Stress and heart disease: a few basics and heuristic models

Kop provides a readable account of psychological risk factors for CAD. His model provides a useful way of organising the material on stress and CVD & the material on “vital exhaustion” will be covered later in the lecture on depression. Kop, WJ (1999) Chronic and acute psychological risk factors for clinical manifestations of coronary artery disease. Psychosomatic Medicine, 61, Black and Garbutt are not for the feint hearted. They offer a very complex physiological model of stress, inflammation and CVD. Incorporates a lot of important new information but only for those with background in biology. I shall use model illustratively Black, PH., & Garbutt, LD (2002). Stress, inflammation and cardiovascular disease. J. of Psychosomatic Res., 52, 1-23

Rozanski paper is very up to date account of stress and heart disease written for cardiologists. I strongly recommend it. Rozanski, A., Blumenthal, JA., Davidson, KW, Saab, PC., Kubzansky, L (2005). The epidemiology, pathophysiology, and management of psychosocial risk factors in cardiac practice. J. American College of Cardiology., 45,

Words you main not have come across Atheroma, Atherosclerosis, Atherosclerotic plaque Thrombus

Process of build up of atherosclerotic plaque, plaque rupture and thrombus formation.

What causes a Myocardial Infarction: Plaque rupture and blocked coronary artery No MI, plaque remains Unstable situation Artery blocked, MI results

Black PH Garbutt LD (2003) Stress, inflammation and cardiovascular disease, J Psychosom. Res 52, 1 -23

Psychological stress and platelet activation: Differences in platelet reactivity in healthy men during active and passive stressors. Patterson, S. M.; Zakowski, SG.; Hall, Martica H.; Health Psychology, Vol 13, pp

Effects of stress on platelets, and hence clotting & process of atherogenesis. See particularly PF (Platelet Factor) 4

The diathesis model: stress plus vulnerability