Stress: A Roundtable

Medical science monitor : international medical journal of experimental and clinical research, 2002

Evidence for a connection between stress and selected cardiovascular diseases is analyzed. Does stress cause or exacerbate cardiovascular diseases? The stress phenomenon is illustrated and the impact of stress on the circulatory system is examined. In particular, the pathophysiological significance of stress in hypertension, atherosclerosis, coronary artery disease, myocardial infarction (and others) is described. Stress plays a major role in various (patho)physiological processes associated with the circulatory system. Thereby, it potentially has ameliorating or detrimental capacities. However, with regard to cardiovascular diseases, stress most often is related to deleterious results. The specific outcome depends on multiple variables (amount of stress, duration of its influence, patient's history/predisposition, genetic components -- as they all may alter functions of the basic stress response components: the hypothalamic-pituitary-adrenal axis and the sympathoadrenal medulla...

Cardiovascular Pharmacology: Open Access, 2015

Studies on Ethno-Medicine

Of late, Coronary Heart Disease (CHD) has emerged as a major contributor to total global mortality and India accounts for about sixty percent of the world's heart disease cases. Stress has been identified as one of the psychosocial factors influencing the onset, development and progression of CHD. It is therefore important to keep stress at bay to ensure a reduction in CHD cases. The paper attempts to understand how stress leads to CHD and develop a model based on interviews with cardiologists, and review of literature. 63 doctors, from both government and private hospitals, were contacted for appointment for the interview out of which 37 agreed. In depth interviews with doctors suggested that stress has a severe impact on human hearts. Further, the medical reports provided by the doctors suggested that it is the daily hassles of life that is more responsible for chronic stress leading to heart diseases. The paper also suggests simple yet effective ways of coping stress as many times the prescriptions we get for stress management prove to be more problematic than the problem itself.

Journal of Advanced Nursing, 2003

2 0 0 3 ) Journal of Advanced Nursing 43(6), 548-554 Stress influence on genesis, onset and maintenance of cardiovascular diseases: literature review Background. Recent mortality profiles in Brazil show that circulatory diseases are the leading cause of death in Brazil. These disorders contribute to 34% of deaths, with 50% of those deaths occurring in people under 50 years of age, that is, in people who are still active in the workforce. We assume that the growing incidence of cardiovascular diseases has occurred as the globalization of Brazil continues and brings with it the associated health risk factors of modern lifestyles, including stress. Aim. This paper reports the evidence on the influence of stress in the development, onset and progress of cardiovascular diseases. We aim to define the concept of stress and to point systematically to the interrelationships between its emotional and bodily manifestations through a discussion of the history and study of stress. We then suggest that factors leading to the experience of stress in Brazil are no different than in any other modern nation. We further offer a perspective on nursing interventions currently undertaken in Brazil in both hospital and community settings, with their more recent emphasis on health promotion and prevention.

Asian Cardiovascular and Thoracic Annals, 2013

Background Coronary heart disease is the leading cause of death worldwide and accounts for 13.7% of deaths in countries like Pakistan. Its association with stress has not been well considered in our setup. Patients with coronary artery disease admitted for coronary artery bypass grafting may have a high prevalence of stress that might increase the risk of adverse outcomes. Methods 60 patients with coronary artery disease admitted to the Civil Hospital Karachi for coronary artery bypass graft surgery from January 1 to March 31, 2012, were evaluated using a stress evaluation scale. Results Stress of varying degrees was found to be a significant independent risk factor in patients with coronary heart disease. Analysis of our collected sample of patients with stress showed 60% with high stress ( p = 0.025) and 36.7% moderate stress ( p = 0.0025). An appreciable relationship was found between stress and patient age, sex, body mass index, blood group, and the incidence of myocardial infar...

