Table Of ContentMarlies E. Alvarenga
Don Byrne
Editors
Handbook of
Psychocardiology
1 3
Reference
Handbook of Psychocardiology
(cid:129)
Marlies E. Alvarenga Don Byrne
Editors
Handbook of
Psychocardiology
With95 Figuresand36Tables
Editors
MarliesE.Alvarenga DonByrne
MonashHEART,MonashCardiovascular ANUMedicalSchool
ResearchCentre CollegeofMedicineBiologyand
MonashHealthandDepartmentofMedicine Environment,AustraliaNationalUniversity
(SCSatMonash) Canberra,ACT,Australia
MonashUniversity
Melbourne,VIC,Australia
ISBN978-981-287-205-0 ISBN978-981-287-206-7(eBook)
ISBN978-981-287-207-4(printandelectronicbundle)
DOI10.1007/978-981-287-206-7
LibraryofCongressControlNumber:2016936690
#SpringerScience+BusinessMediaSingapore2016
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Foreword
Thephrase“heartsandminds”rollsoffthetonguewitheaseandaconvictionthatthe
two are faithfully linked. Risk factors for heart, stroke, and vascular disease have
deeply rooted social and behavioral determinants. People with depression or other
majorpsychiatricillnessaremorelikelytodevelopcardiovasculardiseaseeitherde
novo or as a consequence of the treatment they receive. People with acute cardiac
disease are faced with the possibility of mortality or future disability and it is no
surprisethiscarriesasignificantpsychologicalburden. Thisisacomplex two-way
relationship.
Our knowledge of psychocardiology is increasing rapidly as new tools become
available and the new biology including imaging, omics, and other techniques are
applied to help unravel the links between brain function, the autonomic nervous
system, and the circulation. This book is very timely in addressing a fast moving
fieldwheretherearesignificantchallengesforthefuture.
The burden of cardiovascular disease is increasing worldwide associated with
development, the stresses associated with globalization, and the socioeconomic
gradientsthatoccur.Obesityisontheriseanditsmetabolicconsequencesincluding
diabetesarecloselyrelatedtobehaviorandtofuturecardiacandvasculardiseases.In
developed economies, increasing longevity is giving rise to concerns about the
future burden of dementia. About half of dementia is vascular in origin and the
risk factors for the other half overlap closely with the classical cardiovascular risk
factors.
These andmany other subjects aredealt withinthis book. ProfessorByrne and
Dr.Alvarengahavemadesignificantcontributionstothefieldthemselvesandthey
have assembled an impressive list of authors toproduce a comprehensive resource
forallthoseinterestedinthefield.
The book provides a firm basis for the development of the science of cardiac
psychologyintheopeningsection,providingahistoricalperspective,anoutlineof
the causes, pathophysiology, and role of tobacco smoking, alcohol, and other
lifestyleaspects.Thisisfollowedbyanaccountofthepsychopathologyassociated
with cardiovascular disease, including depression, anxiety, and stress as well as
psychosesandmorespecificandcontemporaryissues suchasposttraumaticstress,
occupational stress, and the stress associated with cardiac disease itself and its
various remedies, particularly surgery. Special populations are particularly
v
vi Foreword
susceptibletobothcardiovasculardiseaseanddepression,andtherearechapterson
indigenous populations, refugees, the poor, and the homeless. These well-known
social determinants of cardiovascular disease are most likely linked by stress,
depression, and associated factors. Controversies on personality and propensity to
developheartdiseasearethesubjectofotherchaptersofthebook.Finally,thereisan
ambitious attempt to explain these associations through the neurobiology of psy-
chologyandofcardiovasculardisease.
This isa comprehensive examination of a complex but important issue, and the
editors have not shirked any of the innate, social, psychological, or biomedical
factors involved. It will no doubt find a place as a valuable resource for all those
interestedinthefield,crossingdisciplinaryboundariesandstimulatingnewworkin
thearea.
GarryJennings
Melbourne,Australia
Preface
In September 2008, the inaugural Heart and Mind: Psychogenic Cardiovascular
Disease Conference was held in the beautiful town of Prato in central Italy. The
conferencewasheldundertheauspicesofthe(then)BakerHeartResearchInstitute
(nowtheBakerIDIHeartandDiabetesInstitute)inMelbourne,Australia,andwas
the product of a fruitful collaboration between an eminent cardiologist (Professor
Murray Esler) and a clinical psychologist (Dr. Marlies E. Alvarenga). The confer-
encebroughttogetheratrulyinternationalparticipationofaround150activescien-
tists and clinicians from diverse disciplinary backgrounds to consider the evidence
linking psychological factors with cardiovascular disease (CVD), and the proceed-
ings were published in a Special Issue of the journal Stress and Health (Volume
24,Issue3)undertheeditorshipofProfessorGrahamBurrows,apsychiatrist.Two
furthermeetingsofwhathadbythenbecomesimplyandfondlyknownasthePrato
Conference were held in 2010 and 2012, and extended this collegial sharing of
knowledge and wisdom to define in clear terms the new and exciting field of
psychocardiology. The two editors of this current volume had the significant priv-
ilege (and the great pleasure) of taking part in both the inaugural and subsequent
Prato Conferences, and from those meetings – and many other discussions we had
between 2008 and 2010 – the idea that this knowledge and wisdom should be
tapped,documented,andputbetweenhardcoverswasborn.
