Physical activity and psychosocial variables in atherosclerosis.

The clinical consequences of atherosclerosis differ substantially by time, by place and by person. The between population variation can largely be explained by differences in the classical risk factors. Within a population it becomes more difficult to predict atherosclerosis risk solely on the basis of blood pressure, serum cholesterol and smoking. On the individual level risk prediction becomes even more hazardous. Among the long list of less well documented or more controversial risk indicators physical activity and psychosocial variables are of prime importance. In epidemiological research the association between physical inactivity and atherosclerosis is modest compared to the classical risk factors. Physical inactivity does not necessarily precede the atherosclerosis process. However a majority of prospective epidemiological surveys performed has found physical inactivity to be a risk factor. The ability of physical inactivity or physical fitness to predict atherosclerosis events has been reproducible when applied crossculturally but the consistency with clinical pathological studies is poor. Regular exercise most likely helps to decrease other risk factors. Therefore the inclusion of regular exercise in one's life style makes good sense for many reasons. Concerning the psychosocial variables there is overwhelming evidence to accept that they play a role in the development of atherosclerosis as well as in the occurrence and recurrence of its clinical consequences. However major problems exist to quantify in a standardized way these psychosocial factors across or within populations and in a given individual. Various hypotheses relating atherosclerosis to stress, social support, personality pattern, psychological traits or life events have been tested in epidemiological, experimental and clinical studies. In a majority of these, significant associations were found.(ABSTRACT TRUNCATED AT 250 WORDS)