The focus of this review article is to examine the importance of psych
ological and social factors in the development and maintenance of card
iovascular diseases, primarily coronary heart and artery disease, and
to provide an overview of the effectiveness of psychosocial risk reduc
tion interventions. First we summarize the prevalence and economic bur
den of cardiovascular disease, as well as the role of psychosocial fac
tors in disease development and progression. We then examine the prima
ry modifiable risk factors and evaluate the role of psychotherapists i
n the treatment of heart disease. Finally, we assess the effectiveness
of risk factor modification and rehabilitation interventions, describ
e the potential costs and benefits of these programs, and discuss the
role of primary prevention programs.