| Cardiac autonomic control buffers blood pressure variability responses to challenge: a psychophysiologic model of coronary artery disease. | |
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MedLine Citation:
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PMID: 10024068 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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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Authors:
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R P Sloan; P A Shapiro; E Bagiella; M M Myers; J M Gorman |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review |
Journal Detail:
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Title: Psychosomatic medicine Volume: 61 ISSN: 0033-3174 ISO Abbreviation: Psychosom Med Publication Date: 1999 Jan-Feb |
Date Detail:
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Created Date: 1999-06-01 Completed Date: 1999-06-01 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0376505 Medline TA: Psychosom Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 58-68 Citation Subset: IM |
Affiliation:
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Columbia-Presbyterian Medical Center, Department of Psychiatry, Columbia University, New York, New York 10032, USA. rps7@columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Disease
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psychology* Depressive Disorder / diagnosis, psychology Female Heart Rate / physiology* Hostility Humans Male Models, Biological* Risk Factors |
| Grant Support | |
ID/Acronym/Agency:
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M01-RR00645/RR/NCRR NIH HHS; MH-01035/MH/NIMH NIH HHS; R01 MH43977/MH/NIMH NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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