Platelet activation and secretion associated with emotional stress.

Levine, Shirley P.; Towell, Brenda L.; Suárez, Ana; Knieriem, Linda K.; Harris, Merle M; George, JN

doi:10.1161/01.cir.71.6.1129

Cited by 189 publications

(86 citation statements)

References 35 publications

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“…232,233 Recently, the effects of acute psychological stress on indices of coagulation have been studied during laboratory mental stress tasks 234,235 and during various naturalistic stressors. 236,237 In both situations, significant, but not always consistent, platelet abnormalities have been observed. Acute laboratory mental stress also causes hemoconcentration through stress-induced decreases in plasma volume, as observed in various studies.…”

Section: Coagulation Effectsmentioning

confidence: 91%

“…However, because blood samples were fortuitously obtained in 42 hypertensive patients before the large Hanshin-Awaji earthquake, investigators obtained repeat blood samples 7 to 14 days afterward to assess the effects of this acute stressor on coagulation parameters. 236 The earthquake induced transient increases in blood pressure; blood viscosity determinants, such as hematocrit and fibrinogen levels; and various hemostatic factors, including fibrin turnover and plasmin-␣ 2 -plasmin inhibitor complex, an activation marker of fibrinolysis. These parameters returned to normal levels by 4 to 6 months after the earthquake.…”

Section: Coagulation Effectsmentioning

confidence: 99%

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Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

1999

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Abstract-Recent studies provide clear and convincing evidence that psychosocial factors contribute significantly to the pathogenesis and expression of coronary artery disease (CAD). This evidence is composed largely of data relating CAD risk to 5 specific psychosocial domains: (1) depression, (2) anxiety, (3) personality factors and character traits, (4) social isolation, and (5) chronic life stress. Pathophysiological mechanisms underlying the relationship between these entities and CAD can be divided into behavioral mechanisms, whereby psychosocial conditions contribute to a higher frequency of adverse health behaviors, such as poor diet and smoking, and direct pathophysiological mechanisms, such as neuroendocrine and platelet activation. An extensive body of evidence from animal models (especially the cynomolgus monkey, Macaca fascicularis) reveals that chronic psychosocial stress can lead, probably via a mechanism involving excessive sympathetic nervous system activation, to exacerbation of coronary artery atherosclerosis as well as to transient endothelial dysfunction and even necrosis. Evidence from monkeys also indicates that psychosocial stress reliably induces ovarian dysfunction, hypercortisolemia, and excessive adrenergic activation in premenopausal females, leading to accelerated atherosclerosis.Also reviewed are data relating CAD to acute stress and individual differences in sympathetic nervous system responsivity. New technologies and research from animal models demonstrate that acute stress triggers myocardial ischemia, promotes arrhythmogenesis, stimulates platelet function, and increases blood viscosity through hemoconcentration. In the presence of underlying atherosclerosis (eg, in CAD patients), acute stress also causes coronary vasoconstriction. Recent data indicate that the foregoing effects result, at least in part, from the endothelial dysfunction and injury induced by acute stress. Hyperresponsivity of the sympathetic nervous system, manifested by exaggerated heart rate and blood pressure responses to psychological stimuli, is an intrinsic characteristic among some individuals. Current data link sympathetic nervous system hyperresponsivity to accelerated development of carotid atherosclerosis in human subjects and to exacerbated coronary and carotid atherosclerosis in monkeys.Thus far, intervention trials designed to reduce psychosocial stress have been limited in size and number. Specific suggestions to improve the assessment of behavioral interventions include more complete delineation of the physiological mechanisms by which such interventions might work; increased use of new, more convenient "alternative" end points for behavioral intervention trials; development of specifically targeted behavioral interventions (based on profiling of patient factors); and evaluation of previously developed models of predicting behavioral change. The importance of maximizing the efficacy of behavioral interventions is underscored by the recognition that psychosocial stresses tend to cluster together. ...

