This is known as ischemia, and if the ischemia crosses the threshold level for maintenance of vitality of cardiac musculature would lead to death of cardiac muscles, known as myocardial infarction (Hemingway and Marmot, 1999). The whole spectrum of this disease process if known as CHD, and there are many known predisposing, precipitating, and promoting factors for this disease. The implication of all the variants of CHD and their outcomes are well known, but it is very interesting to note that that disease happens in particular personalities (Asbury, Creed, and Collins, 2004). The metabolic pathways of cholesterol or lipids are well known, and this is established that dyslipidemia is the basic pathology that predisposes to the CHD. There is a large body of literature on the personalities of these subjects and the psychosocial factors closely associated with this disease. These conditions make the people more prone to coronary artery disease. Researchers have found that people who are aggressively involved in a perennial, chronic struggle to achieve more and more in less and less time are more prone to develop CHD (Sullivan et al., 2001).
Psychosocial Factors: Stress has been related to diabetes, hypertension that are frequent accompaniment of CHD, and stress is an independent risk factor for CHD. Stress is a feeling of being out of control and being under unpleasant, seemingly unending pressure. Many situations cause stress and may be related to illness, bereavement, work problems, career issues, family relationships, personal relationships, financial affairs, and most aspects of daily life. Depression is usually part of stress that affects patients of all ages (Burg et al. for the ENRICHD Investigators, 2005). Unlike blood pressure, cholesterol, weight, blood sugar, or the number of cigarettes a person smokes, stress cannot be measured. Only the person affected knows how severe the stress is. It is subjective. Stress is dangerous for health and emotional well-being and bad for the heart. Certain forms of stress increase the chances of developing angina. Severe stress can trigger heart attacks. Researchers have long debated the role of stress in promoting heart disease, but there's a growing body of evidence that it is a risk factor (Denollet and Brutsaert, 2001). Exactly how stress harms the heart is not fully understood, but researchers do know that constant high levels of stress prompt hormonal changes that can send blood pressure and insulin levels soaring, and likely promote inflammation and other body changes that, over time, increase cardiovascular risk. Stress may also lead to depression, one of several psychological factors linked to an increased risk of a heart attack (Januzzi, Jr. et al., 2000).
Background: Many patients with CHD do not have any associated risk factors that are well known. Several studies published in the last few years have identified depression as an independent factor that increases the risk of a heart attack. Precisely how depression affects heart function is unknown, but diagnosing and treating depression is now considered an important aspect of reducing cardiovascular risk (Lett et al., 2005). This is one of the important psychosocial factors recognized. Although an impressive body