Psychosocial and behavioral influences in the pathogenesis of acquired cardiovascular disease.

When taken together, studies relating psychosocial and behavioral factors to cardiovascular disease phenomena provide justification for the conclusion that such factors are importantly involved. We would emphasize the need to study and evaluate the interaction of environmental and biological factors in both laboratory studies of pathogenesis as well as in clinical studies of management. Indeed, upon careful scrutiny, even the accepted "nonbehavioral" risk factors such as hypercholesterolemia, hypertension, cigarette smoking, obesity, and sedentary lifestyles are each composite manifestations rather than single pathogens whose identities are powerfully impregnanted and bolstered by varieties of behavioral and psychosocial underpinnings. In view of the awesome impact of contemporary cardiovascular disease, both in terms of its increasing socioeconomic importance and its biologic devastation, we can not long afford comprehensive public health programs without increased and improved attention to psychosocial and behavioral influences in the pathogenesis of acquired cardiovascular disease.