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[Stress as a cardiovascular risk factor].

Stress is a reaction of the organism to a stressor with various negative health consequences including the development of arteriosclerosis. Stress may cause myocardial ischemia, rhythm disturbances, platelet stimulation, increased blood viscosity through hemoconcentration as well as endothelial dysfunction and coronary vasoconstriction in the presence of arteriosclerosis of the coronary arteries. Psychosocial risk factors may also lead to the development and to clinical consequences of arteriosclerosis. The five most important psychosocial risk factors are: depression, anxiety, personality factors, social isolation and chronic life stress. Various components are responsible for the fact that life events or certain psychosocial factors can lead to a stress reaction. Psychosocial risk factors have direct pathophysiologic effects but also influence life style and behavior Various stress management intervention programs have proven to be effective. Psychosocial intervention in conjunction with cardiac rehabilitation programs has shown to reduce cardiovascular morbidity and mortality.