How do psychosocial factors affect heart health? Heart-related health problems are a leading cause of death in industrialized areas of the Western world.1 Psychosocial factors such as stress and anxiety are often overlooked, but they play an important role in the development of heart disease. These factors are mostly manageable and help reduce the risk of heart disease. This article aims to discuss the influence of these psychosocial risk factors on cardiac health using the results of epidemiological and pathophysiological studies. Management of these risk factors will also be discussed. This will help to understand the psychosocial factors that may have affected Mr. Petersen's health and his difficulty making changes to his lifestyle. Risk Factors There are many risk factors for heart problems; these can be classified as modifiable and non-modifiable. Non-modifiable risk factors include family history, age and gender while modifiable risk factors include smoking, unhealthy diet, sedentary lifestyle, obesity, hypercholesterolemia and hypertension. One aspect of modifiable risk factors that is often overlooked are psychosocial risk factors, including: stress, anxiety, and other negative emotional states such as anger, depression, and social isolation.1 Anxiety and stress will be discussed in more detail. Social and cultural factors also influence heart disease. We live in a Westernized culture where fast food and a sedentary lifestyle prevail, which increases some risk factors. Socioeconomic status and finances can increase stress or anxiety in a person and indirectly also increase heart disease risk factors. Anxiety and stress Anxiety and stress are often...... half of the document ...... Co; 2009. 19-28.4. Helman CG. Cultural aspects of stress and suffering. Culture, health and disease. 5th ed. London: Hodder Arnold Publishing; 2007.289-293.5. Taylor S. Heart disease, hypertension, stroke, and type II diabetes. Health psychology. 8th ed. Los Angeles: McGraw Hill; 2011. 311 – 337.6. Rozanski A, Blumenthal J, Davidson K, Saab P, Kubzansky L. The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice: the emerging field of behavioral cardiology. 2005; 45(5):637-651.7. Stress and anxiety. [online]. 2011 [cited in 2014, April 21]. Available from: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm.8. Das S, O'Keefe JH. Behavioral Cardiology: Recognizing and Addressing the Profound Impact of Psychosocial Stress on Cardiovascular Health. Current reports on atherosclerosis. 2006; 8: 111-118.