YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==STRESS AND HEART== 3 AUTHOR Fritze E AUTHOR Muller KM TITLE [Cardiac death and acute myocardial infarct after psychological or physical stress--causality questions and insurance law] SOURCE Versicherungsmedizin; VOL 47, ISS 4, 1995, P143-7 (REF: 71) ABSTRACT Often, it is the question to the medical expert, if there is a causality in the lawful sense from professional effort or psychical stress to acute coronary death or acute myocardial infarction. Following the German social law the connection has to be probably. Probability is well defined juridically opposite to possibility. The medical expert has to answer if the physical or psychical stress has caused the fatality or not more than manifested. Here are discussed arguments that the atheromatosis of the coronary vessels has much more importance than the manifestation of acute death or myocardial infarction caused by spasmus. There is no evidence for the existence of spastic genesis without any arteriosclerotic focus. 4 AUTHOR Cas LD AUTHOR Metra M AUTHOR Nodari S AUTHOR Nardi M AUTHOR Giubbini R AUTHOR Visioli O TITLE [Stress and ischemic heart disease] SOURCE Cardiologia; VOL 38, ISS 12 Suppl 1, 1993, P415-25 (REF: 63) ABSTRACT The role of mental stress in ischemic heart disease is two-fold: as a risk factor of coronary artery disease and as a trigger of acute ischemic attacks in patients with established coronary atherosclerosis. The role of stress as a risk factor is still controversial. Data regarding the relationship between occupational factors and development of coronary atherosclerosis have not been confirmed. A type personality, above all when anger and hostility traits are present, seems to be a predisposing factor for the development of coronary artery disease. These data however, were not confirmed in study groups including patients with a higher prevalence of other, more important, risk factors. Stress can have an important role as a trigger of acute ischemic attacks. This is indirectly shown by the circadian distribution of the main manifestations of ischemic heart disease (sudden death, myocardial infarct, ST segment depression). In fact, their incidence is significantly higher in the morning hours, after awakening, when mental stress is higher. In the laboratory setting, mental stress can induce myocardial ischemia in a variable percentage of patients (0 to 80%). Prevalence of mental stress-induced myocardial ischemia varies depending on the stressor used, the patients group and, above all, the diagnostic tool. Ischemic episodes induced by mental stress, in fact, are generally silent and less severe and extensive than those elicited by exercise stress testing. It is therefore often necessary to use methods, such as myocardial scintigraphy, with higher sensitivity for the detection of myocardial ischemia in comparison with ECG. Patients with mental stress-induced myocardial ischemia tend to present higher scores on measures of aggressivity, anger and hostility. These psychological features are related to a hightened cardiovascular reactivity with a brisk and greater increase in heart rate and blood pressure after exposure to stress. It would be therefore useful to identify patients with such a behaviour by psychological assessment and/or analysis of sympatho-vagal balance by analysis of heart rate variability. The mechanism by which mental stress can induce myocardial ischemia is represented by an increase in myocardial oxygen demand, through the increased heart rate and blood pressure, probably associated with an increase in coronary vascular resistance. This last phenomenon is likely caused by small coronary vessel constriction mediated by alpha-adrenergic activation and by a reduced EDRF release by the damaged endothelium. 1 AUTHOR Chesnie B AUTHOR Lampert S AUTHOR Podrid P AUTHOR Lown B TITLE Lorcainide in patients with refractory ventricular tachyarrhythmia. SOURCE J Am Coll Cardiol; VOL 3, ISS 6, 1984, P1531-9 ABSTRACT Lorcainide, a new antiarrhythmic agent with local anesthetic or membrane-stabilizing properties similar to those of quinidine, was tested in 76 patients with diverse types of heart disease and recurrent ventricular tachycardia or ventricular fibrillation. Lorcainide was administered for 72 to 96 hours in a dose ranging from 200 to 400 mg daily. Evaluation of drug efficacy involved ambulatory monitoring and exercise stress testing in 60 patients who had high grade ventricular arrhythmia. Invasive electrophysiologic testing was carried out in the remaining 16 patients who exhibited infrequent ventricular ectopic activity during control studies. Lorcainide was effective in 21 (38%) of 56 patients evaluated for suppression of ventricular ectopic activity and in 6 (40%) of 15 who had invasive testing. In five patients, the drug was discontinued because of toxic reactions. Thus, 27 (38%) of the 71 patients who completed the drug study responded to lorcainide. Side effects, reported by 42 patients (55.3%), consisted primarily of insomnia and gastrointestinal symptoms; 7 experienced aggravation of arrhythmia. Fifteen patients were discharged while receiving lorcainide therapy, but in four the treatment was discontinued after 2 months because of side effects. Three patients died, one suddenly. It is concluded that lorcainide is of value in a small subset of patients with life-threatening ventricular arrhythmias who have proven refractory to conventional drugs. Its usefulness is limited by the high frequency of insomnia. 