Week 3 Flashcards
What is cardiovascular disease ?
condition affecting the structures or function of the heart or blood vessels
What are the 3 types of CVD ?
- Coronary Arterial Disease (coronary heart disease)
- Myocardial infarction (heart attack)
- Stroke (cerebrovascular disease)
What is coronary arterial disease ?
Progressive degenerative inflammatory disease involving atherosclerosis (clogging) of the arteries
What is a myocardial infarction ?
When the heart has insufficient blood supply usually due to occlusion of a coronary artery which results in cardiac tissue death (agina is a warning - innadequate supply to heart)
What is a stroke ?
When brain has insufficient blood supply and oxygen (Ischemic) or ruptured vessel of the brain (hemorrhagic)
Which type of CVD is most common ?
Myocardial infraction (~30-50% of CVD cases)
How are CVD linked to Stress-system activation ?
- Activation of the SAM system leads to increased heart rate, blood pressure and release of stress hormones that facilitate cardiovascular output (FoF)
- Heart displays increased force of contraction of blood through arteries (wear and tear of arteries over time - AL)
- Increase in cholesterol (LDL) and triglycerides in the blood
What is arteriosclerosis ?
Thickening and stiffening of arterial walls
What is atherosclerosis?
Cholesterol (LDL) builds up along the arterial walls
* creates blockage making it difficult for bloof to move through
What is hypertension ?
Blood pressure in the arteries is persistently elevated
* increases risk of CVD
What are the 2 types of blood pressures ?
- Systolic blood pressure
- Diastolic blood pressure
What is systolic blood pressure ?
maximum pressure you heart exerts while beating (pressure of blood as it leaves the heart)
What is diastolic blood pressure ?
amount of pressure of the blood against the arterial walls when the heart is relaxed ( in b/w beats)
What are people with hypertension more likely to have ?
Persons with hypertension are more likely to have high catecholamine (NE and E) levels
What is the Reactivity Hypothesis ?
Exaggerated or high cardiovascular responses during acute psychological stressors may reflect an increased susceptibility to later cardiovascular pathology
What did the R.H consider ?
The reactivity hypothesis only considered sympathetic activation
What is the Bidirectional Multi-system Reactivity Hypothesis ?
The magnitude of the response to acute psychological stress (exaggerated or blunted) in both the SAM system and HPA axis in healthy adults is related to future health and disease outcomes, both physical and mental
What did the study of the relationship b/w stress and hypertension find ?
- Participants: 479 initially healthy men and women (63 yrs)
- Measurement: Salivery cortisol reactivity to mental challenge
- Results: Reactive participants (40%) had 1.59 increased odds of developing hypertension 3 yrs later (increased risk)
What are lipoproteins ?
transport lipids, including cholesterol
What are the 2 types of lipoproteins ?
- Low-density lipoprotein (LDL)
- High-density lipoprotein (HDL)
What are LDL’s ?
- Bad cholesterol
- transfers cholesterol to arterial walls
- increased levels leads to clogged arteries
What are HDL’s ?
- Good cholesterol
- transfers cholesterol to the liver for breakdown
What is hypercholesterolemia ?
excess LDL cholesteroal in the blood
* increased cholesterol accumulates along the walls of blood vessels and arteries (plaques); blocking flow of blood to heart and/or brain
What is INTERHEART ?
Largest global study to measure risk of MI
What did the INTERHEART study find ?
- Observational case-control study over 4 yrs across 52 countries
- Found that 90% of risk can be modified by lifestyle
What did the CHD prevention program find ?
- Multicomponent secondary coronary heart dieasease prevention program
- Participants: 869 CHD patients
- Intervention: Multi-site Cardiac Lifestyle Intervention Program (Exercise, Diet, and/or Stress management
- Results: 3 Lifestyle interventions individually, additively and interactively related to improved coronary risk ( exercise, low-fat diet, stress management, lower hostility)
What did the Ornish lifestyle program study find ?
- Research question: Does a comprehensive lifestyle change stop or reverse coronary atherosclerosis ? (w/ no lipid lowering drugs)
- Ornish lifestyle program: 10%-fat whole foods vegetarian diet, moderate aerobic exercise, stress management, smaking cessation, group psychosocial support
- Control: physician prescirbed lifestyle changes
- Results: Ornish program resulted in 91% angine reduction in yr 1 and 72% angine reduction in yr 5; decreased arterial stenosis over 1 yr and 5 yrs
What was found in regards to myocardial infart in younger and older adults ?
- Background: Rise in MI among yougner individuals - more prooductive years lost
- Objective: compare baseline characteristics, risk factors, angiography & outcomes b/w MI patients younger than 40 & MI patients 41-50 years old
- Findings: Increase in “younger” MI from 2006 - 2016; Outcomes following discharge did not differ b/w younger and older patients over 11 year follow up (even though “young” were 10 yrs younger!)
What is skeletal muscle tension ?
Stress results in tensing. known as “bracing”
What does SMT lead to ?
Leads to the development of muscle pain and aches
What is involved with a tension-type headache (TTH)?
- Most commmon type of headache
- TTH sufferes report a higher # of daily hassles (proximal stress)
- Patients more likely to be pain sensitive
- associated w/ proximal stressors, not distal stressors (migraines)
What is involved within bruxism and temporo-mandibular pain (TMP) ?