Revista De Cercetare Si Interventie Sociala, 2014

The most important objective of this research was to analyze and discuss the current relationship between the level of stress perception and the consequences on cardiometabolic risk in population. The study was based on a literature review, including books, published articles and internet information, as well as on the author’s own experience in this field, regarding the most important concepts about stress, the mediators and systems involved, methods of assessment and evidences about the influences of stress on cardiac, endocrine and metabolic system. Stress and coping with stress have been identified as important variables affecting health, now recognized to be involved in pathogenesis of many diseases: cardiometabolic, respiratory and digestive pathologies, cancer, neuroendocrine and psychiatric disorders. Glucocorticoids, catecholamines, pro- and antiinflammatory cytokines and the parasympathetic nervous system are involved in the adaptation to stressors. The overload of these a...

International Journal of Epidemiology, 2002

The response of the cardiovascular system to stressful situations has long been considered to have implications for health outcomes. Both exaggerated and diminished cardiovascular reactivity to acute psychological stressors have serious consequences for health. This chapter based on my STAR 2014 Early Career Award talk will compare and discuss my research on both high and low cardiovascular responses to psychological stress. Exaggerated reactions are associated with the development of hypertension, markers of systemic atherosclerosis, and cardiovascular disease. Blunted or low reactivity is related to depression, obesity, and a range of addictions. It has been proposed that an interaction between genetics and the environment contributes to individuals' reactivity to stress. The objective of this talk is to explore cutting edge research on the pathways to the development of disease via alterations in stress reactivity. It will also highlight some of the key environmental, social, and mechanistic pathways from high and low cardiovascular reactivity to health and ill health in later life.

Current Psychiatry Reviews, 2007

Until recently it was thought that no more than 50% of clinical coronary heart disease was explicable in terms of classical cardiac risk factors such as dyslipidemia, cigarette smoking, high blood pressure and diabetes. Recent large scale epidemiological studies have increased our understanding of the mechanisms generating cardiac risk and have provided evidence indicating that psychosocial factors, including stress at work and at home, financial stress, recent major life events and the presence of depressive illness are involved here, "triggering" clinical cardiovascular events, and possibly also contributing to hypertension and atherosclerosis development. The underlying mechanisms in play are most likely multi factorial in origin, involving the autonomic nervous system, platelet activation, thrombogenesis and endothelial dysfunction. Given that strategies for preventive therapy remain largely unformulated, future research should focus on generating a better understanding of the neurobiology of psychogenic heart disease as a basis for rational and effective therapy.

Journal of Clinical Medicine, 2022

Epidemiological studies have shown that a substantial proportion of acute coronary events occur in individuals who lack the traditional high-risk cardiovascular (CV) profile. Mental stress is an emerging risk and prognostic factor for coronary artery disease and stroke, independently of conventional risk factors. It is associated with an increased rate of CV events. Acute mental stress may develop as a result of anger, fear, or job strain, as well as consequence of earthquakes or hurricanes. Chronic stress may develop as a result of long-term or repetitive stress exposure, such as job-related stress, low socioeconomic status, financial problems, depression, and type A and type D personality. While the response to acute mental stress may result in acute coronary events, the relationship of chronic stress with increased risk of coronary artery disease (CAD) is mainly due to acceleration of atherosclerosis. Emotionally stressful stimuli are processed by a network of cortical and subcortical brain regions, including the prefrontal cortex, insula, amygdala, hypothalamus, and hippocampus. This system is involved in the interpretation of relevance of environmental stimuli, according to individual's memory, past experience, and current context. The brain transduces the cognitive process of emotional stimuli into hemodynamic, neuroendocrine, and immune changes, called fight or flight response, through the autonomic nervous system and the hypothalamic-pituitaryadrenal axis. These changes may induce transient myocardial ischemia, defined as mental stressinduced myocardial ischemia (MSIMI) in patients with and without significant coronary obstruction. The clinical consequences may be angina, myocardial infarction, arrhythmias, and left ventricular dysfunction. Although MSIMI is associated with a substantial increase in CV mortality, it is usually underestimated because it arises without pain in most cases. MSIMI occurs at lower levels of cardiac work than exercise-induced ischemia, suggesting that the impairment of myocardial blood flow is mainly due to paradoxical coronary vasoconstriction and microvascular dysfunction.