The quiz electrocardiogram: A new diagnostic and research technique for evaluating the relation between emotional stress and ischemic heart disease

Schiffer, Fredric; Hartley, L H; Schulman, Charles L.; Abelmann, Walter H.

doi:10.1016/0002-9149(76)90497-5

Cited by 91 publications

(34 citation statements)

References 25 publications

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“…In addition, there is a mobilization of lipids which exceeds the body's metabolic requirements, and which facilitates aggregation to artery walls and heart tissue. This relationship between psychosocial factors and CVD has received the generic name of "Hypothesis of the cardiovascular reactivity", and has been supported by various prospective studies (Keys & Taylor, 1971;Schiffer, et al, 1976;Manuck, et al, 1992;Steptoe, et al, 2000).…”

Section: Psychosocial Risk Factors and Cardiovascular Diseasementioning

confidence: 82%

Psychophysiological Cardiovascular Functioning in Hostile Defensive Women

Palmero¹,

Guerrero²

2012

The Cardiovascular System - Physiology, Diagnostics and Clinical Implications

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Section: Psychosocial Risk Factors and Cardiovascular Diseasementioning

confidence: 82%

Psychophysiological Cardiovascular Functioning in Hostile Defensive Women

Palmero¹,

Guerrero²

2012

The Cardiovascular System - Physiology, Diagnostics and Clinical Implications

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“…79 -62 Such speculation derives, in part, from the observations that: 1) individuals vary greatly in the magnitude of their physiologic responses to behavioral stimuli; 83 and 2) Type A individuals often exhibit more pronounced cardiovascular and neuroendocrine (e.g., catecholamine) responses than Type B individuals when exposed to frustrating laboratory tasks or other behavioral challenges. 84 Also, in several clinical studies it has been reported that CHD patients exhibited larger pressor reactions to behavioral stressors than did non-CHD patients or nonpatient controls, 85 " 89 and, in one prospective investigation, large diastolic blood pressure reactions to the "cold pressor test" (immersion of a limb in cold water) were found to predict the 23-year incidence of CHD. 90 From such findings, it has been hypothesized that recurrent episodes of acute "psychophysiologic" reactivity may promote atherogenesis, either through the hemodynamic disturbances related to acute rises in heart rate and blood pressure (e.g., turbulence, sheer stress) 79 or as a result of physiologic changes associated with an increased release of certain neuroendocrine hormones (e.g., catecholaminergic influences on platelet aggregation).…”

Section: Potential Mechanisms Of Behavioral Influences On Atherogenesismentioning

confidence: 99%

Behavioral antecedents of coronary heart disease and atherosclerosis.

Manuck

Kaplan²,

Matthews³

1986

Arteriosclerosis

157

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Over 50 epidemiologic, clinical, and experimental studies of behavioral influences on atherosclerosis and CHD have been reviewed; of these investigations, no more than five were published prior to 1975. Despite some inconsistencies and occasional conceptual and methodologic problems in the studies comprising this relatively young literature, the preponderance of available evidence indicates that psychosocial variables play a significant role in coronary disease. To summarize briefly, the Type A behavior pattern has been found predictive of new CHD in nearly all prospective studies of initially healthy individuals, and therapeutic modification of Type A has been shown to reduce risk of recurrent nonfatal MI. Among most prospective studies of post-MI patients and of persons at heightened risk for CHD due to elevations in traditional risk factors, however, Type A has not been found to predict, respectively, recurrence of MI or initial clinical events. Additionally, Type A individuals have shown more extensive coronary artery atherosclerosis on angiographic examination than Type Bs in a minority of studies, and, generally, only where Type A behavior has been measured by the SI. It is noted that many of these clinical studies may be faulted, though, for their use of small and heterogeneous patient samples and for possible biases in the selection and recruitment of subjects. In contrast to the globally defined Type A pattern, a high potential for hostility and an inability or unwillingness to express anger (anger-in) have emerged as significant predictors or correlates of coronary disease in all epidemiologic and clinical studies in which these variables have been examined. These consistent results suggest that a predisposition to hostility and anger, and the inhibited expression of such feelings, represent a "toxic" component of the Type A pattern. Several recent prospective investigations indicate also that high levels of life stress and possession of poor or inadequate social resources are predictive of CHD. The concepts of life stress, social network, and social support, as well as relationships among these variables, are not well-understood, however, and much additional work is needed to identify specific pathogenic and protective attributes of the social environment. In addition to studies of the psychosocial antecedents of CHD in human beings, there now are several published studies of behavioral influences on the development of coronary lesions in animal models.(ABSTRACT TRUNCATED AT 400 WORDS)

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“…Three older case-control studies demonstrated an association between cardiovascular reactivity and CAD (Schiffer, Hartley, Schulman, & Abelmann, 1976;Sime, Buell, & Eliot, 1980;Corse, Manuck, Cantwell, Giordani, & Matthews, 1982). Schiffer et al (1996) examined blood pressure responses among three groups of executives while taking a quiz.…”

Section: Human Studiesmentioning

confidence: 99%

“…Electrocardiographic measures have been used in the laboratory and in ambulatory Holter monitoring to document how acute stress may elicit ischemia (Schiffer, Hartley, Schulman, & Abelmann, 1976;Gabbay et al, 1996).…”

Section: Ischemia Assessed Via Electrocardiographymentioning

confidence: 99%