a Área de Química Biológica, Departamento de Morfofisiología, Facultad de Ciencias Médicas , Universidad Nacional de Cuyo , Mendoza , Argentina.
b Department of Pediatrics , Nephrology Division, Miller School of Medicine, University of Miami , FL , USA.
Stress. 2019 Mar;22(2):169-181. doi: 10.1080/10253890.2018.1542683. Epub 2018 Dec 14.
Although a large number of available treatments and strategies, the prevalence of cardiovascular diseases continues to grow worldwide. Emerging evidence supports the notion of counteracting stress as a critical component of a comprehensive therapeutic strategy for cardiovascular disease. Indeed, an unhealthy lifestyle is a burden to biological variables such as plasma glucose, lipid profile, and blood pressure control. Recent findings identify allostatic load as a new paradigm for an integrated understanding of the importance of psychosocial stress and its impact on the development and maintenance of cardiovascular disease. Allostasis complement homeostasis and integrates behavioral and physiological mechanisms by which genes, early experiences, environment, lifestyle, diet, sleep, and physical exercise can modulate and adapt biological responses at the cellular level. For example, variability is a physiological characteristic of blood pressure necessary for survival and the allostatic load in hypertension can contribute to its related cardiovascular morbidity and mortality. Therefore, the current review will focus on the mechanisms that link hypertension to allostatic load, which includes psychosocial stress, inflammation, and mitochondrial dysfunction. We will describe and discuss new insights on neuroendocrine-immune effects linked to allostatic load and its impact on the cellular and molecular responses; the links between allostatic load, inflammation, and endothelial dysfunction; the epidemiological evidence supporting the pathophysiological origins of hypertension; and the biological embedding of allostatic load and hypertension with an emphasis on mitochondrial dysfunction.
尽管有大量的治疗方法和策略，心血管疾病的患病率仍在全球范围内持续增长。新出现的证据支持将对抗压力作为心血管疾病综合治疗策略的一个关键组成部分的观点。事实上，不健康的生活方式给诸如血浆葡萄糖、血脂谱和血压控制等生物变量带来了负担。最近的发现将应激反应的适应性负担确定为一种新的范例，用于综合理解心理社会应激及其对心血管疾病的发展和维持的重要性。适应性反应补充了体内平衡，并整合了行为和生理机制，通过这些机制，基因、早期经历、环境、生活方式、饮食、睡眠和体育锻炼可以调节和适应细胞水平的生物反应。例如，血压的可变性是生存所必需的生理特征，高血压的适应性反应负担可能导致其相关的心血管发病率和死亡率。因此，目前的综述将重点关注将高血压与适应性反应负担联系起来的机制，其中包括心理社会应激、炎症和线粒体功能障碍。我们将描述和讨论与适应性反应负担及其对细胞和分子反应的影响有关的神经内分泌免疫效应的新见解；适应性反应负担、炎症和内皮功能障碍之间的联系；支持高血压病理生理起源的流行病学证据；以及适应性反应负担和高血压的生物学嵌入，重点是线粒体功能障碍。
