ANXIETY AND CARDIOVASCULAR AUTONOMIC CONTROL

描述：前瞻性流行病学数据显示， 慢性焦虑和/或焦虑症与高血压风险的关系 心源性猝死。其他研究表明，心脏自主神经 稳定焦虑的个体在这个方向上的机制发生了变化 副交感神经减少而交感神经控制力升高。后者 然而，调查是基于非常小的临床样本和 他们对心血管调节的评估是不完整的 焦虑。拟议研究的目标是评估这一假说。 慢性焦虑和/或焦虑症会导致多动症 心血管自主神经调节，通常与 冠脉风险。 该项目将使用一个正在进行的特点良好的队列，退伍军人管理局 规范老龄化研究(NAS)，招募中老年社区- 住进书房的男人和女人。使用各种经过验证的 心理和精神筛查工具--包括Brief 症状清单、综合国际诊断访谈、 斯皮尔伯格状态-特质焦虑量表，以及皇冠-脆度指数-- 研究人群将以以下症状为特征 焦虑和焦虑症的诊断。心血管自主神经 然后在焦虑和非焦虑的个体中评估控制力 使用无创的心率的时域和功率谱测量 和血压变异性。心输出量，外周总输出量 将同时评估阻力和呼气末二氧化碳分压。这 调查将是第一次大规模的以人口为基础的研究 检查心血管生理学方面的焦虑，并应增加 一个人对焦虑和焦虑之间的联系的理解 心源性猝死。这项研究可能会进一步帮助识别 猝死风险增加的普通人群。

DESCRIPTION: Prospective epidemiologic data indicate a strong relationship of chronic anxiety and/or anxiety disorders to risk of sudden cardiac death. Other studies have shown that cardiac autonomic mechanisms are altered among stably anxious individuals in the direction of reduced parasympathetic and elevated sympathetic control. The latter investigations, however, have been based on very small clinic samples and been incomplete in their assessment of cardiovascular regulation in anxiety. The goal of the proposed study is to evaluate the hypothesis that chronic anxiety and/or anxiety disorders result in hyperkinetic cardiovascular autonomic regulation, often associated with increased coronary risk. The project will use an ongoing well-characterized cohort, the VA Normative Aging Study (NAS), to recruit middle-aged and older community- dwelling man and women into the study. Using a variety of validated psychological and psychiatric screening instruments--including the Brief Symptom Inventory, the Composite International Diagnostic Interview, the Spielberger State-Trait Anxiety Inventory, and the Crown-Crisp Index-- the study population will be characterized in terms of symptoms of anxiety and diagnosis of anxiety disorders. Cardiovascular autonomic control will then be assessed among anxious and non-anxious individuals using non-invasive time-domain and power-spectral measures of heart rate and blood pressure variability. Cardiac output, total peripheral resistance, and end-tidal pCO2 will be simultaneously assessed. This investigation will be the first large-scale population-based research examining the cardiovascular physiology of anxiety, and should increase one's understanding of the reported association between anxiety and sudden cardiac death. This study may further help to identify groups in the general population who are at increased risk of sudden death.