Coronary Heart Disease
Overview of Diseases
● Coronary Heart Disease: illnesses caused by narrowing of coronary
arteries (atherosclerosis)
● Hypertension: high blood pressure (cardiovascular disease) occurs with
excessive supply of blood through vessels
● Stroke: disturbance of blood flow to brain (interruption or hemorrhage)
● Type II Diabetes: characterized by high blood sugar, insulin resistance,
and relative lack of insulin
Coronary Heart Disease
● Largest cause of deaths in the U.S.
● Disease of “modernization”: diet changes and reduced exercise
● Manifests as:
○ Angina: insufficient supply
○ Ischemia: lack of blood flow
○ Myocardial infarction: clot
○ Congestive heart failure: inadequate delivery of blood to body
○ Arrhythmia: irregular heartbeat
● Risk factors
○ High cholesterol
○ High blood pressure
○ Elevated levels of inflamamtion
○ Cigarette smoking
○ Diabetes
○ Obesity
○ Lack of syndrome
● Metabolic Syndrome: Increases risk for heart attack
○ Diagnosed when a person has:
■ Obesity centered around the waist
■ High blood pressure
■ Low levels of HDL
■ Difficulty metabolizing blood sugar
■ High levels of triglycerides
Stress and CHD
Biological Reactivity to Stress
● Plays a role in the development of CHD
, ● Cumulative effects lead to damage of the endothelial cells
● Reflected in a prolonged recovery period
● Chronic and acute stress is linked to CHD and adverse clinical events
● Interacts with genetic factors to increase likelihood of CHD
● Associated with increased inflammatory activity
Personality, Biological Reactivity, and CHD
● Negative emotions increase risk for metabolic syndrome and CHD
● Cynical hostility: suspiciousness, resentment, frequent anger,
antagonism, distrust of others
● Hostility can occur from:
○ Insecure and negative feelings
○ Bad family environment
○ Bad child-rearing practices
○ Genetic factors
Depression and CHD
● Well-established-depression affects the development, progression, and
mortality from CHD
● Linked to risk factors for:
○ Coronary heart disease
○ Metabolic syndrome
○ Inflammation and likelihood of a heart attack
○ Heart failure among the elderly and mortality after coronary
artery bypass graft surgery
● Other psychosocial factors
○ Vigilant coping
○ Anxiety
○ Vital exhaustion
○ Hostility
○ Social isolation
Management of Coronary Heart Disease
● Role of Delay: one of the reasons for high rates of mortality and
disability following heart attacks
● Initial Treatment
○ Coronary artery bypass graft (CABG) surgery to treat blockage of
major arteries
Overview of Diseases
● Coronary Heart Disease: illnesses caused by narrowing of coronary
arteries (atherosclerosis)
● Hypertension: high blood pressure (cardiovascular disease) occurs with
excessive supply of blood through vessels
● Stroke: disturbance of blood flow to brain (interruption or hemorrhage)
● Type II Diabetes: characterized by high blood sugar, insulin resistance,
and relative lack of insulin
Coronary Heart Disease
● Largest cause of deaths in the U.S.
● Disease of “modernization”: diet changes and reduced exercise
● Manifests as:
○ Angina: insufficient supply
○ Ischemia: lack of blood flow
○ Myocardial infarction: clot
○ Congestive heart failure: inadequate delivery of blood to body
○ Arrhythmia: irregular heartbeat
● Risk factors
○ High cholesterol
○ High blood pressure
○ Elevated levels of inflamamtion
○ Cigarette smoking
○ Diabetes
○ Obesity
○ Lack of syndrome
● Metabolic Syndrome: Increases risk for heart attack
○ Diagnosed when a person has:
■ Obesity centered around the waist
■ High blood pressure
■ Low levels of HDL
■ Difficulty metabolizing blood sugar
■ High levels of triglycerides
Stress and CHD
Biological Reactivity to Stress
● Plays a role in the development of CHD
, ● Cumulative effects lead to damage of the endothelial cells
● Reflected in a prolonged recovery period
● Chronic and acute stress is linked to CHD and adverse clinical events
● Interacts with genetic factors to increase likelihood of CHD
● Associated with increased inflammatory activity
Personality, Biological Reactivity, and CHD
● Negative emotions increase risk for metabolic syndrome and CHD
● Cynical hostility: suspiciousness, resentment, frequent anger,
antagonism, distrust of others
● Hostility can occur from:
○ Insecure and negative feelings
○ Bad family environment
○ Bad child-rearing practices
○ Genetic factors
Depression and CHD
● Well-established-depression affects the development, progression, and
mortality from CHD
● Linked to risk factors for:
○ Coronary heart disease
○ Metabolic syndrome
○ Inflammation and likelihood of a heart attack
○ Heart failure among the elderly and mortality after coronary
artery bypass graft surgery
● Other psychosocial factors
○ Vigilant coping
○ Anxiety
○ Vital exhaustion
○ Hostility
○ Social isolation
Management of Coronary Heart Disease
● Role of Delay: one of the reasons for high rates of mortality and
disability following heart attacks
● Initial Treatment
○ Coronary artery bypass graft (CABG) surgery to treat blockage of
major arteries
