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Psychological factors may contribute to the development of atherosclerosis. There is some evidence demonstrating that negative emotions such as depression or anger may be associated with an increased risk of coronary artery disease.


The same has been shown for patients developing vascular disease elsewhere in their bodies.

Some studies demonstrate that patients who are considered to be TypeA personalities are more likely to have heart disease.

Psychological factors may even trigger a transient stress related cardiomyopathy (weak heart function) which may appear under circumstances of extreme emotional stress. 

In patients known to have coronary artery disease, negative psychological factors may affect:

  • the threshold level of angina, 

  • the progression of the vascular disease, 

  • the proneness to heart attack or sudden death, 

  • the sense of well being ,

  • the blood pressure

  • the presence of arrhythmias

  • the tendency to heart failure

  • In patients who have undergone bypass surgery, depression may be associated with worse post-operative outcomes including a higher death rate.

The mechanisms for the above observations are not entirely clear and are probably multifactorial. However, it has been demonstrated that negative psychological stresses may trigger many changes in our bodies including but not limited to:

  • higher blood pressure, 

  • faster heart rate,

  • increased cardiac oxygen demands, 

  • reduced blood flow in the coronary arteries, 

  • higher epinephrine levels 

  • higher cortisol levels, 

  • increased inflammatory response,

  • abnormal function and even damage to the endothelial lining of our blood vessels which in turn may promote the development of atherosclerosis

  • etc.

Emotional stressors may have a negative impact on smokers by causing them to smoke more, which has been well recognized as a causative agent in the development and progression of vascular disease.

On the other hand, there is lots of evidence to support the benefits of starting a stress reduction strategy for any type of patient needing it.


In patients with heart disease as well as in those who at risk for it, it stands to reason that good stress management techniques may be extremely useful for good long term health.

A healthy approach to life and the many curves that are placed in our paths just makes sense. Moreover, if we can learn to feel better about ourselves and the circumstances that we find ourselves in, then we are likely to be happier. 

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