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Primary care clinicians can help reduce the risk of cardiovascular disease in patients by addressing psychological needs to decrease stress and distress across the lifespan, indicate study findings published in the Journal of the American College of Cardiology.
E. Alison Holman, PhD, FNP, of the University of California at Irvine, and colleagues analyzed data from 6,714 individuals who were born in the United Kingdom in 1958 within the same one-week birth cohort. Data was collected during the next 45 years to see if early reported distress in childhood would affect the cardiovascular disease (CVD) outcomes in adulthood.
The data taken from a differential attrition analysis during the study showed that distress in childhood contributes significantly to cardiometabolic risk later in life. “The findings send a clear and important message that childhood distress, even if it remits in adulthood, may signal early CVD risk,” Dr. Holman noted.
Researchers know little about the connection between childhood experience and CVD outcomes, despite the fact that stress and psychological distress are known CVD risk factors. Dr. Holman suggested that additional research could help to target certain interventions in childhood to help patients manage stress and avoid CV risk, and to determine how adversity and adversity-related distress each independently contribute to cardiometabolic risk.
Furthermore, researchers must compare psychological distress and cardiometabolic risk at different ages throughout childhood to determine if there is a specific period when CVD risks are particularly strong. This would also suggest that there are certain periods during childhood when distress may cause irreversible physiological, emotional, or behavioral stresses that can increase CVD risk.
According to DR. Holman, each phase of life requires different interventions to prevent CVD. Additional research could help to target specific time periods in childhood when interventions would be critical to prevent increased cardiometabolic risk.
The study findings also suggests that there is an association between psychological and physiological factors that contribute to cardiometabolic risk across the lifespan. Future studies should examine the roles of specific symptoms such as anxiety, depression, or panic. “This study reminds us that we must seriously address our patients’ psychological needs if we want to prevent CVD-related pathology,” the researchers wrote.
It can be difficult for clinicians to address psychological concerns when they have to encourage patients to manage other risk factors like smoking, obesity, elevated cholesterol, and lack of exercise. However, when clinicians avoid addressing those concerns, patients may indulge in unhealthy behaviors and actually increase their CVD risk.
“Building trust by accepting where our patients are in their change process and supporting them to make the changes that they are ready to make will likely decrease the distress they experience in the visits and improve our relationship with them over time,” Holman concluded. “This is perhaps the best, most immediate way we can apply these findings—by using more caring, compassionate approaches to patient communication.”
