Stress And Cardiovascular Disease

The main aim of this book is to evaluate the concept of stress and provide tools for physicians to identify patients who might benefit from stress management. This will incorporate a detailed description of the physiological and pathophysiological consequences of acute and chronic stress that might lead to cardiovascular disease. The book will aim to critically evaluate interventional research (behavioural and other therapies) and provide evidence based recommendations on how to manage stress in the cardiovascular patient. Our intentions are to define and highlight stress as an etiological factor for cardiovascular disease, and to describe an evidence based "tool box" that physicians may use to identify and manage patients in whom stress may be an important contributing factor for their disease and their risk of suffering cardiovascular complications.

The main aim of this book is to evaluate the concept of stress and provide tools for physicians to identify patients who might benefit from stress management. This will incorporate a detailed description of the physiological and pathophysiological consequences of acute and chronic stress that might lead to cardiovascular disease. The book will aim to critically evaluate interventional research (behavioural and other therapies) and provide evidence based recommendations on how to manage stress in the cardiovascular patient. Our intentions are to define and highlight stress as an etiological factor for cardiovascular disease, and to describe an evidence based "tool box" that physicians may use to identify and manage patients in whom stress may be an important contributing factor for their disease and their risk of suffering cardiovascular complications.

The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Annotation This book addresses one major question: Why do men get more heart disease than women? Recent global trends in heart disease show that traditional coronary risk factors, such as elevated blood pressure and cholesterol are poor candidates in explaining the gender gap in heart disease. Changes in these risk factors also cannot explain the recent cardiovascular disease epidemic among middle-aged men in Eastern Europe. This book will focus on environmental, behavioral, and psychosocial variables, as well as new risk factors of a biological nature in an attempt to understand the gender gap in heart disease. It combines perspectives from numerous disciplines, such as demography, epidemiology, medicine, sociology, and psychology. This book features the work of a distinguished group of international researchers appearing in Richard Stone's report on "Stress: the invisible hand in Eastern Europe's death rates" (Science, vol. 288, June 9, 2000, pp. 1732-33). It combines perspectives from numerous disciplines, such as demography, epidemiology, medicine, nutrition, sociology, and psychology to explore the environmental, behavioral, and psychosocial influences on men's greater susceptibility to heart disease

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

This is the seventh edition of a long-selling book (first edition 1991) that was translated into Italian, French, Chinese, Portuguese, Spanish, English. In the last ten years, stress echocardiography has exploded in its breadth and variety of applications. From a one-fits-all approach (wall motion by 2D-echo in the patient with known or suspected coronary artery disease), the field has progressed to an omnivorous, next-generation laboratory employing a variety of technologies (from M-Mode to 2D, from pulsed, continuous, color and tissue Doppler to lung ultrasound) on patients covering the entire spectrum of severity (from elite athletes to patients with end-stage heart failure) and ages (from children with congenital heart disease to the elderly with aortic stenosis). This new edition is enriched with over 300 figures, 150 tables and video-clips. In a societal and economic climate of increasing pressure for appropriate, justified and optimized imaging, stress echocardiography offers the great advantages of being radiation-free, relatively low cost, with minimal environmental impact, and with a staggering versatility: we can get more (information) with less (cost and risk). The volume will be a tremendous aid to current best practices for all health operators who intend to use stress echocardiography and ultrasound for diagnosis and guidance of optimal management in their patients.

An opening address should ask the right questions, which we expect to answer during the coming years. A good opening address should formu late hypotheses for falsification during the conference or in the near fu ture. Mter Dr. Groen's excellent lecture yesterday, I feel better about my task, because I feel I am not alone in asking the ten questions in my ab stract. It is an honor for me to give this short paper largely based on my expe riences during 15 years as medical director of a rehabilitation center in Ba varia, as a teacher at two medical schools in Munich and Innsbruck, and as an old-fashioned holistic cardiologist. However, it also is a difficult task for me because the subject of this conference concerning biobehavioral factors in coronary heart disease is controversial, not only in the medical society, but in my own mind as well. When I organized one of the first conferences on stress and coronary heart disease in West Germany in 1976, followed by conferences in 1979 and 1980, the semantic problems between physicians and psychologists were very significant. However, communication has improved in this area during the last decade. The most encouraging event in this field was a sym posium in May 1984 in Rotenburg/Fulda on the topic "Return to Work af ter Bypass Surgery", organized by a cardiac surgeon, Dr. Walter.

The starting point for understanding the roles of stress and catecholamines in cardiovascular disorders is a theory defining stress. This book presents a new homeostatic theory of stress and distress and uses it to explain how systems using the endogenous catecholamines - norepinephrine, epinephrine, and dopamine - and other effector systems maintain the internal environment during stress. The theory proposes coordinated activation of the body's several stress systems in primitively specific patterns during exposure to various stressors. Comparator homeostats interpret afferent information about specific physiological or chemical variables and regulate operations of the effector systems. Via a hierarchical mosaic of central nerve cell clusters, the brain constantly redefines homeostasis by resetting homeostats, especially during stress.

Not long ago, it was assumed that coronary heart disease mainly--or only--affected men. Now that CHD is recognized as a leading killer of women as well as men, numerous research studies have been made of its diverse presentations in women, causal factors, and possibilities for prevention and treatment. The expert contributions to Psychosocial Stress and Cardiovascular Disease in Women span the results of this cross-disciplinary awareness. This progressive resource takes a three-dimensional approach to its subject, focusing on epidemiology and risk factors for heart disease in women, the psycho- and neurobiology of stress and coronary disease, and promising clinical interventions. Chapters identify and analyze multiple intersections of social, biological, and psychological factors in affecting women's heart health, from the social dimensions of depression to genetic/environmental interactions to the demands of balancing work and family. These wide-ranging findings will assist and motivate professionals in choosing and creating interventions, developing appropriate prevention strategies, and reducing gender-based disparities in health care. Among the topics covered: Enhancing women's heart health: a global perspective. Coronary heart disease in women: evolution of our knowledge. Gender observations on basic physiological stress mechanisms in men and women. Sleep as a means of recovery and restitution in women. LifeSkills training: benefiting both genders, for different reasons. Gender considerations in psychosocial-behavioral interventions for coronary heart disease. In particular this book will be helpful for cardiologists and other clinicians who may ask themselves why patients do not seem to make rational choices. "Why do patients not follow the advice they are offered?" is a common complaint. The role of psychosocial stress for patient compliance and adherence can be traced throughout the volume. It is emphasized in the chapters on psychosocial interventions along with other tangible and conceptual suggestions and experiences with psychosocial stress and life style change. Psychosocial Stress and Cardiovascular Disease in Women offers a deep practical level of understanding of this epidemic to help expand the work of health and clinical psychologists, sociologists, cardiologists, primary care physicians, and epidemiologists.