Recent Life Changes, Myocardial Infarction, and Abrupt Coronary Death

Rahe, Richard H.; Romo, Matti; Bennett, Linda; Siltanen, P

doi:10.1001/archinte.1974.00320140059006

Cited by 140 publications

(24 citation statements)

References 10 publications

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“…In one study, marked elevations in Recent Life Change scores were seen for most cases of MI or sudden cardiac death during the 6-month period preceding these events. 152 Similar confirmations of increased life stress before cardiac events can be extended to specific cohorts, ranging from healthy middle-aged men 153 to patients presenting with acute myocardial infarction. 154 …”

Section: Chronic and Subacute Life Stressmentioning

confidence: 67%

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

1999

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Abstract-Recent studies provide clear and convincing evidence that psychosocial factors contribute significantly to the pathogenesis and expression of coronary artery disease (CAD). This evidence is composed largely of data relating CAD risk to 5 specific psychosocial domains: (1) depression, (2) anxiety, (3) personality factors and character traits, (4) social isolation, and (5) chronic life stress. Pathophysiological mechanisms underlying the relationship between these entities and CAD can be divided into behavioral mechanisms, whereby psychosocial conditions contribute to a higher frequency of adverse health behaviors, such as poor diet and smoking, and direct pathophysiological mechanisms, such as neuroendocrine and platelet activation. An extensive body of evidence from animal models (especially the cynomolgus monkey, Macaca fascicularis) reveals that chronic psychosocial stress can lead, probably via a mechanism involving excessive sympathetic nervous system activation, to exacerbation of coronary artery atherosclerosis as well as to transient endothelial dysfunction and even necrosis. Evidence from monkeys also indicates that psychosocial stress reliably induces ovarian dysfunction, hypercortisolemia, and excessive adrenergic activation in premenopausal females, leading to accelerated atherosclerosis.Also reviewed are data relating CAD to acute stress and individual differences in sympathetic nervous system responsivity. New technologies and research from animal models demonstrate that acute stress triggers myocardial ischemia, promotes arrhythmogenesis, stimulates platelet function, and increases blood viscosity through hemoconcentration. In the presence of underlying atherosclerosis (eg, in CAD patients), acute stress also causes coronary vasoconstriction. Recent data indicate that the foregoing effects result, at least in part, from the endothelial dysfunction and injury induced by acute stress. Hyperresponsivity of the sympathetic nervous system, manifested by exaggerated heart rate and blood pressure responses to psychological stimuli, is an intrinsic characteristic among some individuals. Current data link sympathetic nervous system hyperresponsivity to accelerated development of carotid atherosclerosis in human subjects and to exacerbated coronary and carotid atherosclerosis in monkeys.Thus far, intervention trials designed to reduce psychosocial stress have been limited in size and number. Specific suggestions to improve the assessment of behavioral interventions include more complete delineation of the physiological mechanisms by which such interventions might work; increased use of new, more convenient "alternative" end points for behavioral intervention trials; development of specifically targeted behavioral interventions (based on profiling of patient factors); and evaluation of previously developed models of predicting behavioral change. The importance of maximizing the efficacy of behavioral interventions is underscored by the recognition that psychosocial stresses tend to cluster together. ...

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Section: Chronic and Subacute Life Stressmentioning

confidence: 67%

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

1999

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“…A number of anthropological and biomedical studies suggest a link between psychological stress and sudden death (e.g. Brodsky et al 1987;Cannon 1942;Engel 1971;Greene, Goldstein, and Moss 1972;Lown, Verrier and Corbalan 1973;Ornstein and Swencionis 1990;Rahe et al 1974. ) In the medical anthropological and ethnomedical literature, the notion of beliefs playing a significant role in illness causation (nocebo effect) or its remedy (placebo effect) is widely held (Hahn and Kleinman 1983:3,16;Ornstein andSwencionis 1990, Scheper-Hughes andLock 1987).…”

Section: The Nightmare As the Trigger For Hmong Sundsmentioning

confidence: 99%

Ethnomedical pathogenesis and Hmong immigrants' sudden nocturnal deaths

Adler

1994

Cult Med Psych

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Scores of seemingly healthy Hmong immigrants have died mysteriously and without warning from what has come to be known as Sudden Unexpected Nocturnal Death Syndrome (SUNDS). To date medical research has provided no adequate explanation for these sudden deaths. This study is an investigation into the role of powerful traditional beliefs in illness causation. In Stockton, California, 118 Hmong men and women were interviewed regarding their awareness of and personal experience with a traditional nocturnal spirit encounter. An analysis of this data reveals that the supranormal encounter acts as a trigger for Hmong SUNDS.

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“…Rahe et al (6) found marked eleva tions in magnitude of life changes during 6 months immediately prior to abrupt coronary death. Holmes (5) has recently argued convincingly of the lethal con sequences of the expectation of death under circumstances of crisis, disease, living dangerously, old age, and sin.…”

mentioning

confidence: 97%

“…Studies of the psychosocial determinants of death have focused on the causative roles of sudden emotional shock (1 ,2 ), bereavement (3,4), crisis (5), increased magnitude of life change events (6), and self-prediction (7). Engel (1) described a reaction to crisis he called giving up-given up, which caused death in healthy or sick individuals at any age.…”

mentioning

confidence: 99%

Expectation of Death: Case Reports with Implications for Medical and Psychiatric Care

Jensen¹

1980

Psychother Psychosom

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4 cases are reported in which fatal outcome is attributed to expectation of death. They illustrate the role of the individual and the interaction of the individual and the family. These cases support the contention that the expectation of death and the probability of lethal outcome are high under conditions of crisis, old age, illness, and sin. 2 cases exemplify techniques by which primary caregivers may prevent premature death in persons in which expectation is operative. Awareness of the process will facilitate appropriate diagnostic evaluation which can lead to effective management.

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Recent Life Changes, Myocardial Infarction, and Abrupt Coronary Death

Cited by 140 publications

References 10 publications

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy

Ethnomedical pathogenesis and Hmong immigrants' sudden nocturnal deaths

Expectation of Death: Case Reports with Implications for Medical and Psychiatric Care

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