Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-26T09:41:03.328Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevention of Cardiovascular Disease by Psychological Methods

Published online by Cambridge University Press:  02 January 2018

Derek W. Johnston
Derek W. Johnston*
Affiliation:
Department of Psychology, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE
Get access Rights & Permissions [Opens in a new window]

Abstract

It is generally recognised that much cardiovascular disease is the result of voluntary behaviour such as smoking cigarettes, and the pursuit of stress-prone lifestyles. Since these risks are primarily behavioural, it is appropriate to attempt to alter them, and hence reduce the risk of cardiovascular disease, using psychological methods, and such methods can reduce both biological and psychological stress-related factors. Studies of healthy populations, of those at increased risk, and of patients with clear cardiovascular disease have all shown that risk-related behaviour can be altered and, in some cases, the incidence of cardiovascular disease reduced. Future research will have to extend these findings, which were often on atypical populations, and confirm reduction of cardiovascular disease.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 154 , Issue 2 , February 1989 , pp. 183 - 194
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Agras, W. S., Taylor, C. B., Kraemer, H. C., et al (1987) Relaxation training for essential hypertension at the worksite–II. The poorly controlled hypertensive. Psychosomatic Medicine, 49, 264–273.CrossRefGoogle ScholarPubMed
Anderson, D. E., Kearns, W. D. & Better, W. E. (1983) Progressive hypertension in dogs by avoidance conditioning and saline infusion. Hypertension, 5, 286–291.CrossRefGoogle ScholarPubMed
Bali, L. R. (1979) Long term effect of relaxation on blood pressure and anxiety levels in essential hypertensive males: a controlled study. Psychosomatic Medicine, 41, 637–646.CrossRefGoogle Scholar
Berkman, L. F. & Syme, S. L. (1979) Social networks, host resistance, and mortality: a nine year follow-up of Alameda County residents. American Journal of Epidemiology, 109, 186–204.CrossRefGoogle ScholarPubMed
Blackburn, H., Luepker, R., Kline, F. G., et al (1984) The Minnesota Heart Health Program: a research and demonstration project in cardiovascular disease prevention. In Behavioural Health (eds Matarrazzo, J. D., et al). Chichester: Wiley.Google Scholar
Blanchard, E. R., Miller, S. T., Abel, C. C., et al (1979) Evaluation of biofeedback in the treatment of essential hypertension. Journal Applied Behavioural Analysis, 12, 99–110.CrossRefGoogle ScholarPubMed
Blanchard, E. B., McCoy, G. C., Gerardi, M. A., et al (1986) A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension – 1. Short-term and long-term outcome. Behaviour Therapy, 17, 563–579.CrossRefGoogle Scholar
Booth-Kewley, S. & Friedman, H. S. (1987) Psychological predictors of heart disease: a quantitative review. Psychological Bulletin, 101, 343–362.CrossRefGoogle ScholarPubMed
British Thoracic Society (1983) Comparison of four methods of smoking withdrawal in patients with smoking related diseases. British Medical Journal, 286, 595–597.CrossRefGoogle Scholar
British Thoracic Society (1984) Smoking withdrawal in hospital patients: factors associated with outcome. Thorax, 39, 651–656.CrossRefGoogle Scholar
Brownell, K. D. & Wadden, T. A. (1986) Behaviour therapy for obesity: modern approaches and better results. In Handbook of Eating Disorders: Physiology, Psychology, and Treatment of Obesity, Anorexia, and Bulimia (eds Brownell, K. D. & Foreyt, J. P.). New York: Basic Books.Google Scholar
Burling, T. A., Singleton, E. G., Bigelow, G. E., et al (1984) Smoking following myocardial infarction: a critical review of the literature. Health Psychology, 3, 83–96.CrossRefGoogle ScholarPubMed
Burt, A., Thornley, P., Illingsworth, D., et al (1974) Stopping smoking after myocardial infarction. Lancet, i, 304–306.CrossRefGoogle Scholar
