Psychological status is associated with cardiovascular health and prognosis, and clinicians should consider psychological health in evaluation and management of patients with or at risk for cardiovascular disease, according to an American Heart Association (AHA) scientific statement published Jan. 25 in Circulation.

The document, led by Writing Group Chair Glenn N. Levine, MD, FACC, identifies and reviews studies that link psychological health with cardiovascular health, risk and disease. Specifically, the statement looks at negative psychological health; positive psychological health; pathways linking psychological health and cardiovascular disease; interventions for psychiatric disorders or symptoms to improve cardiovascular health; and interventions to promote psychological well-being and improve cardiovascular health. In addition, the statement explores implications for clinical practice and future research.

According to the statement, data show "clear associations" between psychological and cardiovascular risk and there is "increasing evidence that psychological health may be causally linked to biological processes and behaviors that contribute to and cause" cardiovascular disease. The statement advises psychological screening of patients with or at risk of cardiovascular disease, noting that clinical cardiology visits can be used to assess psychological factors that may affect cardiovascular health.

Moving forward, research is needed to determine which psychological health factors place patients at greatest cardiovascular risk, the mechanisms by which psychological health can positively or negatively affect cardiovascular risk and disease, and the most effective interventions.

"[Cardiovascular disease] should not be addressed as an isolated entity but rather as one part of an integrated system in which mind, heart and body are interconnected," Levine, et al., write. "Clinicians should strive to treat not just the disease state but the patient and the person as a whole," they conclude.

Keywords: Cardiovascular Diseases, American Heart Association, Risk Factors, Cardiology, Mental Health, Cardiovascular System, Mental Disorders

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