Anxiety and depression: risk factors for cardiovascular disease

Coronary heart disease (CHD) is the leading cause of death worldwide, accounting for around 16.7 million deaths each year, mainly from heart attacks and strokes. Furthermore, this number is predicted to increase to approximately 25 million deaths by 2020 if current trends continue. Yet fatalities represent only the tip of the iceberg; the greater burden of cardiovascular disease, affecting an estimated 128 million people, is attributable to nonfatal cardiovascular events and their long-term consequences. Though there are well-accepted national guidelines for the primary and secondary prevention of cardiac illness, far less attention has been paid to the impact of psychological risk factors on cardiovascular disease. Nonetheless, there is compelling evidence that psychological risk factors confer equal and, in some cases, greater risk than other traditional clinical risk factors (Kubzansky & Kawachi, 2000; Rozanski, Blumenthal, & Kaplan, 1999).