The impact of anxiety on the cardiovascular system

Hardiness and sense of coherence and their relation to negative affect

This study attempted to determine the degree to which measures of health proneness and measures of negative affect represent two distinct, although related, constructs. In addition, it examined the relation between Antonovsky's salutogenic construct of sense of coherence (SOC) and Kobasa's health proneness construct of hardiness. Five health proneness and three negative affect measures were filled out by 164 male patients with coronary heart disease. The pattern of correlations between these measures and confirmatory factor analysis indicated that although the measures of health proneness are negatively related to measures of negative affect, these two sets of measures and the constructs to which they are related can be differentiated from each other. However, SOC was found to be less independent of negative affect than was hardiness.

Biological mechanisms in the relationship between depression and heart disease

Psychological depression is shown to be associated with several aspects of coronary artery disease (CAD), including arrhythmias, myocardial infarction, heart failure and sudden death. The physiological mechanisms accounting for this association are unclear. Hypothalamic-pituitary-adrenal dysregulation, diminished heart rate variability, altered blood platelet function and noncompliance with medial treatments have been proposed as mechanisms underlying depression and cardiovascular disease. Recent evidence also suggests that reduced baroreflex sensitivity, impaired immune function, chronic fatigue and the co-morbidity of depression and anxiety may be involved in the relationship between depression and cardiovascular dysregulation. An experimental strategy using animal models for investigating underlying physiological abnormalities in depression is presented. A key to understanding the bidirectional association between depression and heart disease is to determine whether there are common changes in brain systems that are associated with these conditions. Such approaches may hold promise for advancing our understanding of the interaction between this mood disorder and CAD.