Department of Epidemiology and Public Health, University College London, London, UK.
Neurosci Biobehav Rev. 2010 Sep;35(1):76-83. doi: 10.1016/j.neubiorev.2009.11.004. Epub 2009 Nov 10.
Acute psychophysiological stress testing, involving measurement of cardiovascular and biological responses to laboratory-induced mental stress, is an important tool to investigate mechanisms that might account for the association between psychosocial stress and cardiovascular diseases (CVD). Accumulating evidence has demonstrated associations of disturbed psychophysiological responses with sub-clinical measures of atherosclerosis, hypertension, and metabolic risk. The complex pattern of stress responding is influenced by individual differences, such as coping style, race and ethnicity, genetics, background stress, and lifestyle habits, which should be taken into account when interpreting results. For example, an unique interplay between cardiac and vascular responses in black Africans and African Americans is thought to contribute towards a heightened risk of hypertension in this group. Whether or not psychophysiological risk markers provide prognostic information over and above that of established risk markers is not clear. In summary, controlled trials that examine if the modification of psychophysiological responses through lifestyle and psychosocial interventions can reduce the risk of CVD outcomes are needed to establish causality. Further work is also required that examines the associations of ambulatory responses to real life stress in relation to risk of CVD.
急性心理生理学应激测试，包括测量心血管和生物对实验室诱发的精神应激的反应，是研究可能导致心理社会应激与心血管疾病（CVD）之间关联的机制的重要工具。越来越多的证据表明，心理生理学反应的紊乱与动脉粥样硬化、高血压和代谢风险的亚临床指标有关。应激反应的复杂模式受到个体差异的影响，例如应对方式、种族和民族、遗传、背景应激和生活方式习惯，在解释结果时应考虑这些因素。例如，黑人和非裔美国人的心脏和血管反应之间独特的相互作用被认为是导致该人群高血压风险增加的原因之一。心理生理学风险标志物是否提供了比既定风险标志物更有预后意义的信息尚不清楚。总之，需要进行对照试验来检验通过生活方式和心理社会干预来改变心理生理学反应是否可以降低 CVD 结局的风险，以确定其因果关系。还需要进一步的工作来研究与 CVD 风险相关的日常生活应激的动态反应的关联。
