A Path Model of Chronic Stress, the Metabolic Syndrome, and Coronary Heart Disease

Abstract

In older men, pathways occurred from chronic stress to distress to the metabolic syndrome, which in turn predicted CHD. Older women not using HRT showed fewer pathways than men; however, over time, distress, the MS, and CHD were related. No psychophysiological pathways occurred in older women using HRT.

A Comparison of Psychosocial Outcomes in Elderly Alzheimer Caregivers and Noncaregivers

“…However, a large body of literature suggests that the chronic stress associated with providing care to a loved one with AD can have a deleterious impact on physical and mental health. Indeed, caregiving has been associated with increased risk for illnesses and diseases(7) such as coronary heart disease(8, 9). …”

“…Regarding health outcomes, caregivers have been found to have increased inflammation (17)and compromised immune functioning (18)relative to non-caregivers. Further, caregiving status appears to be associated with greater concentrations of stress hormones and antibodies (19), and male caregivers appear at greater risk for coronary heart disease relative to male non-caregivers(20). A comprehensive comparison of dementia and non-dementia caregivers(21) found dementia caregivers provided significantly greater hours of care per day, managed more ADLs/IADLs, and reported greater emotional, physical, and financial strain.…”

Hypercortisolemic depression is associated with the metabolic syndrome in late-life

“…Recent studies suggest that the link between depression and CVD and diabetes may operate through the metabolic syndrome (Vitaliano et al, 2002).The metabolic syndrome is a clustering of risk factors associated with a particularly high risk of cardiovascular events and diabetes, and includes at least three of the following conditions: abdominal obesity, high triglyceride levels, low high density lipoprotein (HDL) cholesterol, high blood pressure, and high levels of fasting glucose (National Cholesterol Education Program, 2002). The estimated prevalence of the metabolic syndrome is as high as 42% in adults aged 60 years and over (Ford et al, 2002).…”

“…Several pathways for these links have been suggested. Vitaliano et al (2002) proposed that chronic stress causes depression and successive poor health habits that can lead to the metabolic syndrome and subsequent coronary heart disease. On the other hand more biological mechanisms have been proposed (Rosmond, 2005).…”

Is A Weight-Centred Health Framework Salutogenic? Some Thoughts on Unhinging Certain Dietary Ideologies

“…body of work explicating metabolic alterations (affecting the cardiovascular, immune and neuroendocrine system) that increase the so-called 'allostatic load' among low SES groups and people living with chronic stress (eg caregivers) and have a role in the aetiology of obesity and its related conditions (eg Bjorntorp, 2001;Bjorntorp and Rosmond, 2000;Vitaliano et al, 2002). (Allostasis is the response to stress that constitutes a controlled deviation from homeostasis, within which coordinates metabolic syndrome begins to be more clearly mapped out as a stress-related disorder as we will see.)…”