Carey, M. P. & Burish, T. G. (1987) Providing relaxation training to cancer chemotherapy patients: a comparison of three delivery techniques. Journal of Consulting and Clinical Psychology, 55, 732–737.CrossRefGoogle ScholarPubMed
Case, R. B., Heller, S. S., Case, N. B., et al (1985) Type A behaviour and survival after acute myocardial infarction. New England Journal of Medicine, 312, 737–741.CrossRefGoogle ScholarPubMed
Chesney, M. A., Black, G. W., Swan, G. E., et al (1987) Relaxation training for essential hypertension at the worksite – I. The untreated mild hypertensive. Psychosomatic Medicine, 49, 250–263.CrossRefGoogle ScholarPubMed
Chiang, B. N., Perlman, L. V. & Epstein, F. H. (1969) Overweight and hypertension. Circulation, 39, 403–421.CrossRefGoogle ScholarPubMed
Dimsdale, J. E., Hackett, T. P., Catanzo, D. M., et al (1979) The relationship between diverse measures for Type A personality and coronary angiographic findings. Journal of Psychosomatic Research, 23, 289–293.CrossRefGoogle ScholarPubMed
Falkner, B., Onesti, G., Angelakos, E. T., et al (1979) Cardiovascular response to mental stress in normal adolescents with hypertensive parents: haemodynamics and mental stress in adolescents. Hypertension, 1, 23–30.CrossRefGoogle ScholarPubMed
Farquhar, J. W., Macoby, N., Wood, P. D., et al (1977) Community education for cardiovascular health. Lancet, i, 1192–1195.CrossRefGoogle Scholar
Farquhar, J. W., Fortman, S. P., Maccoby, N., et al (1984) The Stanford Five City Project: an overview. In Behavioural Health (eds Matarrazzo, J. D., et al). Chichester: Wiley.Google Scholar
Frankel, B. L., Patel, D. J., Horwitz, D., et al (1978) Treatment of hypertension with biofeedback and relaxation techniques. Psychosomatic Medicine, 40, 276–293.CrossRefGoogle ScholarPubMed
Frasure-Smith, N. & Prince, R. (1985) The ischemic heart disease life stress monitoring program: impact on mortality. Psychosomatic Medicine, 47, 431–445.CrossRefGoogle ScholarPubMed
Frasure-Smith, N. & Prince, R. (1987) The ischemic heart disease life stress monitoring program: possible therapeutic mechanisms. Psychology and Health, 1, 273–285.CrossRefGoogle Scholar
Frick, M. H., Elo, O., Haapa, K., et al (1987) Helsinki heart study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. New England Journal of Medicine, 317, 1237–1245.CrossRefGoogle ScholarPubMed
Friedman, M., Thorensen, C. E., Gill, J. J., et al (1984) Alteration of Type A behaviour and reduction in cardiac recurrences in postmyocardial infarction patients. American Heart Journal, 108, 237–248.CrossRefGoogle ScholarPubMed
Friedman, M., Thoresen, C. D., Gill, J. J., et al (1986) Alteration of Type A behaviour and its effect on cardiac recurrences in post myocardial infarction patients: summary results of the recurrent coronary prevention project. American Heart Journal, 112, 653–665.CrossRefGoogle ScholarPubMed
Gill, J. J., Price, V. A., Friedman, M., et al (1985) Reduction of Type A behaviour in healthy middle-aged American Officers. American Heart Journal, 110, 503–514.CrossRefGoogle ScholarPubMed
Goldstein, I. B., Shapiro, D., Thananopavarn, C., et at (1982) Comparison of drug and behavioural treatments of essential hypertension. Health Psychology, 1, 7–26.CrossRefGoogle Scholar
Grobbee, D. E. & Hofman, A. (1986) Does sodium restriction lower blood pressure? British Medical Journal, 293, 27–29.CrossRefGoogle ScholarPubMed
Gruen, W. (1975) Effects of brief psychotherapy during the hospitalization period on the recovery process in heart attacks. Journal of Clinical and Consulting Psychology, 43, 223–232.CrossRefGoogle ScholarPubMed
Haines, A. P., Imeson, J. D. & Meade, T. W. (1987) Phobic anxiety and ischaemic heart disease. British Medical Journal, 295, 297–299.CrossRefGoogle ScholarPubMed
Haynes, S. G., Feinleib, M. & Kannel, W. (1980) The relationship of psychosocial factors to coronary heart disease in the Framingham study – III. Eight year incidence of coronary heart disease. American Journal of Epidemiology, 111, 37–58.CrossRefGoogle ScholarPubMed
