This paper first gives a selective and critical review of conventional sociological variables included into epidemiologic and clinical studies of ischemic heart disease (IHD). In a second section, links between social and biological processes are discussed, and a conceptual sociological approach is developed which relates critical experiences of active distress to impaired long-term control of social status. This approach is elaborated to some extent in order to illustrate possible avenues of future research which strengthen cross-fertilization between medical and social sciences.