title: Cardiovascular disease risk factors in adolescents: do negative emotions and hypothalamic-pituitary-adrenal axis function play a role?
abstract: OBJECTIVE
  Negative emotions such as depression and hostility/anger are important risk factors for cardiovascular disease in adults, but are often neglected in treatment or prevention programs. Adolescence is a stage of life when negative emotions often first become problematic and is also a time when the pathogenesis of cardiovascular disease appears to accelerate. The literature on negative emotions and cardiovascular disease risk factors in adolescents is reviewed here.
  
  
  RESULTS
  Research indicates that negative emotions are associated with cardiovascular disease risk factors in adolescence. Negative emotions are also associated with several types of hypothalamic-pituitary-adrenal axis dysregulation. Such dysregulation appears to have a facilitatory effect on cardiovascular disease development and progression in adults. Thus, it is possible that negative emotions in adolescents may be risk factors for the development of cardiovascular disease via dysregulation of the hypothalamic-pituitary-adrenal axis. Although this hypothesis has not been directly tested, some studies indirectly support the hypothesis.
  
  
  CONCLUSIONS
  Negative emotions are associated with cardiovascular disease risk factors in adolescents; it is possible that hypothalamic-pituitary-adrenal axis dysregulation is an important mechanism. This hypothesis merits further research. If the hypothesis is valid, it has significant implications for early prevention of cardiovascular disease.
authors: Department of Pediatrics, Columbus Children's Research Institute, Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH 43205, USA. pajerk@pediatrics.ohio-state.edu
authors: Kathleen A
authors: KA
authors: Pajer
mesh_terms: D000293:Adolescent; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000523:psychology*; D003863:Depression / Q000150:complications; D004644:Emotions / Q000502:physiology*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology*; D010913:Pituitary-Adrenal System / Q000502:physiology*; D000297:Psychology, Adolescent; D012307:Risk Factors