Effects of Multimodal Interventions for Primary Prevention of CVD on Depression, Anxiety, and the Type D Personality

Abstract

Psychosocial risk factors like depression, anxiety, and the type D (“distressed”) personality are associated with an earlier development and faster progression of cardiovascular disease (CVD). Thus, they may be targets to primary prevention interventions, but evidence is sparse. In a line with comparable clinical trials, the German PreFord study, a randomized-controlled trial (RCT) to evaluate guideline based primary prevention of CVD, did not provide evidence that these psychosocial risk factors can be effectively treated by multimodal behavioral interventions. These null results in primary prevention contrast with findings obtained in secondary prevention. Up to now, it is not possible to assess whether the lack of effect of previous trials on psychosocial risk factors is primarily attributable to the structure and/or the content of the interventions or whether other effects may be responsible. However, recent evidence supports the necessity for more targeted approaches.