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Stress and cardiovascular disease: an update on current knowledge.
Annual Review of Public Health ( IF 20.8 ) Pub Date : 2013-01-07 , DOI: 10.1146/annurev-publhealth-031912-114452
Andrew Steptoe 1 , Mika Kivimäki
Affiliation  

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.

中文翻译:

压力和心血管疾病:当前知识的更新。

在过去十年中,压力对心血管影响的研究取得了相当大的进展。早期生活压力源,例如童年虐待和早期社会经济逆境,与成年期心血管疾病发病率增加有关。我们对截至 2011 年发表的前瞻性研究的最新荟萃分析显示,在经历社会孤立的成年人中,冠心病的风险增加了 1.5 倍(95% 置信区间为 1.2-1.9),工作场所的风险增加了 1.3 倍(1.2-1.5)压力; 不利的代谢变化是潜在的合理机制之一。压力、愤怒和抑郁情绪可以作为主要心脏事件的急性触发因素;在病例交叉研究中,急性冠状动脉综合征发作之前有压力的汇总相对风险为 2.5 (1.8-3.5)。压力还与心血管疾病的预后和压力(takotsubo)心肌病的发展有关。未来十年的一个主要挑战是将压力过程纳入心血管病理生理学研究和理解的主流。
更新日期:2013-03-20
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