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Psychosocial Stress and Cardiovascular Disease

  • Prevention (K Aragam, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

This manuscript reviews the epidemiological data linking psychosocial stress to cardiovascular disease (CVD), describes recent advances in understanding the biological pathway between them, discusses potential therapies against stress-related CVD, and identifies future research directions.

Recent findings

Metabolic activity of the amygdala (a neural center that is critically involved in the response to stress) can be measured on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) yielding a neurobiological signal that independently predicts subsequent CVD events. Furthermore, a serial pathway from ↑amygdalar activity → ↑hematopoietic tissue activity → ↑arterial inflammation → ↑CVD events has been elucidated, providing new insights into the mechanism linking stress to CVD.

Summary

Psychosocial stress and stress conditions are independently associated with CVD in a manner that depends on the degree and duration of stress as well as the individual response to a stressor. Nevertheless, the fundamental biology remains incompletely defined, and stress is often confounded by adverse health behaviors. Thus, most clinical guidelines do not yet recognize psychosocial stress as an independent CVD risk factor or advocate for its treatment in CVD prevention. Clarification of this neurobiological pathway provides a better understanding of the underlying pathophysiology and suggests opportunities to develop novel preventive strategies and therapies.

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Funding

This work is supported in part by the following grants: AHA 18CDA34110366 and National Center for Advancing Translational Sciences NIH KL2TR002542 (MTO) and NIH/NHLBI P01HL131478 (AT).

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  1. Tawseef Dar and Azar Radfar contributed equally to this work.

Authors and Affiliations

  1. Cardiac MR-PET-CT Program, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    Tawseef Dar MD, Azar Radfar MD, PhD, Shady Abohashem MD, Ahmed Tawakol MD & Michael T. Osborne MD

  2. Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 55 Fruit St, Boston, MA, USA

    Tawseef Dar MD, Azar Radfar MD, PhD, Shady Abohashem MD, Ahmed Tawakol MD & Michael T. Osborne MD

  3. Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Roger K. Pitman MD

  4. Cardiology Division, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA, 02114-2750, USA

    Michael T. Osborne MD

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Dar, T., Radfar, A., Abohashem, S. et al. Psychosocial Stress and Cardiovascular Disease. Curr Treat Options Cardio Med 21, 23 (2019). https://doi.org/10.1007/s11936-019-0724-5

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