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Behavioral and Psychological Processes in Ischemic Heart Disease

Robert F. Klein, MD
Arch Intern Med. 1977;137(12):1672-1673. doi:10.1001/archinte.1977.03630240008006.
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The morbidity and mortality associated with ischemic heart disease remain health problems of major proportions and require continuous effort toward prevention. Although primary prevention is the ideal goal, secondary prevention, or that which occurs when persons with clinical manifestations modify their life style or risk factors and reduce the incidence of subsequent illness events, is also desirable. Thus, recovery, or rehabilitation, exerts preventive influences. Physicians and nurses who care for patients with ischemic heart disease have an opportunity here. The article by Stern et al in this issue (p 1680) reports that a behavioral state, characterized primarily by persistent depression, is associated with a higher rate of hospital readmission for reinfarction, coronary insufficiency, or infarct-related physical complications. Persistently depressed patients also showed a lower level of vocational and sexual function one year after infarction. This disclosure of a behavioral correlate of morbidity is not surprising in view of the considerable


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