Central stress pathways in the development of cardiovascular disease
Joe Braun1, Mariya Patel2, Tatiana Kameneva3,4,5
1School of Health Sciences, Swinburne University of Technology, PO Box 218, Hawthorn, Melbourne, VIC, 3122, Australia. jbraun@swin.edu.au.
Insights
Mental stress significantly impacts cardiovascular health by disrupting brain-body communication. Understanding this stress pathway offers new targets for preventing cardiovascular disease.
Area of Science:
- Neuroscience
- Cardiology
- Psychophysiology
Background:
- Mental stress is a critical factor in cardiovascular pathophysiology across patient populations.
- Evidence links stress, cardiovascular disease, and aberrant brain-body communication.
- Understanding stress information flow is vital for therapeutic interventions.
Purpose of the Study:
- To review the flow of stress information in humans.
- To explore the relationship between mental stress and cardiovascular disease.
- To identify potential therapeutic targets for cardiovascular disease.
Main Methods:
- Searched PubMed, ScienceDirect, and Scopus for articles on mental stress, cardiovascular disease, and central control.
- Included studies on heart rate/blood pressure regulation and neural control of cardiovascular disease.
- Focused on human neuroimaging research and brain-body connectivity.
Main Results:
- Corticolimbic circuitry changes encode stress information, integrated by the hypothalamus and amygdala.
- Brain-body relays to brainstem/spinal cord nuclei cause dysautonomia and alter autonomic function.
- This adrenergic state increases risks of cardiac myopathy, arrhythmias, ischemia, hypertension, and heart failure.
Conclusions:
- Mental stress undeniably contributes to cardiovascular disease development.
- Large-scale neuroimaging data analytics offer novel therapeutic targets.
- This research promises advancements in cardiovascular disease detection and prevention.
Purpose:
Mental stress is of essential consideration when assessing cardiovascular pathophysiology in all patient populations. Substantial evidence indicates associations among stress, cardiovascular disease and aberrant brain-body communication. However, our understanding of the flow of stress information in humans, is limited, despite the crucial insights this area may offer into future therapeutic targets for clinical intervention.
Methods:
Key terms including mental stress, cardiovascular disease and central control, were searched in PubMed, ScienceDirect and Scopus databases. Articles indicative of heart rate and blood pressure regulation, or central control of cardiovascular disease through direct neural innervation of the cardiac, splanchnic and vascular regions were included. Focus on human neuroimaging research and the flow of stress information is described, before brain-body connectivity, via pre-motor brainstem intermediates is discussed. Lastly, we review current understandings of pathophysiological stress and cardiovascular disease aetiology.
Results:
Structural and functional changes to corticolimbic circuitry encode stress information, integrated by the hypothalamus and amygdala. Pre-autonomic brain-body relays to brainstem and spinal cord nuclei establish dysautonomia and lead to alterations in baroreflex functioning, firing of the sympathetic fibres, cellular reuptake of norepinephrine and withdrawal of the parasympathetic reflex. The combined result is profoundly adrenergic and increases the likelihood of cardiac myopathy, arrhythmogenesis, coronary ischaemia, hypertension and the overall risk of future sudden stress-induced heart failure.
Conclusions:
There is undeniable support that mental stress contributes to the development of cardiovascular disease. The emerging accumulation of large-scale multimodal neuroimaging data analytics to assess this relationship promises exciting novel therapeutic targets for future cardiovascular disease detection and prevention.
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