The relationship of psychological variables and physiological reactivity to psychological stress in coronary artery disease patients

There is mounting quantitative evidence demonstrating a relationship between various psychological variables and the development or course of coronary artery disease (CAD). Current research in this area clearly illustrates the important role that psychological stress plays in both developing and exacerbating CAD, possibly through the induction of myocardial ischemia (a reduced flow of oxygenated blood to the heart). Therefore it is intuitive that psychological variables aiding a person in avoiding the stress response altogether would serve a protective function against experiencing ischemic episodes. The present study examined link between ischemia and psychological variables such as self-efficacy and preventive coping resources utilization that are thought to serve this protective function. It was hypothesized that individuals who reacted ischemically to psychological (a series of auditory noises and video clips, speech task, and arithmetic task) and physical (treadmill) stress tasks would have lower levels of self-reported preventive coping resources, general self-efficacy, and cardiac self-efficacy, and higher levels of depression than individuals who did not react ischemically. The author’s goal in vi beginning to understand the link between these protective psychological variables and cardiovascular disease is to proactively identify such variables so that these characteristics can be developed and/or strengthened through future treatment interventions. Fifty male military veterans from the Central Texas Veterans Health Care System (CTVHCS) participated in the study. After filling out a series of inventories, the participants engaged in a series of three mental stress tasks and a treadmill stress test. A cardiologist evaluated the participants before and after each of the mental stress tasks and the treadmill stress test using a 12-lead ECG (which also provided information on heart rate), an echocardiogram, and a blood pressure cuff. Using this information, the cardiologist identified participants as either ischemic reactors or non-reactors. Results indicate that ischemic reactor and non-reactor groups do indeed differ on measures of depression and preventive coping resources when exposed to psychological stress and on levels of social self-efficacy when exposed to physical stress. Further, depression was predicted by the participants’ perceived level of preventive coping resources. Implications of the study, as well as study limitations and directions for future research are discussed.