Kop W J
Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Psychosom Med. 1999 Jul-Aug;61(4):476-87. doi: 10.1097/00006842-199907000-00012.
Psychological factors are known to affect biological processes involved in the progression of coronary artery disease. This article focuses on psychological risk factors for progression of coronary artery disease and its clinical manifestations. Recent research on the adverse cardiovascular consequences of feelings of exhaustion and acute psychological arousal is reviewed, and a classification of psychological risk factors is presented distinguishing (1) chronic psychological risk factors, such as hostility; (2) episodic risk factors, such as exhaustion, with a duration ranging from several months to 2 years; and (3) acute psychological triggers, including mental activity and anger. The distinctive pathophysiological mechanisms by which these psychological risk factors promote coronary disease progression and cardiac ischemia are described, including hemodynamic reactivity, blood clotting, and inflammatory processes.
众所周知，心理因素会影响冠状动脉疾病进展过程中涉及的生物过程。本文重点关注冠状动脉疾病进展的心理危险因素及其临床表现。综述了近期关于疲惫感和急性心理应激对心血管不良影响的研究，并提出了心理危险因素的分类，区分出（1）慢性心理危险因素，如敌意；（2）发作性危险因素，如疲惫，持续时间从数月到2年不等；以及（3）急性心理触发因素，包括精神活动和愤怒。描述了这些心理危险因素促进冠心病进展和心脏缺血的独特病理生理机制，包括血流动力学反应性、血液凝固和炎症过程。
