Negative emotions and coronary heart disease: Causally related or merely coexistent? A review

Negative emotions have been claimed to be a cause of coronary heart disease (CHD) as well as a consequence of cardiovascular disorders. Early case stu dies of cardiac disorders of soldiers in battle drew attention to the possi bility that strong negative emotional states could cause CHD. Subsequent re ports of reactions to natural disasters supported the notion that intense n egative emotions could precipitate somatic disorders such as CHD. Since the n, numerous studies have investigated relations between negative emotions a nd CHD. Over the years, retrospective studies have found, for example, that negative emotions are often present before the occurrence of CHD. Cross-se ctional studies have indicated that symptoms of depression and anxiety are often present in CHD patients. Prospective studies have shown that the like lihood of CHD tends to he higher for people with negative emotions than for those without them. The main symptoms of negative emotional stares that se em to be most closely associated with CHD are nervousness, getting easily u pset, feeling fatigue, being indecisive. having sleep disturbances. being u sually worried about something, and feeling that others would be better off if oneself were dead. Although the findings appear to support the notion o f causal connections between negative emotions and CHD, they fail to provid e conclusive proof of such relations. An alternative explanation that could also account for the findings is simply that negative emotions and CHD oft en coexist.