Heart rate reactivity and variability as psychophysiological links between stress, anxiety, depression, and cardiovascular disease: Implications for health psychology interventions

While there are some data indicating that health psychologists can assist with the rehabilitation and prevention of coronary heart disease (CHD), most "psychological" interventions are aimed at variables that are some causal distance from the actual end-organ itself (i.e., the heart). However, medical focus is often towards physiological indices such as heart rate reactivity (HRR) and heart rate variability (HRV) while under stress, because these have been shown to predict both gradual arterial deterioration and sudden death. These cardiovascular indices of coronary health may also be used as treatment variables within psychological interventions for stress, anxiety, and depression. This paper describes the links that HRR and HRV make between common "psychological" presenting problems of stress, anxiety, and depression, and the more life-threatening CHD. In addition, some suggestions for potential health psychological interventions in everyday practice are made, based on the wider literature on stress, anxiety, depression, and CHD.