The Path From Chronic Stress To Heart Disease
Vitaliano, Ph.D., of the University of Washington, reports that while
the exact path connecting chronic stress and heart disease may vary
from person to person, there appears to be a general pattern — at
least in men.
says chronic stress is associated with psychological distress; factors
such as unsatisfactory social support and poor coping skills may
contribute to the link, he noted.
psychological distress is associated with poor health habits, such as
insufficient exercise; poor diet; and a number of changes in body
composition and metabolism that are well-established risk factors for
heart disease, Vitaliano reported. Eventually, these changes in body
composition and chemistry, known collectively as the metabolic
syndrome, produce heart disease, he said.
said he and his colleagues collected the evidence for this model from a
30-month study of 152 married, older adults. Eighty of the subjects
were caregivers for spouses with Alzheimer’s disease, while the
other 72 adults, none of whom were caregivers, served as a comparison
group, he explained.
studies have shown that caregivers routinely experience numerous
physical, emotional and financial stressors, according to the research
of caregiving, coupled with the biological vulnerabilities of aging,
put spouse caregivers at increased risk [for coronary heart disease],"
said the research team began the study by examining each subject for
attributes that tend to produce psychological distress, such as low
income, high exposure to stressors and insufficient coping skills. They
also assessed each subject’s level of psychological distress,
including depressive symptoms and sleep problems; obtained a
self-rating of exercise and diet habits; and looked for indications of
metabolic syndrome, including obesity, high blood pressureand elevated
levels of cholesterol, insulin and sugar, the researchers reported. All
of the evaluations were repeated 15 to 18 months later, the team said.
The team said
their findings revealed that the caregivers started from a more
vulnerable position than the comparison group and had a greater
tendency to suffer from obesity, depression and disturbed sleep. Heart
disease was equally prevalent among the caregivers and comparison group
when the study began; however, 27 to 30 months later, 54 percent of the
caregiver men suffered from heart disease, compared to 26 percent of
comparison group men, according to the findings.
"In men, the
pathway from [psychological] distress to the metabolic syndrome was one
of the largest pathways from caregiving to [heart disease]," Vitaliano
He said the
study findings suggest a direct, immediate relationship between
distress and metabolic syndrome, and an indirect delayed link where
distress promotes poor health habits that eventually exacerbate
hormone replacement therapy (HRT) may affect many of the factors that
predispose women to heart disease, the researchers divided the women
into two groups: those using HRT and those who did not, Vitaliano said.
Evidence of a connection between chronic stress and heart disease was
less clear in either group of women than it was among the men, he
the research was provided by grants from the National Institute of
Mental Health, the National Institute on Aging, the National Cancer
Institute and the National Heart, Lung and Blood Institute.
Copyright 2002 Health Resources Publishing