Psychological stress and cardiovascular disease
Psychological stress and cardiovascular disease
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DOI：
10.1016/j.jacc.2007.12.024
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发表时间：
2008-04-01
影响因子：
24
通讯作者：
Dimsdale, Joel E.
中科院分区：
文献类型：
--
作者：
Dimsdale, Joel E.
有大量关于心理压力和心血管疾病的文献。这份报告回顾了定义压力的概念问题，然后从急性应激源和长期应激源对心功能的影响方面探讨了应激的影响。急性应激源研究的例子在灾害(地震)和实验应激生理学研究的背景下进行了讨论，这些研究提供了关于潜在生理学的更详细的视角。对慢性压力源的研究从工作压力、婚姻不幸福和照顾负担的角度进行了讨论。从所有这些研究中，有大量的数据表明应激源对各种病理生理变化的贡献，包括猝死、心肌梗死、心肌缺血和室壁运动异常，以及以交感神经系统活动和止血变化为指标的心脏调节变化。尽管压力源会触发事件，但不太清楚的是，压力“导致”了这些事件。然而，有压倒性的证据表明，压力对心脏的有害影响，以及脆弱性和复原力因素在放大或抑制这些影响方面发挥了作用。有许多方法可以用于压力管理，可以减少患者的痛苦，提高他们的生活质量。
There is an enormous amount of literature on psychological stress and cardiovascular disease. This report reviews conceptual issues in defining stress and then explores the ramifications of stress in terms of the effects of acute versus long-term stressors on cardiac functioning. Examples of acute stressor studies are discussed in terms of disasters (earthquakes) and in the context of experimental stress physiology studies, which offer a more detailed perspective on underlying physiology. Studies of chronic stressors are discussed in terms of job stress, marital unhappiness, and burden of caregiving. From all of these studies there are extensive data concerning stressors' contributions to diverse pathophysiological changes including sudden death, myocardial infarction, myocardial ischemia, and wall motion abnormalities, as well as to alterations in cardiac regulation as indexed by changes in sympathetic nervous system activity and hemostasis. Although stressors trigger events, it is less clear that stress "causes" the events. There is nonetheless overwhelming evidence both for the deleterious effects of stress on the heart and for the fact that vulnerability and resilience factors play a role in amplifying or dampening those effects. Numerous approaches are available for stress management that can decrease patients' suffering and enhance their quality of life.