Heart disease, as with most illnesses and conditions from which we may suffer, is affected by our attitude and belief systems. The relatively new field of health psychology attempts to understand how the biology of your illness or condition relates to your behavior and social influences.

Studies published in 1997 by researchers at Duke University Medical Center found that patients who learned stress management had a lower risk of heart attack after having suffered from ischemia and coronary vessel disease.

The results over five years showed that the group that received stress management had a 74% reduction in cardiac events, improvement in blood cholesterol/fat profiles and reduced ischemia.

High Blood Pressure, Stress and Stroke

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At the University of Pittsburgh researches linked extreme increases in blood pressure to mental stress and associated it with thickening of the carotid arteries (arteries that feed the brain).

Their results, published in Circulation 1997, found that increased stress and high blood pressure over long periods of time may trigger heart attacks and strokes.(1)

Indeed, research has linked overall health psychology to heart disease, back pain, likelihood to report workman’s comp cases, recovery from injury, and recovery from surgery.

In an article published in the Journal of American Medical Association researchers found that out of 419 patients found to have hypertension at the doctor’s office, 26% measured normal pressure measurements at home. This has been coined the “White Coat Syndrome” and believed to be affected by stress.(2)

Psychological Interventions

According to 2013 research from Athens, Greece, psychological interventions halve deaths and cardiovascular events in heart disease patients.3

“The nurses on our coronary care unit observed that patients were less likely to have another heart attack, die, or return to hospital when we talked to them about their treatment, played music for them or helped religious patients to say prayers. It made us think that coronary heart disease is not just physical but also has a psychological component,” said Dr Zoi Aggelopoulou, nurse and study author.

“We found a huge benefit of psychological interventions after 2 years, with less patients dying or having a cardiovascular event and therefore fewer repeat hospital visits. The interventions included talking to patients and their families about issues that were worrying them, relaxation exercise, music therapy, and helping them to say prayers."

The researchers concluded that psychological interventions should be incorporated into the rehabilitation of patients with coronary heart disease.

She added: “Patients want to know what will happen to them when they leave hospital, whether or not they can have sex, and how to take their medication. Our research shows that giving them information and providing reassurance decreases the chances of them dying or having another heart attack. Patients can help instigate this new culture of information by asking more questions and getting more involved in decisions about their treatment."

Clinical Treatment

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Health psychology is sometimes defined as the use of psychology to promote health and to prevent illness. It is also incorporated into clinical treatment for established illnesses.

Health psychology and heart disease can be used to decrease risk of further coronary damage and will consider the patients biological, behavioral, emotional, social and environmental factors as they relate to the particular condition from which the patient suffers.

Psychology services are sometimes provided by health psychologists who will help the patient to identify their behaviors and experiences that may have led to illness and influences their health. Then, in cooperation with the patient, they will recommend changes in the way that patients process information that may help them to decrease their stress levels, their blood pressure and therefore their risk of more cardiac events.

During evaluations for heart disease the practitioner will evaluate the factors that may have lead to the behaviors that caused the illness. For instance, physical addiction plays an important role in smoking cessation or jobs may contribute to a high stress levels that lead to heart disease.

You can compare the health psychology and heart disease evaluation to what was once referred to as a ‘Type A’ personality. Type A was once believed to be a precursor to heart disease – impatient, high-achieving sort of person.

Now we understand that people can’t be solely categorized into one or another ‘Type’ without evaluating the rest of their behaviors and environmental factors.


(1) Circulation: Exaggerated Blood Pressure Responses During Mental Stress are Associated with Enhanced Carotid Atherosclerosis

(2) Blood Pressure: Cardiovascular Risk in White-Coat and Sustained Hypertensive Patients

  1. Psychological interventions halve deaths and CV events in heart disease patients European Society of Cardiology.

(4) American Psychological Association: Mind/Body Health: Heart Disease

(5) Academia: Psychological Interventions and Coronary Heart Disease

(6) Psychology Today: Double Trouble

(7) Archives of General Psychiatry: Emotional Vitality and Incident Coronary Heart Disease

(8) Archives of General Psychiatry: Healthy Psychological Functioning and Incident Coronary Heart Disease

(9) Health Central: How has psychology played a role in managing coronary heart disease problems

Top Photo by Airman Magazine

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