Threat to social status and cardiovascular risk

An approach focusing on the detrimental role of fundamental threats to one's social status for cardiovascular pathology is briefly outlined. Recent findings of epidemiologic studies in humans and experimental studies in monkeys are interpreted in this framework. Results of a large retrospective case-control study on 380 male patients with clinically documented first acute myocardial infarction (AMI), aged 30-55, and matched controls show a significantly higher percentage of subjects experiencing occupational downward mobility, forced occupational change, and recent cut-down in personnel combined with increased work load in the patient group. Finally, first results of an ongoing prospective study on blue-collar workers are presented indicating predictive power of these social stressors for new AMI cases if combined with indicators of a critically lowered coping threshold.