1 AUTHOR GINTER E TITLE High cardiovascular mortality in postcommunist countries: Participation of oxidative stress? SOURCE INTERNATIONAL JOURNAL FOR VITAMIN AND NUTRITION RESEARCH; 66 (3). 1996. 183-189. ABSTRACT BIOSIS COPYRIGHT: BIOL ABS. Age-standardized death rates from cardiovascular diseases (0-64 years) of male populations in postcommunistic Central and Eastern Europe are now several times higher than those in Western Europe. This phenomenon is only partly explainable by the higher prevalence of "classical" cardiovascular risk factors (smoking, hypertension, hypercholesterolemia). Socio-economic background of the cardiovascular epidemic in the USA and Western Europe after 1950, and in the Soviet bloc in 1960-1990 was substantially different. It is suggested that the influence of further risk factors should be considered: - oxidative stress caused by prolonged disorders in life style (alcoholism, smoking), high degree of environmental pollution and nutritional disbalances (chronic deficiency of antioxidants due to low consumption of fruits, vegetables and vegetable oils); - psychosocial factors - chronic stress, tension, anger hostility, frustration and apathy leading to a lowered interest in one's own health. The situation in postcommunist countries is unique and its analysis could provide important new information about the etiology of cardiovascular diseases and their prevention. 14 AUTHOR GROSSARTH-MATICEK R AUTHOR EYSENCK HJ TITLE Personality, stress, and motivational factors in drinking as determinants of risk for cancer and coronary heart disease. SOURCE PSYCHOL REP; 69 (3 PART 1). 1991. 1027-1043. ABSTRACT BIOSIS COPYRIGHT: BIOL ABS. Alcohol consumption is a well-known risk factor for cancer, coronary heart disease (CHD), and various other diseases. It is here suggested that motivational factors may be important in mediating any effects of drinking on health. In particular, the hypothesis was tested that drinking to drown one's sorrows (S-type) was much more a risk factor than pleasure drinking (P-type). A total of 1,706 men were tested followed for 13 years, when death and cause of death were established. The hypothesis was supported for all levels of drinking. In addition, subjects were divided into those 900 who were under stress at the beginning of the study and those 806 who were not. Stress and drinking combined in a complex fashion to form a risk factor for disease, and motivation combined with both in the predicted direction. 15 AUTHOR EYSENCK HJ AUTHOR GROSSARTH-MATICEK R AUTHOR EVERITT B TITLE Personality, stress, smoking, and genetic predisposition as synergistic risk factors for cancer and coronary heart disease. SOURCE INTEGR PHYSIOL BEHAV SCI; 26 (4). 1991. 309-322. ABSTRACT BIOSIS COPYRIGHT: BIOL ABS. Risk factors for cancer have been found in the past to act synergistically in a number of studies. However, these studies were not always designed to test the hypothesis of synergism, and have sometimes failed to equate for important variables, which might influence the results. The present study tests the hypothesis that psychosocial variables and physical ones (personality/stress, smoking, and genetic predisposition) interact in a synergistic fashion in the causation of lung cancer and coronary heart disease (CHD). 16 AUTHOR GROSSARTH-MATICEK R AUTHOR EYSENCK HJ TITLE Coca-cola, cancers, and coronaries: Personality and stress as mediating factors. SOURCE PSYCHOL REP; 68 (3 PART 2). 1991. 1083-1087. ABSTRACT BIOSIS COPYRIGHT: BIOL ABS. A theory is presented relating the consumption of stimulant and depressant drugs to cancer and coronary heart disease, with stress/personality acting as an intermediary. The predictions from the theory that large-scale consumption of Coca-Cola would prevent cancer and promote coronary heart disease was tested and found to be supported by the results of a long-scale prospective study. Results replicate those from an earlier study using coffee as a stimulant drug. 3 AUTHOR Falger PR AUTHOR Schouten EG TITLE Exhaustion, psychological stressors in the work environment, and acute myocardial infarction in adult men. SOURCE J Psychosom Res; VOL 36, ISS 8, 1992, P777-86 ABSTRACT In a case-control study in adult men from The Netherlands, the associations of work stressors with both exhaustion prior to first acute myocardial infarction (AMI) and with first AMI itself were explored. The 133 AMI-cases reported more exhaustion, work stressors, and smoking than the controls (i.e. 133 neighborhood controls and 192 hospital controls). After controlling for smoking, exhaustion constituted a firm risk indicator for first AMI; it was also positively associated with work stressors, in particular conflicts at work. Work stressors that may disrupt one's occupational career, and increased responsibility (in younger AMI-cases), were directly associated with elevated risk for first AMI. Conflicts at work were conducive to first AMI through their associations with exhaustion. 