Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient
Viola Vaccarino1, Amit J Shah2, Puja K Mehta3
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
Insights
Psychological stress significantly impacts cardiovascular disease (CVD) through a brain-heart axis. Understanding these mind-body connections is crucial for managing CVD risks, especially in vulnerable patient groups.
Area of Science:
- Cardiology
- Psychophysiology
- Neurobiology
Background:
- Psychological stress is increasingly recognized as a significant factor influencing cardiovascular disease (CVD) development and progression.
- A "brain-heart axis" is central to understanding how mental states affect cardiovascular physiology, particularly in individuals with existing CVD.
Purpose of the Study:
- To review current knowledge on the influence of psychological stress on cardiovascular physiology and disease outcomes.
- To highlight the importance of mind-body connections in cardiac patients and identify potential intervention targets.
Main Methods:
- Review of recent scientific literature on psychological stress and cardiovascular disease.
- Analysis of laboratory-based acute psychological stress provocation studies.
- Examination of physiological, immune, vascular, and neurobiological responses to stress.
Main Results:
- Acute psychological stress provokes changes in cardiovascular physiology, immune function, and vascular reactivity.
- Dynamic perturbations in physiological pathways during stress impact cardiovascular outcomes.
- Specific patient subgroups, including women and those with early-onset myocardial infarction, face heightened risks.
Conclusions:
- The brain-heart axis plays a critical role in the interplay between psychological stress and cardiovascular health.
- Integrated mind-body approaches are essential for a comprehensive understanding and management of cardiovascular disease.
- Further research into stress-related pathways may lead to novel intervention strategies for CVD.
Abstract:
The influence of psychological stress on the physiology of the cardiovascular system, and on the etiology and outcomes of cardiovascular disease (CVD) has been the object of intense investigation. As a whole, current knowledge points to a "brain-heart axis" that is especially important in individuals with pre-existing CVD. The use of acute psychological stress provocation in the laboratory has been useful to clarify the effects of psychological stress on cardiovascular physiology, immune function, vascular reactivity, myocardial ischemia, neurobiology and cardiovascular outcomes. An emerging paradigm is that dynamic perturbations of physiological and molecular pathways during stress or negative emotions are important in influencing cardiovascular outcomes, and that some patient subgroups, such as women, patients with an early-onset myocardial infarction, and patients with adverse psychosocial exposures, may be at especially high risk for these effects. This review summarizes recent knowledge on mind-body connections in CVD among cardiac patients and highlights important pathways of risk which could become the object of future intervention efforts. As a whole, this research suggests that an integrated study of mind and body is necessary to fully understand the determinants and consequences of CVD.
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