Researchers are shedding new light on the relationship between psychosocial factors and heart disease. A study, recently published in Arthritis Care & Research has found that depressive symptoms, stress, anxiety, and anger and lack of social support in patients with rheumatoid arthritis (RA) were linked to atherosclerosis.
“Understanding the risk factors that lead to greater mortality in those with chronic conditions like RA is extremely important, ” explains lead investigator Jon Giles, M.D., M.P.H., assistant professor of medicine at Columbia University, College of Physicians & Surgeons in New York City, in the August 13, 2015 news release. “Our study is the first to investigate the association between psychosocial comorbidities and elevated risk of atherosclerosis in RA patients.”
Dr. Giles told OTW, “We were most surprised at the magnitude of the associations of many of the psychosocial comorbidities (such as anger and anxiety) with measures of atherosclerosis and how much they were different in RA patients from those of the non-RA controls.”
“Our study was cross-sectional and involved patients with all stages of disease. Future work would explore the effects of psychosocial comorbidities on cardiovascular disease following patients from the early stages of disease onward. Also importantly, it is not known whether treating depression, anxiety, and other negative mood states has the potential to lessen cardiovascular risk in RA patients.”
Asked if orthopedic surgeons should involve social workers in these patients’ care, Dr. Giles commented to OTW, “I don’t think there is enough evidence yet to support causation over association, and as mentioned above, whether treating anxiety and depression affects outcomes reduces cardiovascular risk is not yet known. However, it would not be unreasonable to try to identify and refer patients with psychosocial comorbidities for more than just cardiovascular risk reduction, since negative emotional states also affect subjective reporting of body pain, impair physical functioning, and overall reported well-being.”
