Mental stress as a trigger for heart attacks Flashcards
How many survivors attributed myocardial infarction to a behavioural trigger, such as emotional upset or change in posture?
~50%
How many CAD patients does lab stress induce ischemia in?
Up to 90%
What is lab mental stress-induced ischemia associated with?
Ambulatory ischemia; increased cardiac event risk; increased mortality
What are four ways that acute stress can trigger a cardiac event?
Increased HR and blood pressure; increased blood viscosity and haematocrit; changes in procoagulants; inflammatory reaction
How do inflammatory markers differ in patients?
Higher C-reactive protein in CAD patients and RA patients; increases further with stress
How do inflammatory markers relate to heart disease?
CRP is an indicator of the pathogenesis, progression, and complications
How do different patients respond to mental stress?
Patients with coronary heart disease, heart failure, and RA all had increase in systemic vascular resistance/ reduced ability to vasodilate
How can inflammation be induced?
By giving a vaccine
How does inducing inflammation affect vascular responses to stress?
Reduces vascular responses (e.g. resistance and dilation not affected as much) without altering HR = decreased risk of cardiac event
What factors can influence reactions to mental stress?
Resting inflammation, vascular function, blood pressure, lipids, coagulation
How does exercise affect risk of heart attacks?
Decreases risk of cardiac events; reduces levels of inflammation; improves vascular endothelial function; has been shown to increase, decrease, and not change vascular resistance (very unclear)