- seems to be stress-related
- Patients have high muscle-tension
- Correlations b/w reports of stress during day and bruxism at night
- TMP related to hyperactivity and spams of masticatory muscles
What prevention strategies can be used for SM conditons ?
- CBT (indentify underlying issues)
- Biofeedback/combined w/ relaxation
- Progressive muscle relaxation
- Mindfulness
- Night guard
- Botox (neuromodulator)
What are Atopic disorders ?
mucosal inflammatory disorders caused by biological hypersensitivity and inflammation
What are 2 types of atopicdisorders ?
- Asthma
- Atopic dermatitis (e.g., psoriasis)
What is hypersensitivity ?
exaggerated or innapropriate immunologic responses occurs in response to an antigen or allergen
What is linked to atopic disorders ?
- High Th2, increases pro-inflammatory cytokines, IgE antibody
- Comobidity with mental health conditions (anxiety, depression)
What type of relationship do atopic disorders have w/ stress?
- Bidirectional - etiological and prognostic role of stress
What can asthma be caused by ?
Asthma can be caused by allergens, exertion, and even early psychosocial factors
* Etiology: early stress exposure and psychological distress predicted onset of atopic disorders
* Bidirectional: asthma attacks create stress, increasing the attacks
* Prevention: Writing about stressful expereinecs can helo minimize asthma
What is Atopic dermatitis ?
Hypersenistivity of the skinf to food or environmental allergens
What did the study looking at the 1995 Great Hanshin earthquake find ?
- Participants: 1457 atopic dermatitis pateints: area A ( greater than 20%), area B (less than 20%) and area C (unaffected)
- Results: Area A reported greater onset of symptom and symptom exacerbation; perceived stress was great contributor, controlling for debris exposure and medication cessation
What do the stress-sensitive systems look like in atopic disorder ?
- HPA axis: blunted response in AD patients
- SAM axis: enhanced reactivity in AD patients
- Suggests that HPA and SAM are independent systems!
What is cancer ?
endogenous abnormal cells develop, proliferate, and invade the body’s healthy tissues
How is stress connected to cancer ?
- Stress-cancer association stems from animal research
- Stress supresses immune function - suppresses NK cells which destroy cancerous cells
- Stress increases GCs and glucose, both which can feed the cancer cell and aid proliferation
What is the issue with animal research in relation to cancer ?
- Issue: Does this translate to humans?
- Cancer in mice and humans is not created equal - tumors are usually induced in mice, not spontaneous and are induced via a virus
- Developmental of humanized animal models providing better “spontaneous” cancer models (NSG-SSGM3 mice)
What is the “iffy” evidence surrounding cancer ?
- Research in humans is limited to observational studies
- Most findings in humans stem from poorly design research or designs that preclude causality
- Overall, findings have been mixed for the etiological role of stress
What did the study conducted on the association b/w AL and breast cancer risk find ?
- Participants: 181,4555 women from the UK Biobank
- Follow-up: 2006-2020
- AL score from 0-11
- Women w/ BC: older, White, younger age menarche, ever used HRT, post-menopause, family hisotry, ever smoker, sedentary, heavy drinker, genetic risk
- Compared to low AL group (1-2), high AL group (3-11) have 1.17 -fold increased risk of breast cancer
- For every 1-point increase in AL, cancer risk increased by 5%
What did the Ornish Lifestyle and Prostate Cancer study find ?
- Participants: Men with early stage prostate cancer not seeking convetional treatment ( 49 controls vs 44 Ornish lifestyle)
- Outcome Measures: Prostate specific antigen (PSA) levels and tumor growth at 12 months
What is the link b/w stress and GID ?
- Stress reduces saliva production and increases hydrochloric acid production
- Stress can alter rhythmic movement of food, leading to bowel distress and diseases
What are some GI Disorders ?
- Peptic Ulcers
- Inflammatory Bowel Disease
- Irritable Bowel Syndrome
What are Peptic ulcers ?
erosions in lining of esophagus, stomach or duodenum (bacterial or stress)
What are Inflammatory Bowel Disease ?
- organic (abnormallity in GI tract)
- ulcerative colitis and Crohn’s disease
What is Irritable Bowel Syndrome ?
- functional (nothing wrong w/ organ/tissue)
- impact 11.2 of the global population
What evidence has been found in regards to GID ?
- Talley et al 1994: Thosw who had an abuse hisotry were 2x as likely to have IBS. Those who reported abuse in both childhood and adulthood were 3x as likely to have IBS
- Walker et al 1993: Patients with IBS had a significantly higher rate of severe lifetime sexual trauama, severe childhood sexual abuse, and any lifetime sexual victimization compared w/ IBD patients
What is Type II Diabetes Mellitus (T2DM) ?
A metabolic disorder where glucose is high. Body does not produce enough insulin to move glucose into cells; or cells stop responding (insulin resistance)
What does cortisol do in the context of T2DM?
Cortisol raises blood glucose levels and directs cells to resist insulin’s signals to store glucose
What are risk factors of T2DM ?
- Increased weight
- High blood pressure
- Low HDL and high TRI
- Race (BIPOC)
- Sedentary lifestyle
- Diet
What does research state regarding T2DM ?
- National Comobidity Survey: A history of childhood neglect was associated with a higher risk of diabetes; risk was higher among women
- The Hoorn Study: Persons who experienced significant life events during the past 5yrs had a 1.6-fold increased risk for T2DM compared to those who didn’t
