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Stress and cardiovascular disease

Andrew Steptoe1, Mika Kivimäki

  • 1Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK. a.steptoe@ucl.ac.uk

Nature Reviews. Cardiology
|April 5, 2012
PubMed

Insights

Psychological stress is linked to coronary heart disease (CHD) risk, with chronic stress predicting events and acute stress triggering them. Stress management is crucial for cardiovascular disease prevention but is underutilized clinically.

Area of Science:

  • Cardiology
  • Psychology
  • Public Health

Background:

  • The physiological stress response involves the hypothalamic-pituitary-adrenocortical and sympatho-adrenomedullary axes.
  • The connection between psychological stress and cardiovascular disease (CVD) risk, particularly coronary heart disease (CHD), requires further elucidation.
  • Chronic stress and social isolation are associated with an increased risk of initial CHD events.

Purpose of the Study:

  • To explore the multifaceted relationship between psychological stress and cardiovascular disease risk.
  • To highlight the role of stress as both a predictor and a trigger of cardiac events.
  • To emphasize the clinical underapplication of stress management strategies in cardiovascular disease prevention.

Main Methods:

  • Review of epidemiological data linking stress to coronary heart disease (CHD).
  • Examination of the impact of acute and chronic psychological stress on cardiac events.
  • Analysis of stress-induced conditions like Takotsubo cardiomyopathy.
  • Assessment of stress management's role in clinical settings and guidelines.

Main Results:

  • Chronic stress predicts coronary heart disease (CHD) occurrence.
  • Work-related stress, social isolation, and loneliness increase the risk of first CHD events.
  • Acute emotional stress can trigger cardiac events in patients with atherosclerosis.
  • Psychological stress can induce myocardial ischemia and increase mortality risk in CHD patients.
  • Stress cardiomyopathy (Takotsubo) is a recognized stress-related cardiac syndrome.

Conclusions:

  • Psychological stress is a significant risk factor for cardiovascular disease, including coronary heart disease.
  • Effective stress management is essential for cardiovascular disease prevention, as recommended by European guidelines.
  • Clinical application of stress management strategies for cardiovascular health needs improvement.

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