Key result
Psychosocial factors are linked to ASCVD risk, and psychological interventions improve symptoms and may reduce cardiac mortality, though an effect on total mortality remains unproven.
Why the study?
ASCVD accounts for a substantial share of cardiovascular mortality in Europe despite progress in controlling traditional risk factors, and psychosocial factors are associated with ASCVD development and prognosis as potential contributors to residual cardiovascular risk.
Do psychological interventions and screening improve psychological symptoms and reduce mortality in patients with atherosclerotic cardiovascular disease and psychosocial risk factors?
Do psychological interventions and screening improve psychological symptoms and reduce mortality in patients with atherosclerotic cardiovascular disease and psychosocial risk factors?
This narrative review highlights the role of psychosocial risk factors in ASCVD and summarizes current European consensus recommending two-stage screening and multidisciplinary psychological interventions to improve mental health symptoms and potentially reduce cardiac mortality.
Answers are grounded in this paper and cite their sources.
Supports structured psychosocial screening and multidisciplinary care in ASCVD; reinforces 2025 ESC consensus on mental health integration.
Cardiovascular disease remains the leading cause of death in Europe, with atherosclerotic cardiovascular disease (ASCVD) accounting for a substantial share of this burden despite progress in controlling lipids, blood pressure, glycemia, and smoking. Epidemiological evidence indicates that psychosocial factors, including depression, anxiety, chronic occupational stress, social isolation, and personality-related distress, are associated with the development and prognosis of ASCVD and may contribute to the broader burden of residual cardiovascular risk. European cardiology has moved decisively on this question: psychosocial factors were recognized as risk modifiers in the 2021 prevention guidelines, and in 2025 the European Society of Cardiology published a dedicated Clinical Consensus Statement on mental health and cardiovascular disease. This narrative review summarizes evidence linking psychosocial factors to ASCVD, outlines plausible neurobiological, inflammatory and behavioral pathways, and considers practical implications for assessment and management. PubMed, Scopus, and the Cochrane Library were searched for English-language literature published between January 1995 and July 2026, with priority given to prospective cohorts, meta-analyses, randomized trials, society statements, and guidelines. Current European consensus favors two-stage screening only when a defined referral pathway is available, with care delivered through a multidisciplinary team that includes a mental health professional. Psychological interventions reliably improve psychological symptoms and may reduce cardiac mortality, although an effect on total mortality remains unproven.
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Ourania Andreopoulou (2026) conducted a review in Atherosclerotic cardiovascular disease (ASCVD). Psychosocial risk factors and psychological interventions was evaluated on Development and prognosis of ASCVD, psychological symptoms, and mortality. Psychosocial factors are linked to ASCVD risk, and psychological interventions improve symptoms and may reduce cardiac mortality, though an effect on total mortality remains unproven.
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