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Cardiac Autonomic Control Buffers Blood Pressure Variability Responses to ChallengeA Psychophysiologic Model of Coronary Artery Disease

 

作者: R. P. Sloan,   P. A. Shapiro,   E. Bagiella,   M. M. Myers,   J. M. Gorman,  

 

期刊: Psychosomatic Medicine  (OVID Available online 1999)
卷期: Volume 61, issue 1  

页码: 58-68

 

ISSN:0033-3174

 

年代: 1999

 

出版商: OVID

 

数据来源: OVID

 

摘要:

This article presents a model that identifies effects of blood pressure variability (BPV) as a possible mechanism by which psychological/psychiatric factors and health behaviors confer increased risk of coronary artery disease (CAD) and acute coronary syndromes.Recent research in vascular biology and dynamics of coronary artery blood flow suggests that BPV may have pathogenic effects on the coronary endothelium, plaque formation, and plaque stability. Thus, BPV may be a risk factor for cardiovascular disease independent of mean arterial pressure. The model proposes that autonomic control of the heart exerts a buffering or inhibitory influence on oscillations in blood pressure. Established psychological/behavioral risk factors for CAD, such as depression, hostility, and anxiety, as well as physical deconditioning and aging, are associated with diminished autonomic control of the heart, which may disinhibit pathogenic BPV. Together, these data suggest a coherent, testable psychophysiological model of CAD. In this article, we review these data and make recommendations for research to examine the model.

 



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