Monday, August 9, 2010

Stress, Inflammation and Cardiovascular Disease.

Various psychosocial factors have been implicated in the etiology and pathogenesis of certain cardiovascular diseases such as atherosclerosis, now considered to be the result of a chronic inflammatory process.

Atherosclerosis is a condition in which fatty material collects along the walls of arteries. This fatty material thickens, hardens (forms calcium deposits), and may eventually block the arteries.

In an article of the same title published in the Journal of Psychosomatic Research, Paul H. Black and Lisa D. Garbutt reviewed the evidence that repeated episodes of acute psychological stress, or chronic psychologic stress, may induce a chronic inflammatory process culminating in atherosclerosis.

The researchers from the Boston University School of Medicine found that inflammatory events, caused by stress, may account for the approximately 40% of atherosclerotic patients with no other known risk factors.

The inflammatory response is contained within the stress.

Stress

  • by activating the sympathetic nervous system, the hypothalamic-pituitary axis, and the renin-angiotensin system,
  • causes the release of various stress hormones such as catecholamines, corticosteroids, glucagon, growth hormone, and renin, and elevated levels of homocysteine,
  • which induce a heightened state of cardiovascular activity, injured endothelium, and induction of adhesion molecules on endothelial cells to which recruited inflammatory cells adhere and translocate to the arterial wall.

An acute phase response (APR), similar to that associated with inflammation, is also engendered.

The acute phase response is characterized by macrophage activation, the production of cytokines, other inflammatory mediators, acute phase proteins (APPs), and mast cell activation, all of which promote the inflammatory process.

Stress also induces an atherosclerotic lipid profile with oxidation of lipids and, if chronic, a hypercoagulable state that may result in arterial thromboses.

Shedding of adhesion molecules and the appearance of cytokines, and APPs in the blood are early indicators of a stress-induced APR, may appear in the blood of asymptomatic people, and be predictors of future cardiovascular disease.

The inflammatory response, which evolved later and is adaptive in that an animal may be better able to react to an organism introduced during combat.

Humans reacting to stressors, which are not life-threatening but are "perceived" as such, mount similar stress/inflammatory responses in the arteries, and which, if repetitive or chronic, can create significant damage to the cardiovascular system by

  • increasing the risk of coronary artery disease,
  • elevating blood pressure
  • increasing atherosclerosis
  • increasing risk of myocardial infarction
  • increasing the risk of diabetes, and
  • increasing the likelihood of obesity

Journal Reference

Black PH, Garbutt LD. Stress, inflammation and cardiovascular disease. Journal of Psychosomatic Research. 2002 Jan;52(1):1-23.

Stress has also been linked to:

  • cancer
  • diabetes
  • breakdown in the immune system
  • alcohol and substance abuse,and
  • cardiovascular disease

The Take Home Message - Learn to Manage Stress

It’s is all about taking charge:

  • Take charge of your thoughts
  • Take charge of your emotions
  • Take charge of your schedule
  • Take charge of your environment,and
  • Take charge of your the way you deal with problems

The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun – plus the resilience to hold up under pressure and meet challenges head on.

Make lifestyle change, such as

  • Loose Weight
  • Exercise Regularly
  • Control Diabetes
  • Stop Smoking,
  • Control High blood Pressure, and
  • Reduce Alcohol Intake
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