Mental stress and coronary artery disease: a multidisciplinary guide.
Research suggests that acute and chronic stress are risk factors for the development and progression of coronary artery disease. Much of this work is multidisciplinary, using unfamiliar concepts deriving from disciplines other than cardiology and medicine. This article addresses and clarifies, for the cardiologist, some of the key concepts and issues in this area and provides an overview of evidence linking acute and chronic stress to cardiac pathology. Areas addressed include definitions and measurement of mental stress, methodological issues in stress research, and distinctions between stress and variables such as personality, emotion, and depression. Mental stress is a multifactorial process involving the environment, individual experiences and coping, and a set of neuroendocrine, autonomic, cardiovascular, and other systemic physiologic responses. There are difficulties identifying a single consensus physiologic stress measure because of individual differences in perceptions and physiologic response patterns. Nonetheless, important associations exist between mental stress and clinically relevant cardiovascular end points. As multidisciplinary research in this area continues, one major goal is the better integration of psychosocial knowledge and measures with cardiology research and practice.
Holmes
Sari D
SD
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA.
Krantz
David S
DS
Rogers
Heather
H
Gottdiener
John
J
Contrada
Richard J
RJ
D003327:Coronary Disease / Q000209:etiology* / Q000523:psychology; D018450:Disease Progression; D006801:Humans; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*