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Stress in cardiovascular diseases.

Tobias Esch, George B Stefano, Gregory L Fricchione, Herbert Benson

Med Sci Monit 2002; 8(5): RA93-101

ID: 420828

OBJECTIVE: Evidence for a connection between stress and selected cardiovasculardiseases is analyzed. Does stress cause or exacerbate cardiovascular diseases? METHOD: The stress phenomenonis illustrated and the impact of stress on the circulatory system is examined. In particular, the pathophysiologicalsignificance of stress in hypertension, atherosclerosis, coronary artery disease, myocardial infarction(and others) is described. RESULTS: Stress plays a major role in various (patho)physiological processesassociated with the circulatory system. Thereby, it potentially has ameliorating or detrimental capacities.However, with regard to cardiovascular diseases, stress most often is related to deleterious results.The specific outcome depends on multiple variables (amount of stress, duration of its influence, patient'shistory/predisposition, genetic components -- as they all may alter functions of the basic stress responsecomponents: the hypothalamic-pituitary-adrenal axis and the sympathoadrenal medullary system). CONCLUSIONS:Stress has a major impact upon the circulatory system. It plays a significant role in susceptibility,progress, and outcome of cardiovascular diseases. Subjective or individual differences have also to betaken into account. Stress, especially 'adequate' acute stress - stress that is not 'overwhelming' -may improve performance and thus be beneficial in certain cases. The close relationship between stressand cardiovascular diseases may represent an important aspect of modern medicine. New therapeutic strategieshave to be set in place.

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