The data reported in the study by Prugger et al. are undoubtedly of outstanding interest for making the argument in favor of stronger funding for preventive medicine (1).
In common with previous studies (2), the authors emphasize again that restating the classic cardiovascular risk factors did not succeed in modifying patients’ behaviors. We think that this lack of translating theory into practice results in a certain inevitability in focusing on the psychosomatic roots of adverse lifestyle habits, so that pointing out the high importance of psychological and psychosomatic roots in such an article would be much welcomed. It seems easier to just focus on epidemiological data, although these provide only the foundation for effective measures. Ladwig et al (3) mentioned the eminent importance of psychocardiology in a position paper as early as 2008. A current prospective study in our own institution (4) shows the high incidence of anxiety and depression in patients with aortocoronary bypass.
The change in lifestyle factors that was mentioned in the article is not possible in a sustained fashion without influencing the psychosomatic roots.
The future for preventive strategies thus seems to lie primarily in the evaluation and intervention of the psychosomatic disorders underlying the classic risk factors.
Footnotes
Conflict of interest statement
Professor Korbmacher has been reimbursed for conference delegate fees by Orion. He has received speaker honoraria and honoraria into a third-party account of the Klinik für Kardiovaskuläre Chirurgie (the Department for Cardiovascular Surgery) from MSD. Dr Schäfer has been reimbursed for conference delegate fees and travel expenses by the Institut für Seelische Gesundheit und Prävention e.V. (the institute for mental health and prevention). He has received moneys into a third-party account of Düsseldorf University from PALME Plus.
References
- 1.Prugger C, Heidrich J, Wellmann J, et al. Trends in cardiovascular risk factors among patients with coronary heart disease: results from the EUROASPIRE I, II, and III surveys in the Münster region. Dtsch Arztebl Int. 2012;109(17):303–310. doi: 10.3238/arztebl.2012.0303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Lenfant C. Shattuck lecture - clinical research to clinical practice - lost in translation? N Engl J Med. 2003;349:868–874. doi: 10.1056/NEJMsa035507. [DOI] [PubMed] [Google Scholar]
- 3.Ladwig KH, Lederbogen F, Völler H, et al. Positionspapier zur Bedeutung von psychosozialen Faktoren in der Kardiologie. Kardiologe. 2008;4:274–287. [Google Scholar]
- 4.Korbmacher B, Ulbrich S, Dalyanoglu H, et al. Perioperative and long-term development of anxiety and depression in CABG-patients. Thorac Cardiov Surg. 2012;60 doi: 10.1055/s-0032-1333326. [DOI] [PubMed] [Google Scholar]