CARDIOVASCULAR AUTONOMIC CONTROL IN STRESS AND ANXIETY

描述(改编自申请者摘要)：这是一份申请 获得研究心血管自主神经的独立科学家奖(K02) 控制压力和焦虑。它是基于一个研究项目，该项目 重点是探索心理/行为之间的关系 焦虑、敌意、抑郁和身体状况等特征 调节、中枢和自主神经系统，以及 心血管和呼吸系统。 该应用程序提出了一系列实验，该实验源自一个模型 通过以下方式将血压变异性(BPV)确定为潜在的机制 哪些心理/精神因素和健康行为赋予 增加冠状动脉疾病(CAD)和灾难性心脏病的风险 事件。虽然有证据表明焦虑等心理因素， 抑郁和敌意与冠心病风险的增加有关， 这些因素发挥致病作用的机制只是 人们对此知之甚少。我们的模型认为心脏的自主控制 对血液中的波动起缓冲或抑制作用 压力，最近血管生物学和动力学的研究表明 可能对内皮细胞有致病作用，在这种情况下 在灾难性心脏疾病的情况下，动脉粥样硬化的形成和斑块稳定性 事件。我们最近已经证明，在心理状态下 压力，这些血压波动的幅度是相反的 心脏自主控制的与心脏自主控制程度有关的，由 心脏周期变异性(HPV)。因此，在受试者中， 心脏自主神经控制，血压波动很小，而 在控制力水平较低的受试者中，它们会显著增加。 由于心理/行为特征如焦虑、抑郁、 和敌意已被证明与较低水平的HPV有关， 这些特征可能与解除血压抑制有关。 在休息时，或者更有可能是对心理反应的摆动 压力。总而言之，这些发现表明， 敌意等心理特征有其致病作用 是通过减少对挑战的BPV反应的抑制，这反过来 促进动脉粥样硬化和斑块破裂。在此应用程序中，5 给出了该模型的实验测试结果。

DESCRIPTION (Adapted from the Applicant's Abstract): This is an application for an Independent Scientist Award (K02) to study cardiovascular autonomic control in stress and anxiety. It is based on a research program whose focus is to explore the relationships among psychological/behavioral characteristics such as anxiety, hostility, depression, and physical conditioning, the central and autonomic nervous system, and the cardiovascular and respiratory systems. The application proposes a series of experiments deriving from a model which identifies blood pressure variability (BPV) as a potential mechanism by which psychological/psychiatric factors and health behaviors confer increased risk of coronary artery disease (CAD) and catastrophic cardiac events. While evidence suggests that psychological factors such as anxiety, depression, and hostility are associated with increased risk of CAD, the mechanisms by which these factors exert their pathogenic effects are only poorly understood. Our model holds that autonomic control of the heart serves a buffering or inhibitory function over oscillations in blood pressure, which recent research in vascular biology and dynamics suggests may have pathogenic effects on the endothelium, in the case of atherogenesis, and on plaque stability, in the case of catastrophic cardiac events. We recently have shown that under conditions of psychological stress, the magnitude of these blood pressure oscillations is inversely related to the degree of autonomic control of the heart, as measured by heart period variability (HPV). Thus, in subjects with high levels of cardiac autonomic control, blood pressure oscillations are minimal whereas in subjects with low levels of control, they are increased considerably. Since psychological/behavioral characteristics such as anxiety, depression, and hostility have been shown to be associated with lower levels of HPV, these characteristics may be associated with disinhibition of blood pressure oscillations, either at rest, or more likely, in response to psychological stress. Together, these findings suggest that the mechanism by which psychological characteristics such as hostility have their pathogenic effect is through reduced inhibition of BPV responses to challenge, which in turn promotes atherogenesis and plaque rupture. In this application, 5 experimental tests of this model are proposed.