TheHandbookofPsychocardiologythenistoourknowledgetheonlycurrently
availablecompendiumof evidenceandpractice whichhasboth systematicallyand
comprehensivelyaddressedtheroleofpsychologicalandbehavioralfactors,broadly
defined, in the genesis, clinical course, and management of CVD. In bringing this
about, the Handbook has striven to address four areas in the overall domain of
CVD – epidemiology, stress and psychopathology, psychobiological mechanisms,
andpatientmanagement–which,onthefaceofit,mayappeartobequiteseparate,
butwhich(webelieve)areintricatelyinterrelatedtooneanother.Andinbriningthis
material together, we have held as our dominant objective the establishment of
psychocardiology as an emerging force majeure in the field of CVD. To achieve
this,ithasbeenouraimfromtheverybeginning–andoneinwhichwebelievewe
havewellsucceeded–toseekchaptersfromscientistsandcliniciansofpreeminent
international distinction in each of the fields of the basic biomedical sciences,
cardiology andcardiovascularbiology(of course),psychiatry andpsychology,and
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viii Preface
epidemiology. We have sought to question the rigidity of the boundaries between
these disciplinary areas and to suggest, instead, that those boundaries are in fact
surprisingly porous. We (as the Handbook’s editors) see the field of
psychocardiology asatrulyconstructive intermingling ofthese seeminglyseparate
areas of investigation and discourse – a new field in which the Gestalt principle is
beautifullyillustrated,thatthewholeisindeedgreaterthanthesumoftheparts.But
naturally,thesuccessofthisobjectivewillbeforthereadertojudge.
In our respective careers in psychocardiology, we have each, at various times,
beensofortunatetohavebeeninthecompanyofsomerealgiantsinthearea.Oneof
us(MA)hashadthebenefitofworkingcloselywithProfessorMurrayEsler,andhis
quitepioneeringresearchonbringingcardiologytogetherwithpsychologyhasbeen
inspirational. And for theother ofus(DB),the opportunitysome timeago tohave
researched and published with one of the true (perhaps grand) parents of cardiac
psychology,thelateDr.RayRosenman,wasanundeservedbutdeeplyappreciated
privilege,andaformativeexperiencenevertobeforgotten.
Anumberofcolleaguesgenerouslyreviewedchaptercontentforus,andweare
grateful in particular to Professor Murray Esler (Prof. Murray D. Esler, Senior
Director, BakerIDI Heart and Diabetes Research Institute, Melbourne, Australia)
and Dr. Miguel A. Fernandez Rubio (Dr. Miguel A. Fernandez Rubio, Unit Head,
Youth ELMHS, and Consultant Psychiatrist, RAPP Team, Monash Health, Mel-
bourne,Australia)forclearreviewsofchapterswheretheformalcontentexceeded
our levels of expertise. At a more informal level, very useful comments on some
chaptersweregiventousbyanumberoffriendsandcolleaguesinthearea,andwe
arealsogratefultoeachfortheirvaluableinput.
Wealsoconsideritamatterofgreatfortunetohavebeenacceptedbyapublisher
as prominent in the field as Springer. The Handbook was commissioned by
Dr. Mokshika Gaur and we are grateful indeed that she first saw merit in the work
and then placed her faith in us to bring it to a successful conclusion. The Springer
editorial team (Ms. Keerthi Sudevan,Ms. NiveditaBaroi,and Ms.Indu MG) have
beenanoutstandingsupporttousthroughoutthepublicationprocess–andwecould
nothavebeenblessedwithamoreconsummatelyprofessionalgroup.Theirorgani-
zational skills, editorial acumen, attention to details which had escaped us, and so
importantlytheirexceptionalpatiencewhenprogressdidnotseemtobehappening
atourendoftheenterprisewassooftenabletoallayourownfrequentanxietythat
theworkwouldneverquitecometogether.Andsowethankyou–eachofyou–so
much!
AworksuchasthisHandbookwouldnot,however,havecometogetheratallhad
itnotbeenforthescholarlyeffortsofourauthors.Asonemightexpectfromawork
of this magnitude, there are so many of them to thank. As working scientists and
clinicians ourselves, we well know the pressures that face eminent and productive
people in universities and health care facilities across the world. There are always
oftendauntinglylargenumbersofstudentstoteachandsupervise,grantapplications
to write, data to collect and papers to publish, patients to treat with great skill and
care,andseeminglyendlessadministrativetaskstocomplete.Yetinthefaceofthis
workload,ourauthorsgenerouslysharedwithustheirscholarship,theirexperience,
Preface ix
and their own particular visions for psychocardiology. And from our own experi-
ence, where scholarly writing has often taken precedence over relaxation, we
confidently predict that their contributions to the Handbook were so often done
“outofhours.”Wearesincerelygratefultothemforthis–anditisonsuchwillingly
shared wisdom that the Handbook’s value to cardiac psychology will ultimately
stand.
September2015 DonByrne
Canberra
MarliesE.Alvarenga
Melbourne