Haynes, R. B., Harper, A. C., Costley, S. R., et al (1984) Failure of weight reduction to reduce mildly elevated blood pressure: a randomized trial. Journal of Hypertension, 2, 535–539.CrossRefGoogle ScholarPubMed
Henry, J. P., Stephens, P. M. & Santisteban, G. A. (1975) A model of psychosocial hypertension showing reversibility and progression of cardiovascular complications. Circulation Research, 36, 156–164.CrossRefGoogle Scholar
Hjerman, I., Velve Byre, K., Holme, I., et al (1981) Effect of diet and smoking on the incidence of coronary heart disease. Lancet, ii, 1303–1310.CrossRefGoogle Scholar
Irvine, J., Johnston, D. W., Jenner, D., et al (1986) Relaxation and stress management in the treatment of essential hypertension. Journal of Psychosomatic Research, 30, 437–450.CrossRefGoogle ScholarPubMed
Jacob, R. G., Shapiro, A. P., Reeves, R. A., et al (1986) Relaxation therapy for hypertension: comparison of effects with concomitant placebo, diuretic and β-blocker. Archives of Internal Medicine, 146, 2335–2340.CrossRefGoogle ScholarPubMed
Johnston, D. W. (1976) Criterion level and instructional effects in the voluntary control of heart rate. Biological Psychology, 4, 1–17.CrossRefGoogle ScholarPubMed
Johnston, D. W. (1985) Psychological interventions in cardiovascular disease. Journal of Psychosomatic Research, 29, 447–456.CrossRefGoogle ScholarPubMed
Johnston, D. W. (1986) How does relaxation training reduce blood pressure in primary hypertension? In Biological and Psychological Factors in Coronary Heart Disease (eds Dembroski, T. D., Schmidt, T. H. & Blumchen, C.). Berlin: Springer-Verlag.Google Scholar
Johnston, D. W. (1987) The behavioural control of high blood pressure. Current Psychological Research and Reviews, 6, 99–114.CrossRefGoogle Scholar
Johnston, D. W., Cook, D. G. & Shaper, A. G. (1987) Type A behaviour and ischaemic heart disease in middle aged British men. British Medical Journal, 295, 86–89.CrossRefGoogle ScholarPubMed
Joint National Committee on the Detection, Evaluation and Treatment of High Blood Pressure (1986) Nonpharmacological approaches to the control of high blood pressure. Hypertension, 8, 444–467.Google Scholar
Kornitzer, M., Debacker, G., Dramaix, M., et al (1983) Belgian heart disease prevention project: incidence and mortality results. Lancet, i, 1066–1070.CrossRefGoogle Scholar
Langford, H. G., Blaufox, M. D., Oberman, A., et al (1985) Dietary therapy slows the return of hypertension after stopping prolonged medication. Journal of the American Medical Association, 253, 657–664.CrossRefGoogle ScholarPubMed
Lasater, T., Abrams, D., Artz, L., et al (1984) Lay volunteers delivery off a community-based cardiovascular risk factor change program: the Pawtucket experiment. In Behavioural Health (eds Matarrazzo, J. D., et al). Chichester: Wiley.Google Scholar
Lawler, J. E., Barker, G. F., Hubbard, J. W., et al (1981) Effects of stress on blood pressure and cardiac pathology in rats with borderline hypertension. Hypertension, 3, 496–505.CrossRefGoogle ScholarPubMed
Lewis, B., Mann, J. I. & Mancini, M. (1986) Reducing the risk of coronary heart disease in individuals and in the population. Lancet, i, 956–959.CrossRefGoogle Scholar
Lipid Research Clinics Program (1984) The Lipid Research Clinics coronary primary prevention trial results – 1. Reduction in the incidence of coronary heart disease. Journal of the American Medical Association, 251, 351–364.CrossRefGoogle Scholar
Lovibond, S. H., Birrell, P. C. & Langeluddecke, P. (1986) Changing coronary heart disease risk factor status: the effects of three behavioural programs. Journal of Behavioural Medicine, 9, 415–437.CrossRefGoogle Scholar
MacDougall, J. M., Dembroski, T. M., Dimsdale, J. E., et al (1985) Components of Type A: hostility and anger. Further relationships to angiographic findings. Health Psychology, 4, 137–152.CrossRefGoogle ScholarPubMed
MacGregor, G. A. (1985) Sodium is more important than calcium in essential hypertension. Hypertension, 7, 628–637.CrossRefGoogle ScholarPubMed
MacMahon, S. (1987) Alcohol consumption and hypertension. Hypertension, 9, 111–121.CrossRefGoogle ScholarPubMed
