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Year : 2022  |  Volume : 6  |  Issue : 4  |  Page : 209-210

Stressors and cardiovascular disease

Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, Canada

Date of Submission11-Nov-2022
Date of Acceptance22-Nov-2022
Date of Web Publication16-Dec-2022

Correspondence Address:
Prof. Ismail Laher
Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/hm.hm_56_22

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How to cite this article:
Laher I. Stressors and cardiovascular disease. Heart Mind 2022;6:209-10

How to cite this URL:
Laher I. Stressors and cardiovascular disease. Heart Mind [serial online] 2022 [cited 2023 May 31];6:209-10. Available from: http://www.heartmindjournal.org/text.asp?2022/6/4/209/363955

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in both developed and developing nations. Traditional and nontraditional risk factors are casually associated with CVDs, and much recent research provides persuasive evidence that nontraditional factors, such as noise, obstructive sleep apnea (OSA), loneliness, and psychosocial stress, among others act as “stressors” of the cardiovascular system. My long-standing interest in the regulation of the cardiovascular system in health and disease stimulated my efforts to be the guest editor of this issue that focuses on nontraditional factors of CVD and named the issue “Stressors and Cardiovascular Disease.

In a review entitled “Psychosocial Stressors in Psychosomatic Cardiology: A Narrative Review,” Töres Theorell (Sweden) discusses the definition of a psychosocial stressor and reactions to it in terms of individual and environmental factors. The relation of this model to psychophysiological stress reactions and regeneration, as well as its significance for CVDs, is described. Three classes of psychosocial stressors (life changes, work conditions, and family conflicts) are then described in relation to cardiovascular illness and risk factors. A particular emphasis is placed on longitudinal studies of patients. Heart contractility and urinary adrenaline excretion are discussed in detail. Epidemiological data on psychosocial stressors and CVD outcomes (mainly myocardial infarction) are also discussed.

Yuxi Wei et al. (Canada) provide a review entitled “A Narrative Review on Obstructive Sleep Apnea in China: A Sleeping Giant in Disease Pathology.” They reviewed aspects of OSA, with emphasis placed on experiences in China. This article indicates that undiagnosed and untreated OSA patients place a large and ongoing burden on health-care costs and services, transportation systems, workplace performance, and patient welfare. In addition, OSA increases the risk of developing CVDs and metabolic diseases. Therefore, they suggested giving priority to developing sleep quality scales more suitable to the Chinese culture and which are effective and less labor-intensive OSA treatment methods.

Simon W. Rabkin (Canada) contributed his work on “Does Psychosocial Stress Lead to Spontaneous Coronary Artery Dissection? A Review of the Evidence.” In this review, a systematic search was conducted of Medline and EMBASE from the inception of each database to June 30, 2022. The author conducted a literature search with the terms: coronary artery dissection or spontaneous coronary artery dissection (SCAD) and psychological stress, anxiety, or depression. He concluded that chronic psychological stress, anxiety, or depression is not associated with the development of SCAD, but that acute emotional stress may be a factor precipitating SCAD in some patients.

An interesting review entitled “Loneliness and Health: An Umbrella Review” is provided by Nima Rezaei et al. (Iran), where they reviewed systematic and meta-analytic studies on the epidemiology and etiology associated with medical and neuropsychiatric conditions, and interventions for loneliness. In particular, the current interventions for alleviating loneliness are mostly focused on older people. There is insufficient evidence to make firm conclusions on the effectiveness of interventions in youth. Therefore, the authors call for pathology- and population-specific interventions for loneliness reduction/prevention and also surveying loneliness longitudinally to examine the causality of loneliness-health associations.

Andre Faria et al. (Brazil) present a review “Is Noise Exposure a Risk Factor for Cardiovascular Diseases? A Literature Review.” They reviewed key epidemiological data indicating that noise pollution is not only associated with annoyance, disruption of sleep, and daily activities but also contributes to the pathogenesis and aggravation of CVDs. Given that, establishing efficient translational models for the pathology of noise-induced CVDs and identifying possible therapeutic targets are in critical need.

Nicole Virzi et al.'s (United States) study entitled “Depression Symptom Patterns as Predictors of Metabolic Syndrome and Cardiac Events in Symptomatic Women with Suspected Myocardial Ischemia: The Women's Ischemia Syndrome Evaluation (WISE and WISE-CVD) Projects,” continues investigations of their previous research on the subject. In this study, they examined relationships between somatic symptoms (SS) of depression, cognitive symptoms of depression, metabolic syndrome (MetS), inflammatory markers, coronary artery disease severity, and functional capacity in two independent cohorts of women with suspected ischemic heart disease. They report that SS was associated with MetS, where both SS and MetS independently predicted all-cause mortality and major adverse cardiovascular events. In conclusion, they suggest that clinicians need to pay specific attention to elevated CVD risk for women with SS.

Perceived stress plays an important role in the pathogenesis of CVDs, as discussed in the research “Perceived Stress and Cardiovascular Disease in a Community-Based Population” by Yiqiang Zhan et al. (China). The authors investigated the associations of perceived stress with well-defined CVDs in a population-based survey in Shenzhen, China, and report that greater perceived stress is associated with higher risks of CVDs among adults. Future studies are warranted to clarify the biological mechanisms and shed light on these associations.

This issue explores the role of stressors in the cardiovascular system and the benefits of mindfulness as mitigating strategies. Authors from various countries contributed their excellent articles and emphasize the need to consider CVD as a condition that can be initiated, sustained, or worsened by underlying psychosocial stressors. I remain grateful to all contributors for their enthusiastic support.


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