Stress and cardiovascular disease.
10.5124/jkma.2013.56.6.462
- Author:
Jung Jin CHO
1
Author Information
1. Department of Family Medicine, Hallym University Medical Center, Anyang, Korea. fmjjcho@naver.com
- Publication Type:Original Article
- Keywords:
Stress, psychological;
Cardiovascular diseases;
Affective disorders, psychotic;
Life style
- MeSH:
Affective Disorders, Psychotic;
Anxiety;
Arrhythmias, Cardiac;
Atherosclerosis;
Axis, Cervical Vertebra;
Cardiovascular Diseases;
Depression;
Foster Home Care;
Hostility;
Humans;
Life Style;
Mood Disorders;
Myocardial Ischemia;
Surveys and Questionnaires;
Risk Factors;
Social Isolation;
Specialization;
Stress, Psychological
- From:Journal of the Korean Medical Association
2013;56(6):462-470
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
As we have summarized, a confluence of pathophysiological and epidemiological studies establish that both acute and chronic forms of psychosocial stress contribute to the pathogenesis of atherosclerosis. Clinical consequences of acute stress include the development of myocardial ischemia, cardiac arrhythmias, and fostering of more vulnerable coronary plaques and hemostatic changes. Chronic stress and affective disorders, such as depression, appear to promote atherosclerosis via hypothalamic-pituitary-adrenal (HPA) axis overstimulation. Chronic stress can contribute to the occurrence of cardiovascular disease (CVD) by direct and indirect pathways. These results establish that, in addition to traditional CVD risk factors, psychosocial factors contribute to CVD. Physicians should never neglect to assess psychosocial risk factors, for example depression, hostility, social isolation, and chronic life stress and job stress, by clinical interview or standardized questionnaires. Management approaches include directly treating patients with mild forms of psychological distress by applying multifactorial lifestyle interventions and treating patients with clinical depression and anxiety. However, patients with severe psychological distress should be referred to specialists. Additional attention and research related to stress and CVD will be needed in the future.