MacMahon, S. W., MacDonald, G. J., Bernstein, D., et al (1985) Comparison of weight reduction with metoprolol in treatment of hypertension in young overweight patients. Lancet, i, 1233–1236.CrossRefGoogle Scholar
MacMahon, S. W., Wilcken, D. E. L. & MacDonald, G. J. (1986) The effect of weight reduction on left ventricular mass: a randomized controlled trial in young, overweight hypertensive patients. New England Journal of Medicine, 314, 334–339.CrossRefGoogle Scholar
Manuck, S. B., Kaplan, J. R. & Matthews, K. A. (1986) Behavioural antecedents of coronary heart disease and atherosclerosis. Arteriosclerosis, 6, 2–14.CrossRefGoogle ScholarPubMed
Marmot, M. G. (1984) Alcohol and coronary heart disease. International Journal of Epidemiology, 13, 160–167.CrossRefGoogle ScholarPubMed
Matthews, K. A., Glass, D. C., Rosenman, R. H., et al (1977) Competitive drive, pattern A, and coronary heart disease: a further analysis of some data from the Western Collaborative Group Study. Journal of Chronic Diseases, 30, 489–498.CrossRefGoogle ScholarPubMed
Maxwell, M. H., Kushiro, T., Dornfield, L. P., et al (1984) BP changes in obese hypertensive subjects during rapid weight loss: comparison of restricted $v. unchanged salt intake. Archives of International Medicine, 144, 1581–1584.CrossRefGoogle ScholarPubMed
McCarron, D. A. (1985) Is calcium more important than sodium in the pathogenesis of essential hypertension? Hypertension, 7, 607–627.CrossRefGoogle ScholarPubMed
Medical Research Council Working Party (1981) Adverse reactions to bendrofluazide and propranolol for the treatment of mild hypertension. Lancet, ii, 539–543.Google Scholar
Medical Research Council Working Party (1985) MRC trial of treatment of mild hypertension: principal results. British Medical Journal, 291, 97–104.CrossRefGoogle Scholar
Miller, W. R. (1985) Motivation for treatment: a review with special emphasis on alcoholism. Psychological Bulletin, 98, 84–107.CrossRefGoogle ScholarPubMed
Multiple Risk Factor Intervention Trial Research Group (1982) Multiple risk factor intervention trial: risk factor changes and mortality results. Journal of the American Medical Association, 248, 1465–1477.CrossRefGoogle Scholar
Myrtek, M. & Greenlee, M. E. W. (1984) Psychophysiology of Type A behaviour pattern: a critical analysis. Journal of Psychosomatic Research, 28, 455–466.CrossRefGoogle Scholar
Paffenbarger, R. S., Wing, A. L., Hyde, R. R., et al (1983) Physical fitness and incidence of hypertension in college alumni. American Journal of Epidemiology, 117, 2345–2357.CrossRefGoogle ScholarPubMed
Patel, C. & North, W. R. S. (1975) Randomised controlled trial of yoga and biofeedback in the management of hypertension. Lancet, ii, 93–95.CrossRefGoogle Scholar
Patel, C., Marmot, M. G., Terry, D. J., et al (1985) Trial of relaxation in reducing coronary risk: four year follow up. British Medical Journal 290, 1103–1106.CrossRefGoogle ScholarPubMed
Patel, C., & Marmot, M. G., (1988) Can general practitioners use training in relaxation and management of stress to reduce mild hypertension? British Medical Journal, 296, 21–24.CrossRefGoogle ScholarPubMed
Peveler, R. & Johnston, D. W. (1986) Subjective and cognitive effects of relaxation. Behaviour Research and Therapy, 24, 413–420.CrossRefGoogle ScholarPubMed
Potter, J. F. & Beevers, D. G. (1984) Pressor effect of alcohol in hypertension. Lancet, i, 119–122.CrossRefGoogle Scholar
Powell, L. H. & Thoresen, C. E. (1985) Behavioral and physiologic determinants of long-term prognosis after myocardial infarction. Journal of Chronic Disease, 38, 253–263.CrossRefGoogle ScholarPubMed
Puddey, I. B., Beilin, L. J., Vandongen, R., et al (1985) Evidence for a direct effect of alcohol consumption on blood pressure in normotensive men: a randomized controlled trial. Hypertension, 7, 707–713.CrossRefGoogle ScholarPubMed
Puska, P., Nissinen, A., Tuomilehto, J., et al (1985) The community based strategy to prevent coronary heart disease: conclusions from ten years of the North Karelia project. Annual Review of Public Health, 6, 147–193.CrossRefGoogle ScholarPubMed
