Anxiety and Adverse Health Outcomes Among Cardiac Patients A Biobehavioral Model
Anxiety and Adverse Health Outcomes Among Cardiac Patients A Biobehavioral Model
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DOI：
10.1097/jcn.0b013e318292b235
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发表时间：
2014-07-01
影响因子：
2
通讯作者：
Moser, Debra K.
中科院分区：
文献类型：
--
作者：
Abed, Mona A.;Kloub, Manal I.;Moser, Debra K.
背景：焦虑是急性冠脉综合征（ACS）患者的常见经历，可对健康结局产生负面影响。尽管如此，焦虑的负面作用仍然没有得到充分的认识，这反映在临床医生对焦虑的住院和非住院ACS患者的认识不足和治疗不足。对焦虑作用的低估可能与对焦虑可能对健康结果产生不利影响的机制的理解不足有关。目的：本研究的目的是综合有关焦虑和不良健康结果相关的潜在机制的证据。结论：生物行为模型将焦虑与ACS患者血栓形成和血栓事件的发生联系起来。在生物学上，焦虑可能会干扰免疫系统、血脂、自动神经系统平衡和凝血级联反应，而在行为学上，焦虑可能会对健康习惯的养成和降低心脏风险的行为产生不利影响。生物和行为途径在产生不良结果方面相互补充。临床意义：焦虑需要临床心脏病学更多的关注。通过有效的评估和治疗，可以避免焦虑对健康结果的不利影响。
Background: Anxiety is a common experience among patients with acute coronary syndrome (ACS) that can have a negative impact on health outcomes. Nonetheless, the negative role of anxiety remains underappreciated, as reflected by clinicians' underrecognition and undertreatment of anxious hospitalized and nonhospitalized patients with ACS. Underappreciation of the role of anxiety is possibly related to inadequate understanding of the mechanisms whereby anxiety may adversely affect health outcomes. Purpose: The aim of this study was to synthesize the evidence about potential mechanisms by which anxiety and adverse health outcomes are related. Conclusions: A biobehavioral model links anxiety to the development of thrombogenic and arrhythmic events in patients with ACS. Biologically, anxiety may interfere with the immune system, lipid profile, automatic nervous system balance, and the coagulation cascade, whereas behaviorally, anxiety may adversely affect adoption of healthy habits and cardiac risk-reducing behaviors. The biological and behavioral pathways complement each other in the production of poor outcomes. Clinical Implications: Anxiety requires more attention from clinical cardiology. The adverse impact of anxiety on health outcomes could be avoided by efficient assessment and treatment of anxiety.