Stress, behavior and the heart

Sgoifo, Andrea; Montano, Nicola; Esler, Murray; Vaccarino, Viola

doi:10.1016/j.neubiorev.2016.11.003

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Recent studies implicate chronic stress as an important driver of the metabolic syndrome, diabetes, and CVD development (20,54,98,179,211). For example, both the INTERHEART Study (n ϭ 29,972 participants from 52 countries) and the INTERSTROKE Study (n ϭ 26,919 participants from 32 countries) identified psychosocial stress as one of 10 modifiable risk factors for CVD onset (143,162).…”

Section: The Intersection Between Chronic Stress and Cvdmentioning

confidence: 99%

Chronic stress and endothelial dysfunction: mechanisms, experimental challenges, and the way ahead

Sher

Geddie

Olivier

et al. 2020

American Journal of Physiology-Heart and Circulatory Physiology

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Although chronic stress is an important risk factor for cardiovascular diseases (CVD) onset, the underlying mechanisms driving such pathophysiologic complications remain relatively unknown. Here, dysregulation of innate stress response systems and the effects of downstream mediators are strongly implicated, with the vascular endothelium emerging as a primary target of excessive glucocorticoid and catecholamine action. This review article therefore explores the development of stress-related endothelial dysfunction by focusing on the following: 1) assessing the phenomenon of stress and complexities surrounding this notion; 2) discussing mechanistic links between chronic stress and endothelial dysfunction; and 3) evaluating the utility of various preclinical models currently employed to study mechanisms underlying the onset of stress-mediated complications such as endothelial dysfunction. The data reveal that preclinical models play an important role in our efforts to gain an increased understanding of mechanisms underlying stress-mediated endothelial dysfunction. It is our understanding that this provides a good foundation going forward and we propose that further efforts should be made to a) more clearly define the concept of stress and b) standardize protocols of animal models with specific guidelines to better indicate the mental complications that are simulated.

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Section: The Intersection Between Chronic Stress and Cvdmentioning

confidence: 99%

Chronic stress and endothelial dysfunction: mechanisms, experimental challenges, and the way ahead

Sher

Geddie

Olivier

et al. 2020

American Journal of Physiology-Heart and Circulatory Physiology

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“…Cardiometabolic risk factors such as hypertension, diabetes, and obesity are major contributors to CAD, but there is unexplained heterogeneity in the risk and outcome of CAD. It is increasingly recognized that psychological stress contributes to CAD risk and outcomes [ 2 , 3 ], and such effects can be especially powerful among high-risk individuals with preexisting CAD [ 4 ]. Stressful exposures such as work stress, interpersonal conflict, low socioeconomic status, early life trauma, and care-giver strain play an important role in CAD in both men and women, but women may be more susceptible to these effects.…”

Section: Introductionmentioning

confidence: 99%

“…More recently, mental stress and depression in the COVID-19 pandemic era have been linked to increased cardiovascular risk factors, especially in women [ 5 , 6 ]. Psychosocial stressors contribute to cardiovascular risk factors by influencing health behaviors (i.e., poor dietary choices, lack of exercise, less medication compliance, and follow-up care) [ 3 , 7 ], but stress also has direct adverse effects on cardiovascular physiology [ 8 •]. Substantial prior evidence links mental stress to endothelial dysfunction [ 9 ], atheroma progression, ischemia, arrhythmias, and cardiovascular morbidity and mortality [ 10 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Mental Stress-Induced Myocardial Ischemia

et al. 2022

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Purpose of Review To summarize recent evidence on mental stress-induced myocardial ischemia (MSIMI), its mechanisms, and clinical significance. Recent Findings MSIMI can occur in patients with normal cardiac stress testing, is only weakly related to severity of coronary artery disease (CAD), and it is often silent. Among patients with CAD, MSIMI is associated with a twofold increased risk of major adverse cardiovascular events compared to those who do not have MSIMI. Certain groups such as young women with myocardial infarction and those with psychological comorbidities are more susceptible to MSIMI. Abnormal microvascular vasoreactivity and inflammation are implicated mechanisms in MSIMI. Increased brain activity in regions that modulate autonomic reactivity to emotional stress and fear is associated with MSIMI. Summary MSIMI has important prognostic implications in patients with CAD. Stress can no longer be ignored as a risk factor in cardiology care. Clinical trials testing effective strategies to target MSIMI are needed.

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“…The impact of psychological stress on health has been widely confirmed ( Glaser and Kiecolt-Glaser, 2005 ; de Vente et al, 2006 ; Bengtsson et al, 2009 ; Lupien et al, 2009 ; Hemmerle et al, 2012 ; Gradus, 2017 ; Sgoifo et al, 2017 ). Stress is a major risk factor for the development of mental disorders such as major depression ( Kessler, 1997 ; Uehara et al, 1999 ; Mino et al, 2006 ; Hankin et al, 2015 ), representing one of the most burdensome diseases worldwide ( Lim et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

A Modified Version of the Transactional Stress Concept According to Lazarus and Folkman Was Confirmed in a Psychosomatic Inpatient Sample

et al. 2021

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BackgroundStress is a major risk factor for the impairment of psychological well-being. The present study aimed to evaluate the empirical evidence of the Transactional Stress Model proposed by Lazarus and Folkman in patients with psychosomatic health conditions.MethodsA structural equation model was applied in two separate subsamples of inpatients from the Department of Psychosomatic Medicine (total n = 2,216) for consecutive model building (sample 1, n = 1,129) and confirmatory analyses (sample 2, n = 1,087) using self-reported health status information about perceived stress, personal resources, coping mechanisms, stress response, and psychological well-being.ResultsThe initial model was created to reflect the theoretical assumptions by Lazarus and Folkman about their transactional stress concept. This model was modified until a sufficient model fit was reached (sample 1: CFI = 0.904, TLI = 0.898, RMSEA = 0.072 [0.071–0.074], SRMR = 0.061). The modified model was confirmed in a second sample (sample 2: CFI = 0.932, TLI = 0.928, RMSEA = 0.066 [0.065–0.068], SRMR = 0.052). Perceived external stressors and personal resources explained 91% of the variance of the stress response, which was closely related to symptoms of depression (63% variance explained). The attenuating effect of resources on stress response was higher (standardized β = -0.73, p < 0.001) than the impact of perceived stressors on stress response (standardized β = 0.34, p < 0.001).ConclusionThe empirical data largely confirmed the theoretical assumption of the Transactional Stress Model, which was first presented by Lazarus and Folkman, in patients with a wide range of psychosomatic conditions. However, data analyses were solely based on self-reported health status. Thus, proposed inner psychological mechanisms such as the appraisal process could not be included in this empirical validation. The operationalization and understanding of coping processes should be further improved.

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Stress, behavior and the heart

Cited by 8 publications

References 19 publications

Chronic stress and endothelial dysfunction: mechanisms, experimental challenges, and the way ahead

Chronic stress and endothelial dysfunction: mechanisms, experimental challenges, and the way ahead

Mental Stress-Induced Myocardial Ischemia

A Modified Version of the Transactional Stress Concept According to Lazarus and Folkman Was Confirmed in a Psychosomatic Inpatient Sample

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