A myocardial infarction (MI) – potentially the most acute manifestation of coronary heart disease (CHD) – may be a devastating event. Its onset can be sudden, distressing and potentially life-threatening. Even if this is not the case, knowledge of disease status can trigger strong and frequently long-term emotional reactions as well as acting as a catalyst for risk behaviour change. As a consequence, it has been the focus of much of the psychological research in CHD.

Behavioural change

An infarction does seem to trigger appropriate behaviour change, although some changes may be relatively short-term. Hajek et al. (2002), for example, found that 6 weeks following MI, 60% of former smokers who did not intervention were reported to be not smoking. One year after MI, the figure had dropped to 37%. Similarly, Dornelas et al. (2000) found 43% and 34% of patients not receiving any form of intervention were abstinent at 6 and 12 months respectively. Of note, here, was the finding by Scott and Lamparski (1985) that only patients who believed that smoking contributed to their cardiac problems were likely to maintain abstinence. Diet may also change in the short-term (Bennett et al., 1999), although old habits may creep back over time. Leslie et al. (2004), for example, found the target of their nutritional programme of 5 portions of fruit and vegetables per day was achieved by 65% of participants involved. Thirty-one percent of their control group achieved this goal.