A review published in Postgraduate Medicine provides a comprehensive overview of the growing pool of clinical and epidemiological data concerning the association between psychological stress and cardiovascular disease, as well as the impact of cardiac rehabilitation and exercise therapy on psychological stress-related cardiovascular events.
“Stress” is one of the most common patient complaints and up to 75% of all visits to physicians’ offices are stress-related. An increasing body of evidence indicates that psychological stress and cardiovascular diseases (CVD) are intertwined more closely than initially suspected about 4-5 decades ago.
Epidemiological studies indicate that chronic stress predicts the occurrence of coronary heart disease, and that employees who experience work-related stress and individuals who are socially isolated have an increased risk to develop coronary heart diseases.
Thus, stress is believed to contribute to diverse pathophysiological changes including myocardial infarction, myocardial ischemia, and changes in sympathetic nervous system activity and hemostasis. Moreover, a stress-specific coronary syndrome, known as transient left ventricular apical ballooning cardiomyopathy or stress (Takotsubo) cardiomyopathy, also exists.
In the Postgraduate Medicine review Arthur Menezes and colleagues from the John Ochsner Heart and Vascular Institute, New Orleans, LA, USA discuss the mechanisms linking stress and cardiovascular diseases, and the role of depression, anxiety, hostility, and acute and chronic stressors in this process.
According to the authors depression and chronic stress are strongly associated with CVD, whereas the role of anxiety and hostility remains much less clear. Furthermore, cardiac rehabilitation, exercise training and cardio respiratory fitness have positive effects, and may markedly reduce the effects of psychological stress and/or stress-related cardiovascular mortality and morbidity.
Source: Postgrad Med 2011, 123:165
Read more: Postgraduate Medicine
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