There's an association between psychosocial factors, such as stress, depression, hostility, and social isolation, and risk for adverse cardiac events, especially for individuals who already have heart disease.

Peripheral Artery Disease

Peripheral Artery Disease (PAD) is the narrowing of arteries in areas of the body not near the heart-most commonly the pelvis and legs. Individuals develop PAD when plaque builds up in the arteries and limits the flow of blood to these areas. It is similar to coronary artery disease and carotid artery disease, which is the narrowing of arteries to the heart and brain, respectively.

PAD is a serious condition. Patients with PAD are far more likely to suffer a heart attack or stroke and, left untreated, PAD can lead to gangrene or amputation.

The symptoms of pad include cramping, pain, and tiredness in the legs or hip muscles while walking or climbing stairs. Physicians diagnose PAD through physical exam, imaging techniques, and checking pulse and blood pressure in the legs. Unfortunately, PAD is often under-diagnosed.

PAD and Depression

According to the National Heart Lung and Blood Institute, psychosocial risk factors for cardiovascular disease and physical risk factors tend to cluster in individuals and groups of individuals. Experts believe these factors probably interact to increase an individual's risk of disease. Psychosocial factors may contribute to risk of cardiovascular disease through their effect on physical risk factors. In other words, people who are depressed or hostile may engage in behaviors, such as smoking or consuming a poor diet, which may increase their physical risk factors.

Personality type may play a role as well. In an analysis of nine studies that included patients with different types of heart disease (including PAD), having Type D personality was associated with an almost four times greater risk for poor long-term prognosis. The researchers believe biology related to stress, such as the release of stress hormones, potentially play a role in increasing the risk of cardiovascular events. Individuals with Type D personality tend to experience negative emotions, such as anxiety, depression, and stress, and are often socially inhibited. An analysis of 11 additional studies also showed that Type D personality is associated with a three times greater risk of emotional distress, including poor mental health, anxiety, and depression.

You can reduce your risk of PAD by quitting smoking, remaining active, and controlling other diseases, such as diabetes, through diet and lifestyle modifications.


Neale, Todd. "Depression Linked to PAD." MedPage Today. Web. 20 April 2012.

American Heart Association. "About Peripheral Artery Disease (PAD) ." Web. 29 Mar 2012.

National Heart, Lung, and Blood Institute. "Task Force Report on Research in Prevention of Cardiovascular Disease." Web. October 2001.

National Heart, Lung, and Blood Institute. "FACT BOOK FISCAL YEAR 2011." Web. February 2012.

O'Riordan, Michael. "'Distressed"Personality Heart-Disease Patients at Increased Risk of Future Events." Medscape Medical News. Web. 14 September 2010.