Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study

Gillespie, Shannon L.; Anderson, Cindy M.; Zhao, Songzhu; Tan, Yubo; Kline, David; Brock, Guy; Odei, James B.; O’Brien, Emily C.; Sims, Mario; Lazarus, Sophie A.; Hood, Darryl B.; Williams, Karen Patricia; Joseph, Joshua J.

doi:10.1016/j.psyneuen.2019.06.020

Cited by 60 publications

(37 citation statements)

References 56 publications

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“…Consideration of allostatic load may increase the pre dictive power of the assessment procedure and may con tribute to the understanding of many symptoms that are commonly encountered in clinical practice, but that, in a predominantly disease focused model, fail to receive ade quate attention and care [303,304]. Clinical assessment of allostatic overload may help to demarcate important dif ferences in patients who otherwise seem deceptively simi lar because they share the same medical diagnosis, as it was found to be the case in cardiovascular diseases [242][243][244], particularly congestive heart failure [248], atrial fibrillation [246] and hypertension [249]. Allostatic load acknowledg es the burden of different phases of medical disorders.…”

Section: Discussionmentioning

confidence: 99%

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Allostatic Load and Its Impact on Health: A Systematic Review

Guidi

Lucente

Sonino

et al. 2020

Psychother Psychosom

593

466

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Introduction: Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. Objective: To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. Methods: PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. Results: A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. Conclusions: The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.

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Section: Discussionmentioning

confidence: 99%

“…Allostatic load was linked to increased risk for cardio vascular diseases, particularly coronary heart disease [242], ischemic heart disease [243] and peripheral arte rial disease [244].…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

Allostatic Load and Its Impact on Health: A Systematic Review

Guidi

Lucente

Sonino

et al. 2020

Psychother Psychosom

593

466

View full text Add to dashboard Cite

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“…AL index includes different biological markers divided in two main groups; 1-Primary mediators: represented by stress hormones (adrenaline, noradrenaline, and cortisol) in combination with inflammatory cytokines (e.g., interleukin-6, tumor necrosis factor), 2-Secondary mediators: represented by biomarkers of metabolic, cardiovascular, and immune systems that compensate primary mediators alterations [e.g., insulin, glucose, total cholesterol, high density lipoprotein cholesterol, triglycerides, visceral fat depositing, systolic and diastolic blood pressure, fibrinogen, c-reactive protein; (2,8,28)]. Different authors have applied the AL index in population-based studies and/or in clinical trials and studied the association with depression and anxiety disorders (8,11,(28)(29)(30)(31)(32). Table 1 summarizes the AL index and the cut off points analyzed in a previous study performed by our group, in patients with general anxiety disorder (12,32).…”

Section: The Allostasis Concept and The Allostatic Load Indexmentioning

confidence: 99%

“…In patients with major depressive disorder, cortisol levels are elevated, the diurnal rhythm is distorted and the HPA axis is resistant to suppression by dexamethasone (9,33,37,38). Moreover, higher AL index has been associated with higher levels of depressive symptoms in many studies (8,11) (28)(29)(30)39). Compared with patients with personality disorders, emergency psychiatric patients primarily diagnosed with bipolar, depressive, or anxiety disorders showed altered AL parameters including cortisol, interleukin-6, systolic blood pressure, and heart rate (11).…”

Section: Depression Anxiety and Almentioning

confidence: 99%

Reducing Allostatic Load in Depression and Anxiety Disorders: Physical Activity and Yoga Practice as Add-On Therapies

et al. 2020

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The allostatic load (AL) index constitutes a useful tool to objectively assess the biological aspects of chronic stress in clinical practice. AL index has been positively correlated with cumulative chronic stress (physical and psychosocial stressors) and with a high risk to develop pathological conditions (e.g., metabolic syndrome, cardiovascular pathology, inflammatory disorders) and the so-called stress-related psychiatric disorders, including anxiety and depressive disorders. Chronic stress has negative effects on brain neuroplasticity, especially on hippocampal neurogenesis and these effects may be reversed by antidepressant treatments. Several evidences indicate that nonpharmacological interventions based on physical activity and yoga practice may add synergizing benefits to classical treatments (antidepressant and benzodiazepines) for depression and anxiety, reducing the negative effects of chronic stress. The aim of this review is to provide a general overview of current knowledge on AL and chronic stress in relation to depression and anxiety, physical activity and yoga practice.

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“…Apart from genetic traits manifestation of a high set point may ensue from chronic psychosocial stress. This is termed type 2 allostatic load and a well-recognized cardiovascular risk indicator (19)(20)(21)(22)(23)(24). Set point alterations have been linked to acute and chronic stress situations including psychosis, alcohol withdrawal and post-traumatic stress disorder (PTSD), all of which are known risk factors for cardiovascular mortality (25)(26)(27)(28)(29)(30).…”

Section: Introductionmentioning

confidence: 99%

The Two Faces of Janus: Why Thyrotropin as a Cardiovascular Risk Factor May Be an Ambiguous Target

Dietrich

Hoermann²,

Midgley

et al. 2020

Front. Endocrinol.

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Elevated concentrations of free thyroid hormones are established cardiovascular risk factors, but the association of thyrotropin (TSH) levels to hard endpoints is less clear. This may, at least in part, ensue from the fact that TSH secretion depends not only on the supply with thyroid hormones but on multiple confounders including genetic traits, medication and allostatic load. Especially psychosocial stress is a still underappreciated factor that is able to adjust the set point of thyroid function. In order to improve our understanding of thyroid allostasis, we undertook a systematic meta-analysis of published studies on thyroid function in post-traumatic stress disorder (PTSD). Studies were identified via MEDLINE/PubMed search and available references, and eligible were reports that included TSH or free thyroid hormone measurements in subjects with and without PTSD. Additionally, we re-analyzed data from the NHANES 2007/2008 cohort for a potential correlation of allostatic load and thyroid homeostasis. The available evidence from 13 included studies and 3386 euthyroid subjects supports a strong association of both PTSD and allostatic load to markers of thyroid function. Therefore, psychosocial stress may contribute to cardiovascular risk via an increased set point of thyroid homeostasis, so that TSH concentrations may be increased for reasons other than subclinical hypothyroidism. This provides a strong perspective for a previously understudied psychoendocrine axis, and future studies should address this connection by incorporating indices of allostatic load, peripheral thyroid hormones and calculated parameters of thyroid homeostasis.

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Allostatic load in the association of depressive symptoms with incident coronary heart disease: The Jackson Heart Study

Cited by 60 publications

References 56 publications

Allostatic Load and Its Impact on Health: A Systematic Review

Allostatic Load and Its Impact on Health: A Systematic Review

Reducing Allostatic Load in Depression and Anxiety Disorders: Physical Activity and Yoga Practice as Add-On Therapies

The Two Faces of Janus: Why Thyrotropin as a Cardiovascular Risk Factor May Be an Ambiguous Target

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