Psychosomatic factors in coronary heart disease.

The concept of the "coronary personality" has been part of the clinical tradition since the turn of this century. Certain salient psychological features have now been extracted from the numerous studies; many of these are probably secondary to the somatic disease. Acute and chronic life stress seem to be associated more reliably with coronary events, and a definite behaviour pattern -- closely related with the traditional "coronary personality" and characterized particularly by hostile competitiveness -- appears to lead frequently to coronary heart disease. From the physiological mechanisms involved in this psychosomatic process those accounted for by the responses of the sympathetic nervous system seem to be most important. Certain therapeutic implications are presently under clinical evaluation particularly in the field of secondary prevention.