Schneiderman N, Chesney M A, Krantz D S
Department of Psychology, University of Miami, Coral Gables, FL 33124.
Health Psychol. 1989;8(6):649-76.
Cardiovascular disorders pose a major health problem for industrialized societies in terms of excess morbidity and mortality. Hypertension (HT) is a major risk factor for coronary heart disease (CHD) and cerebrovascular disease. The impact of psychosocial factors, personality traits, genetic-behavioral interactions, sodium sensitivity, obesity, insulin metabolism, and psychophysiology on HT status is discussed. An understanding of pathophysiologic processes is needed to provide a better basis for risk factor reduction and other aspects of treatment. The study of myocardial ischemia appears to provide an important link between the development of coronary artery disease and the occurrence of CHD. Further studies are needed to assess the clinical significance of stress-induced myocardial ischemia as well as whether mental stress is predictive of future CHD. Associations have been made between behavioral risk factors and CHD, but the exact nature of the relationship remains to be clarified. Hostility has been identified as an important aspect of coronary-prone behavior, but considerable research will have to be completed before a comprehensive understanding of coronary-prone behavior and the manner in which it has an impact on disease can be fully understood.
心血管疾病在发病率和死亡率过高方面给工业化社会带来了重大的健康问题。高血压（HT）是冠心病（CHD）和脑血管疾病的主要危险因素。文中讨论了社会心理因素、人格特质、基因-行为相互作用、钠敏感性、肥胖、胰岛素代谢和心理生理学对高血压状态的影响。需要了解病理生理过程，以便为降低危险因素和治疗的其他方面提供更好的基础。对心肌缺血的研究似乎为冠状动脉疾病的发展与冠心病的发生之间提供了重要联系。需要进一步研究以评估应激性心肌缺血的临床意义，以及精神压力是否可预测未来的冠心病。行为危险因素与冠心病之间已建立了关联，但这种关系的确切性质仍有待阐明。敌意已被确定为易患冠心病行为的一个重要方面，但在全面了解易患冠心病行为及其对疾病产生影响的方式之前，还需要完成大量研究。
