Anxiety and coronary heart disease: A synthesis of epidemiological, psychological, and experimental evidence

被引:200
作者
Kubzansky, LD
Kawachi, I
Weiss, ST
Sparrow, D
机构
[1] Harvard Univ, Sch Publ Hlth, Dept Hlth & Social Behav, Boston, MA 02115 USA
[2] Brigham & Womens Hosp, Channing Lab, Boston, MA 02115 USA
[3] Beth Israel Hosp, Boston, MA USA
[4] Harvard Univ, Sch Med, Cambridge, MA 02138 USA
关键词
D O I
10.1007/BF02884448
中图分类号
B84 [心理学];
学科分类号
04 ; 0402 ;
摘要
The purpose of this review is to examine the epidemiological, psychological, and experimental evidence for an association between anxiety and coronary heart disease (CHD). Papers published during the pears 1980-1996 on anxiety and CHD and relevant publications from earlier years were selected for this review: Epidemiologic evidence suggests that anxiety may be a risk factor for the development of CHD. Chronic anxiety may increase the risk of CHD by: (a) influencing health behaviors (e.g. smoking); (b) promoting atherogenesis (e.g. via increased risk of hypertension); and (c) triggering fatal coronary events, either through arrhythmia, plaque rupture, coronary vasospasm, or thrombosis. Electrophysiologic evidence is particularly compelling: anxiety appears to be associated with abnormal cardiac autonomic control, which may indicate increased risk of fatal ventricular arrhythmias. The strength, consistency and dose-response gradient of the association between anxiety and CHD, together with the biologic plausibility of the experimental evidence, suggest that anxiety may contribute to risk of CHD and that the relationship warrants further investigation.
引用
收藏
页码:47 / 58
页数:12
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