Psychological Stress and Cardiovascular Disease

Dimsdale, Joel E.

doi:10.1016/j.jacc.2007.12.024

Cited by 929 publications

(665 citation statements)

References 41 publications

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“…Both tests have been used extensively in psychophysiological research. 24,25 Each task lasted for 1 min, followed by a 15-min recovery. Beat-to-beat BP was continuously assessed throughout psychophysiological testing using the Finometer device.…”

Section: Blood Pressure Measurementsmentioning

confidence: 99%

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

Schutte

Huisman

et al. 2011

Hypertens Res

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The prognostic significance of blood pressure (BP) variability has lately enjoyed considerable attention. The need for early markers of cardiovascular dysfunction is imperative in black South Africans who have a significant risk for cardiovascular disease. We therefore compared 24-h BP variability with various traditional and advanced BP measurements, regarding their association with sub-clinical organ damage in black and white South Africans. The study included 409 African and Caucasian teachers aged 25-60 yrs. We measured office BP, 1-min continuous (finger) BP, ambulatory BP, BP reactivity and determined weighted 24-h BP variability. Albumin-to-creatinine ratio, Cornell product and carotid cross-sectional wall area (CSWA) were measures of organ damage. Africans had higher 24-h BP, BP variability, BP reactivity and sub-clinical organ damage (Po0.001). Correlations of BP variability with organ damage were overall weak when compared with other BP measurements. In normotensive groups, we found an independent association of 24-h systolic BP (SBP) variability with Cornell product only in Africans (r¼0.37; P¼0.01), confirmed in multiple regression models, with 24-h SBP included in the model. Only in hypertensive Caucasians, a significant correlation between CSWA and 24-h SBP variability was evident (r¼0.30; P¼0.01), although CSWA indicated stronger correlations with office or 24-h SBP than 24-h SBP variability. To conclude, 24-h SBP variability could potentially be an effective measure for the early detection of normotensive Africans at increased risk for the development of cardiovascular complications. Its usefulness based on associations with target organ damage in hypertensive groups seems to be less than traditional office or 24-h BP measurements. Hypertension Research (2011Research ( ) 34, 1127Research ( -1134 doi:10.1038/hr.2011; published online 28 July 2011Keywords: albumin-to-creatinine ratio; ethnicity; intima-media thickness; left ventricular hypertrophy INTRODUCTIONThe prognostic significance of blood pressure (BP) variability has lately enjoyed considerable attention in the literature. [1][2][3][4][5][6][7][8][9][10] Where some papers emphasize the importance of BP variability in prediction of risk of vascular events, 1,2,6,9 others question its prediction of cardiovascular outcome. 4,5,10 Despite this upsurge of recent papers, consistent evidence over the past three decades lends support that both target organ damage and the rate of cardiovascular events of hypertensive patients are significantly and independently related to the degree of BP variability. [11][12][13][14][15] A limitation of many of these papers is that either BP variability alone was investigated, or various measures of BP variability (such as s.d. of 24-h BP, average real variability index 16 and weighted 24-h BP s.d. 17 ) were being compared, regarding the strength of their association with target organ damage.The question therefore arises how BP variability would benchmark against a comprehensive range of both traditional and advanced

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Section: Blood Pressure Measurementsmentioning

confidence: 99%

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

Schutte

Huisman

et al. 2011

Hypertens Res

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“…82,83 In fact, the AHA has recently targeted the evaluation and treatment of depression in patients with established CHD, 84 listing CRSP services as a major therapeutic modality to decrease depression and its associated risks. 85 Although most of the attention has been directed at depression, 84,86 other adverse psychological characteristics, including anxiety, 87,88 hostility, [88][89][90] and total psychosocial stress, 82,91,92 may also be significant CHD risk factors. In this regard, we have demonstrated reductions of between 40% and 70% in the prevalence of depression, anxiety, and hostility after formal, early outpatient CRSP services.…”

Section: Cicero 81mentioning

confidence: 99%

Exercise Training and Cardiac Rehabilitation in Primary and Secondary Prevention of Coronary Heart Disease

Lavie

Thomas

Squires

et al. 2009

Mayo Clinic Proceedings

241

103

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“…Several studies have proposed an association between psychosocial stress or marital status and cardiovascular disease 20, 21. High levels of marital or job stress were associated with progression of coronary stenosis in women with a previous coronary event 22.…”

Section: Discussionmentioning

confidence: 99%

Sex Differences in Clinical Characteristics, Psychosocial Factors, and Outcomes Among Patients With Stable Coronary Heart Disease: Insights from the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) Trial

Guimarães

Granger

Stebbins

et al. 2017

JAHA

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BackgroundGreater understanding of differences between men and women with coronary heart disease is needed.Methods and ResultsIn this post hoc analysis of the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial, we described psychosocial factors, treatments, and outcomes of men versus women with stable coronary heart disease and explored the association of sex with psychosocial characteristics and cardiovascular risk. Cox proportional hazards models were used to assess the relationship between sex and outcomes. Interactions among sex, psychosocial factors, and the composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke were tested. Of 15 828 patients, 2967 (19%) were women. Among women, 21.2% felt often or always stressed at home (versus 9.8% of men), and 19.2% felt often or always sad or depressed (versus 10.1% of men; all P<0.0001). The median duration of follow‐up was 3.7 years (25th–75th percentiles: 3.5–3.8 years). Use of evidence‐based medications for coronary heart disease at baseline and 24 months was similar between sexes, as were event rates for all outcomes analyzed. In the multivariable model including psychosocial measures, female sex was associated with lower cardiovascular risk. There was a statistically significant interaction (P=0.03) such that the lower risk in women varied by depressive symptom frequency, whereby women who were more depressed had a risk similar to men.ConclusionsFemale sex was independently associated with better long‐term clinical outcomes, although this was modified by frequency of depressive symptoms. This suggests that emotional state may be an important target for improving outcomes in patients with coronary heart disease, specifically in women.Clinical Trial RegistrationSTABILITY ClinicalTrials.gov number (NCT00799903).

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Psychological Stress and Cardiovascular Disease

Cited by 929 publications

References 41 publications

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

Blood pressure variability is significantly associated with ECG left ventricular mass in normotensive Africans: The SABPA Study

Exercise Training and Cardiac Rehabilitation in Primary and Secondary Prevention of Coronary Heart Disease

Sex Differences in Clinical Characteristics, Psychosocial Factors, and Outcomes Among Patients With Stable Coronary Heart Disease: Insights from the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) Trial

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