevent it relies on the behavioural patterns a person uses to deal and cope with stress. 

Psychotherapies can also be used in the prevention and treatment of cardiovascular disease and there are several studies that can prove its effectiveness to persons with heart disease. If a person cannot control his/her health degrading behaviours, behaviour modification can be used while if a person’s problem is in his social functioning and this can be a possible risk factor in the development of heart disease, interpersonal psychotherapy can be used.

In general, there are many psychological applications that can be used in the prevention of cardiovascular diseases. It is good to be informed of its theories and applications to be able to help in its prevention and treatment.

Nikka Celeste is a relationship and wellness expert.  

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