Key result
Psychosocial factors like sleep disturbance increase CV risk, but management fails to reduce recurrent MI.
Why the study?
Psychological and psychosocial factors including sleep disturbance increase cardiovascular risk and impact quality of life, but their management's effect on hard cardiovascular endpoints is unclear.
Addressing psychosocial factors, particularly sleep disturbance, is important for improving quality of life in cardiac patients, even if it does not reduce hard cardiovascular endpoints.
Supports psychosocial screening for risk stratification; leaves open whether interventions reduce recurrent events.
Psychological and psychosocial factors have long been linked to cardiovascular disease. These psychosocial factors, including low socioeconomic status, social support/isolation, stress and distress, personality, and sleep disturbance increase risk of cardiovascular events and negatively impact quality of life. These factors may have direct effects on cardiovascular disease via immune or neuroendocrine pathways, or more indirect effects, by, for example, limiting adherence to recommended therapies and cardiac rehabilitation. Most psychosocial risk factors can be assessed relatively easily using standardised tools. Sleep disturbance, in particular, is gaining evidence for its importance and may be crucial to address. While the management of certain psychosocial risk factors is an ethical requirement for care and improves quality of life, unfortunately there is little evidence that such strategies impact on 'hard' endpoints such as recurrent myocardial infarction. A comprehensive biopsychosocial approach to management of these psychosocial factors is required to maximise the benefits patients derive from cardiac care.
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Gallagher et al. (2015) conducted a review in Cardiovascular disease. Psychosocial factors and sleep disturbance was evaluated on Cardiovascular events and quality of life. Psychosocial factors, particularly sleep disturbance, increase cardiovascular risk and reduce quality of life, though managing them has little proven effect on hard endpoints like recurrent myocardial infarction.
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