Ragland, D. R. & Brand, R. J. (1988) Type A behaviour and mortality from coronary heart disease. New England Journal of Medicine, 318, 65–69.CrossRefGoogle ScholarPubMed
Rose, G. (1981) Strategy of prevention: lessons from cardiovascular disease. British Medical Journal, 282, 1847–1851.CrossRefGoogle ScholarPubMed
Rosenman, R. H., Brand, R. J., Jenkins, C. D., et al (1975) Coronary heart disease in the Western Collaborative Group study: final follow-up experience of 8½ years. Journal of the American Medical Association, 233, 872–877.CrossRefGoogle Scholar
Roskies, E., Seraganian, P., Oseasohn, R., et al (1986) The Montreal Type A intervention project: major findings. Health Psychology, 5, 45–69.CrossRefGoogle ScholarPubMed
Saunders, J. B., Beevers, D. G. & Paton, A. (1981) Alcohol induced hypertension. Lancet, ii, 653–656.CrossRefGoogle Scholar
Seeman, T. E. & Syme, S. L. (1987) Social networks and coronary artery disease: a comparison of the structure and function of social relations as predictors of disease. Psychosomatic Medicine, 49, 341–354.CrossRefGoogle ScholarPubMed
Shaper, A. G., Waler, M., Cohen, N. M. (1981) British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. British Medical Journal, 283, 179–186.CrossRefGoogle ScholarPubMed
Shaw, L. (1981) Effects of a prescribed, supervised exercise program on mortality and cardiovascular morbidity in myocardial infarction subjects. American Journal of Cardiology, 48, 39–46.CrossRefGoogle Scholar
Shepherd, J., Betterideg, D. J., Durrington, P., et al (1987) Strategies for reducing coronary heart disease and desirable limits for blood lipid concentrations: guidelines of the British Hyperlipidaemia Association. British Medical Journal, 295, 1245–1246.CrossRefGoogle ScholarPubMed
Southam, M. A., Agras, W. S., Taylor, C. B., et al (1982) Relaxation training: blood pressure during the working day. Archives of General Psychiatry, 39, 715–717.CrossRefGoogle ScholarPubMed
Stamler, R., Stamler, J., Grimm, R., et al (1987) Nutritional therapy for high blood pressure: final report of a four-year randomized controlled trial – The Hypertension Control program. Journal of the American Medical Association, 257, 1484–1491.CrossRefGoogle ScholarPubMed
Steptoe, A. (1976) Blood pressure control: a comparison of feedback and instructions using pulse transit time feedback. Psychophysiology, 13, 528–536.CrossRefGoogle Scholar
Taylor, C. B., Farquhar, J. W., Nelson, E., et al (1977) Relaxation therapy and high blood pressure. Archives of General Psychiatry, 34, 339–342.CrossRefGoogle ScholarPubMed
Truett, J., Cornfield, J. & Kannel, W. (1967) A multivariate analysis of the risk of coronary heart disease in Framingham. Journal of Chronic Disease, 20, 511–524.CrossRefGoogle ScholarPubMed
Tuomilehto, J., Geboers, J., Salonen, J. T., et al (1986) Decline in cardiovascular mortality in North Karelia and other parts of Finland. British Medical Journal, 293, 1068–1071.CrossRefGoogle ScholarPubMed
Veterans Administration Co-Operative Study on Antihypertensive Agents (1967) Effects of treatment on morbidity in hypertension – 1. Results in patients with diastolic blood pressure averaging 115 though 129 mm Hg. Journal of the American Medical Association, 202, 1028–1034.CrossRefGoogle Scholar
Williams, R. B., Haney, T. L., Lee, K. L., et al (1980) Type A behaviour: hostility and coronary atherosclerosis. Psychosomatic Medicine, 42, 539–549.CrossRefGoogle ScholarPubMed
World Health Organization European Collaborative Group (1986) European collaborative trial of multifactorial prevention of coronary heart disease: final report on the 6-year results. Lancet, i, 869–872.Google Scholar
Verrier, R. L. & Lown, B. (1984) Behavioral stress and cardiac arrhythmias. Annual Review of Physiology, 46, 155–176.CrossRefGoogle ScholarPubMed
Zurawski, R. M., Smith, T. W. & Houston, B. K. (1987) Stress management for essential hypertension: comparison with a minimally effective treatment, predictors of response to treatment, and effects on reactivity. Journal of Psychosomatic Research, 31, 453–462.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.