ANXIETY AND CARDIOVASCULAR AUTONOMIC CONTROL

描述：前瞻性流行病学数据表明， 慢性焦虑和/或焦虑症与 心源性猝死 其他研究表明，心脏自主神经 在稳定焦虑的个体中， 副交感神经的控制减弱而交感神经的控制增强。后者 然而，研究是基于非常小的临床样本， 在他们的心血管调节评估中， 焦虑这项研究的目的是评估假设 慢性焦虑症和/或焦虑症导致运动过度 心血管自主调节，通常与增加 冠心病风险 该项目将使用一个正在进行的特征良好的队列，VA 规范老龄化研究（NAS），招募中老年社区- 男人和女人进入研究。使用各种经过验证的 心理和精神检查工具-包括《简报》 症状量表、综合国际诊断访谈、 斯皮尔伯格状态-特质焦虑量表和皇冠-克里斯普指数-- 研究人群将根据以下症状进行表征： 焦虑和焦虑症的诊断。 心血管自主 然后在焦虑和非焦虑个体之间评估控制 使用心率的非侵入性时域和功率谱测量 和血压变异性。心输出量，总外周 阻力和潮气末pCO 2将同时评估。 这 这项调查将是第一次大规模的基于人口的研究 检查焦虑的心血管生理学，并应增加 一个人对焦虑和焦虑之间关系的理解， 心源性猝死这项研究可能有助于进一步确定群体， 一般人群猝死的风险增加。

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.