Proposal for an Exploratory Study: Investigating the Role of Social Support for Recurrent Myocardial Infarction in High Risk Males

Coronary heart disease (CHD) is responsible for considerable morbidity and morality. Research over the past decades has clarified traditional risk factors such a high cholesterol, elevated blood pressure, obesity, or smoking. Recent research has begun exploring controversial relationships between CHD and potential risk factors such as lack of social support, social isolation, depression, Type A behavior, and hostile temperaments. Due to lack of power or methodological flaws these studies have been unable to establish consistent findings or clarify a theoretical basis for observed correlations. This paper surveys traditional risk factor interventions, provides a brief summary of the literature on the social risk factors, and proposes an exploratory study to investigate a conceptual model of CHD progression and potential risk factors. The proposed study builds from the strengths of the ENRICHD trial and addresses its weakness while providing a comprehensive data set for exploring risk factor interactions. Understanding these interactions within a conceptual model would serve as the basis for further effectiveness trials that would translate to clinical practice.