Psychological and Behavioural Determinants of Cardiovascular Disease: An Integrative Ayurvedic Perspective

Cardiovascular diseases (CVDs) are the leading cause of global morbidity and mortality. Although conventional risk factors are well recognized, psychological and behavioural factors also contribute to cardiovascular dysfunction. Ayurveda describes Hridaya as the seat of Chetana (consciousness), Manas (mind), Prana (vital force), and Ojas, emphasizing the close relationship between mental and cardiovascular health. Classical texts identify Manasika Nidana, including Chinta (worry), Shoka (grief), Bhaya (fear), Krodha (anger), Trasa (terror), and Abhighata (psychological trauma), as etiological factors in Hridroga. This integrative review examines psychological and behavioural determinants of cardiovascular disease and interprets contemporary evidence through Ayurvedic concepts including Hridaya, Manasika Nidana, Dosha Vaishamya, Agni Dushti, Ama, Srotodushti, and Satvavajaya Chikitsa. Literature was reviewed from PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and classical Ayurvedic texts, with evidence synthesized narratively. Contemporary evidence indicates that psychological stress, depression, anxiety, anger, social isolation, and maladaptive behaviours influence cardiovascular health through neuroendocrine, autonomic, inflammatory, metabolic, and vascular pathways. From an Ayurvedic perspective, these factors may disturb Rajas and Tamas, contributing to Dosha Vaishamya, Agni Dushti, Ama formation, and dysfunction of Rasavaha and Pranavaha Srotas, ultimately contributing to Hridroga. Satvavajaya Chikitsa offers a psychotherapeutic framework emphasizing mental regulation, behavioural modification, and stress management. Ayurveda therefore provides a holistic conceptual framework linking psychological, behavioural, and cardiovascular health. Further interdisciplinary clinical research is required to validate this integrative approach.