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Section: Coagulation Effectsmentioning

confidence: 91%

Section: Coagulation Effectsmentioning

confidence: 99%

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

1999

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“…These psychosocial factors are composed of depression, anxiety, personality and character traits as well as chronic and subacute life stress. 4,[10][11][12][13] A growing number of epidemiologic studies has suggested that anger and hostility are related to incidence of MI, 14 especially in older men. 14,15 Efforts to raise public awareness of these issues may carry a larger importance as terrorism remains a constant threat.…”

Section: Discussionmentioning

confidence: 99%

“…The attacks on the World Trade Center (WTC) on September 11,2001 were the most shocking and severe acts of terrorism ever experienced on American soil. The immediate psychological sequelae, including post-traumatic stress disorder (PTSD) and depression, following the terrorist attacks have been studied both nationwide 1 and locally 2 in Manhattan, New York City.…”

Section: Introductionmentioning

confidence: 99%

Cardiac sequelae in Brooklyn after the September 11 terrorist attacks

Jin¹,

Lenihan²,

Johnson

et al. 2006

Clinical Cardiology

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Background: Terrorism, such as the attacks on the World Trade Center (WTC) on September 11,2001, result in higher stress‐related disorders, especially in those persons in close proximity. Hypothesis: Cardiac events resulting from the September 11,2001 tragedy have not been detailed near the WTC. Methods: Patients admitted to the Telemetry and Coronary Care Units at New York Methodist Hospital 4 miles from the WTC 60 days prior to and after the September 11 attacks were analyzed. In all, 1,653 admissions were reviewed: 427 records pre 9/11/2001 and 422, 393, and 411 records in the post‐9/11/2001, pre‐9/11/2000, and post‐9/11/2000 data sets, respectively. Patients were categorized based on diagnosis: acute myocardial infarction (MI), unstable angina (UA), tachyarrhythmia (TA), and others (including syncope and congestive heart failure). Results: There was a significant difference in the proportion of the various cardiac diagnoses post 9/11/01 (p = 0.008 by chi‐square analysis). Compared with pre 9/11/2001, there were significantly more patients with acute MI (15.5 vs. 11.2%) and TA(19.9vs. 13.6%)but fewer with UA(39.6vs. 47.3%)after the terrorist attacks. The distribution of cardiac events during a similar period of time in 2000 revealed no such pattern. Conclusions: There was a significant increase in acute MI and TA and a smaller increase in UA after the September 11 attacks. The difference did not appear to be due to temporal variation. It appears that stress likely contributed to an increase in TA by itself or with ischemia, resulting in progression of UA to acute MI.

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“…Pathophysiologic links appear to include increases in platelet aggregation or reactivity associated with anger expression 47 and hostility 48 ; between Type A/hostility and reduced bleeding time, as well as increased prostacyclin formation 49 ; and between enhanced platelet aggregation and mental stress related to increases in catecholamines and sympathetic nervous system activity. 50 …”

Section: Psychosocial Stress and Thrombosismentioning

confidence: 99%

Psychosocial Stress and Cardiovascular Disease: Pathophysiological Links

Merz¹,

Dwyer²,

Nordstrom³

et al. 2002

Behavioral Medicine

134

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The remarkable decline in cardiovascular disease (CVD) experienced in developed countries over the last 40 years appears to have abated. Currently, many CVD patients continue to show cardiac events despite optimal treatment of traditional risk factors. This evidence suggests that additional interventions, particularly those aimed at nontraditional factors, might be useful for continuing the decline. Psychosocial stress is a newly recognized (nontraditional) risk factor that appears to contribute to all recognized mechanisms underlying cardiac events, specifically, (a) clustering of traditional cardiovascular risk factors, (b) endothelial dysfunction, (c) myocardial ischemia, (d) plaque rupture, (e) thrombosis, and (f) malignant arrhythmias. A better understanding of the behavioral and physiologic associations between psychosocial stress and CVD will assist researchers in identifying effective approaches for reducing or reversing the damaging effects of stress and may lead to further reductions of CVD morbidity and mortality. Index Termscardiovascular disease; psychosocial interventions; psychosocial stress; review Cardiovascular disease (CVD) remains the largest contributor to morbidity and mortality in developed countries. 1 Advances in prevention and treatment in the last 40 years have resulted in a 40% decline in mortality from this disease. 1 Despite this remarkable success, it is sobering to note that the decline has abated recently,2 paradoxically despite continued reductions in traditional risk factors.3 Up to 50% of patients with established coronary artery disease have recurrent cardiac events, such as myocardial infarction and cardiac death, even with aggressive

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Platelet activation and secretion associated with emotional stress.

Cited by 189 publications

References 35 publications

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

Cardiac sequelae in Brooklyn after the September 11 terrorist attacks

Psychosocial Stress and Cardiovascular Disease: Pathophysiological Links

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