5 AUTHOR Sihm I AUTHOR Dehlholm G AUTHOR Hansen ES AUTHOR Gerdes LU AUTHOR Faergeman O TITLE The psychosocial work environment of younger men surviving acute myocardial infarction. SOURCE Eur Heart J; VOL 12, ISS 2, 1991, P203-9 ABSTRACT In a retrospective, consecutive case-control study, the psychosocial work environment of 52 men younger than 55 years, who had survived an acute myocardial infarction, was analysed with respect to workload and work quality using a comprehensive self-administered questionnaire. Patients more frequently reported exhaustion after work, had less responsibility at their job, held less well esteemed positions, and had less possibility of social contact during working hours. These differences bore no simple relationship to social class or conventional risk factor distribution, although higher workloads were associated with a significantly higher frequency of smoking. The study suggests that the ideal cardioprotective job is a well esteemed job at a certain responsibility level with good conditions for social interaction during working hours, in which the experienced job demands are reasonable, and where extra resources are available if needed. 7 AUTHOR Mazzuero G AUTHOR Zotti AM AUTHOR Bertolotti G AUTHOR Tavazzi L TITLE Hemodynamic response to different types of mental stress in patients with recent myocardial infarction. SOURCE Jpn Heart J; VOL 30, ISS 1, 1989, P35-46 ABSTRACT The purpose of this study was to analyze the cardiovascular effects induced by mental stress evoked by different stressors in patients with recent uncomplicated myocardial infarction. Twenty four males, aged 52 +/- 10 years, were studied 45 +/- 22 days after uncomplicated myocardial infarction in the absence of specific cardiovascular drugs. During electrocardiographic and hemodynamic monitoring with a Swan-Ganz catheter the patients underwent 4 different stressors: mental arithmetic, Sacks test, Raven progressive matrices, white noise. All hemodynamic parameters were significantly (p less than 0.001) modified by 3 of the 4 stressors, while noise significantly affected (p less than 0.005) only blood pressure. Mental arithmetic was more powerful in inducing hemodynamic effects than either the Sacks test or the Raven matrices. Thus, experimentally induced mental stress challenges the recently infarcted patient's cardiovascular system to a quantifiable extent, causing important increments in left ventricular filling pressure. Hemodynamic response is different depending on the stressor employed. 13 AUTHOR Frasure-Smith N AUTHOR Rolicz-Woloszyk E TITLE Memory problems after ischemic heart disease episodes: effects of stress, benzodiazepines and smoking. SOURCE J Psychosom Res; VOL 26, ISS 6, 1982, P613-22 ABSTRACT Post-IHD episode memory problems and their correlates were investigated among 157 male ischemic heart disease patients under the age of 65. Twenty-five per cent of these patients reported memory difficulties originating during the year following admission to hospital. Of the wide variety of socio-demographic factors, measures of disease severity, and lifestyle variables evaluated, only three differentiated those patients with post-IHD episode memory problems from patients with no memory difficulties. These three were: quitting smoking during the year following hospitalization, using psychotropic drugs (benzodiazepines), and having high psychosocial stress levels one year after discharge. Further analysis revealed that stress was related to memory problems primarily because stressed patients were more likely to use psychotropic drugs. It was suggested that the relationship between quitting smoking and memory problems could be explained by reference to two contradictory effects of tobacco use: a short-acting memory facilitating effect due to nicotine and a longer lasting memory impairment due to smoking-related atherosclerosis which might persist long after giving up smoking. YOU ARE NOW CONNECTED TO THE TOXLINE65 (1965 - 80, NON-ROYALTY) FILE. 3 AUTHOR Eliot RS AUTHOR Clayton FC AUTHOR Pieper GM AUTHOR Todd GL TITLE Influence of environmental stress on pathogenesis of sudden cardiac death. SOURCE Fed Proc; VOL 36, ISS 5, 1977, P1719-24 (REF: 59) ABSTRACT The effects of 20th-century stress on the cardiovascular system are reviewed and correlated with experimental animal models. A classic example of such stress is drawn from a study of the aerospace workers at Cape Kennedy who were shown to be exposed to excessive occupational stress. Surprisingly, the usual risk factors did not predict a greater risk, yet the population exhibited a higher incidence of sudden cardiac death and acute myocardial infarction. Acute myocardial necrosis was much more frequently demonstrated than was acute coronary obstruction of any type. Retrospective coroner's studies revealed two types of myocardial necrosis: 1) elongated, thinned or wavy fibers and 2) anomalous contraction bands. Correlation of these clinical observations with experimental data was duplicated in canine models of myocardial infarcion and/or catecholamine-induced necrosis. Catecholamines can lead to irreversible myocardial necrosis but the underlying mechanisms appear to be complex. Extrapolation of the results from the experimental and clinical studies suggests that environmental stress can lead to myocardial necrosis.