Biological and psychosocial risk factors in ischaemic heart disease: Empirical findings and a biopsychosocial model

The objective of this research was to investigate simultaneously biological and psychosocial risk factors in groups of 187 male ischaemic heart disease (IHD) patients and 187 controls. Initially, a multivariate logistic regression was used to compare the two groups on 11 standard biological and 7 suggested psychosocial risk factors. The multivariate regression model supported altogether 9 risk factors for IHD: 5 individual ones with sensitisation amongst them and 4 interactions of risk factors including a synergistic one between neuroticism and smoking. Next, the principal component analysis of all 18 (11 biological and 7 psychosocial) was used to extract 4 biopsychosocial and 2 biological correlates of IHD risk factors. It was concluded that psychosocial coronary proneness plays an important role in predicting IHD, even after taking into account the main, most notably atherogenic, biological risk factors. Two potential mechanisms of psychosocial pathogenicity have been suggested, notably alterations in health related behaviours and behaviourally evoked perturbations of neuroendocrine responses. Moreover, the presence of synergistic psychobiological interaction between neuroticism and smoking suggests the involvement of the former risk factor in sudden deteriorations in the coronary flow due to vasoconstriction. The results and related implications are consistent with the present knowledge about the risk of developing IHD.