Journal
ANNUAL REVIEW OF PUBLIC HEALTH, VOL 34
Volume 34, Issue -, Pages 337-+Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev-publhealth-031912-114452
Keywords
work stress; social isolation; emotional triggering; coronary heart disease; hypertension
Categories
Funding
- British Heart Foundation [RG/10/005/28296] Funding Source: Medline
- Medical Research Council [MR/K013351/1] Funding Source: Medline
- NHLBI NIH HHS [R01HL036310] Funding Source: Medline
- NIA NIH HHS [R01AG034454] Funding Source: Medline
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL036310] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R01AG034454] Funding Source: NIH RePORTER
- Economic and Social Research Council [ES/J023299/1] Funding Source: researchfish
- ESRC [ES/J023299/1] Funding Source: UKRI
- MRC [MR/K013351/1] Funding Source: UKRI
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Considerable progress has been made during the past decade in research on cardiovascular effects of stress. Early-life stressors, such as childhood abuse and early socioeconomic adversity, are linked to increased cardiovascular morbidity in adulthood. Our updated meta-analyses of prospective studies published until 2011 show a 1.5-fold (95% confidence interval 1.2-1.9) increased risk of coronary heart disease among adults experiencing social isolation and a 1.3-fold (1.2-1.5) excess risk for workplace stress; adverse metabolic changes are one of the underlying plausible mechanisms. Stress, anger, and depressed mood can act as acute triggers of major cardiac events; the pooled relative risk of acute coronary syndrome onset being preceded by stress is 2.5 (1.8-3.5) in case-crossover studies. Stress is also implicated in the prognosis of cardiovascular disease and in the development of stress (takotsubo) cardiomyopathy. A major challenge over the next decade is to incorporate stress processes into the mainstream of cardiovascular pathophysiological research and understanding.
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