Stress in cardiovascular diseases.
OBJECTIVE
Evidence for a connection between stress and selected cardiovascular diseases is analyzed. Does stress cause or exacerbate cardiovascular diseases?


METHODS
The stress phenomenon is illustrated and the impact of stress on the circulatory system is examined. In particular, the pathophysiological significance of stress in hypertension, atherosclerosis, coronary artery disease, myocardial infarction (and others) is described.


RESULTS
Stress plays a major role in various (patho)physiological processes associated 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's history/predisposition, genetic components -- as they all may alter functions of the basic stress response components: 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 be taken 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 stress and cardiovascular diseases may represent an important aspect of modern medicine. New therapeutic strategies have to be set in place.
Esch
Tobias
T
The Mind/ Body Medical Institute, CareGroup and Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA. tesch@caregroup.harvard.edu
Stefano
George B
GB
Fricchione
Gregory L
GL
Benson
Herbert
H
D001161:Arteriosclerosis / Q000150:complications; D002318:Cardiovascular Diseases / Q000150:complications* / Q000209:etiology*; D003324:Coronary Artery Disease / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D009203:Myocardial Infarction / Q000150:complications; D013315:Stress, Psychological; D013997:Time Factors