Kop W J
Department of Medical and Clinical Psychology, University of the Health Sciences, Bethesda, Maryland 20814, USA.
J Psychosom Res. 1997 Aug;43(2):167-81. doi: 10.1016/s0022-3999(97)80002-5.
This article provides a selective review of the effects of psychosocial factors and responses to acute mental stress on the onset of acute coronary syndromes. The literature suggests that the relationship between the anatomical severity of coronary artery disease (CAD) and likelihood of subsequent cardiac events, such as myocardial infarction, is not linear. Furthermore, evidence will be provided that the age-dependent associations between psychosocial factors and risk of cardiac events is at least in part mediated through the severity of underlying CAD. Finally, research will be summarized that supports the importance of both chronic psychosocial factors (e.g., low socioeconomic status and/or high hostility) and episodic psychological distress syndromes, such as vital exhaustion and depression. In reviewing this literature, two perspectives will be focused on: (1) the relationship between psychosocial factors and progressive CAD; and (2) the evidence concerning underlying pathophysiological mechanisms.
本文对社会心理因素的影响以及对急性精神应激的反应与急性冠状动脉综合征发病之间的关系进行了选择性综述。文献表明，冠状动脉疾病（CAD）的解剖学严重程度与随后发生心脏事件（如心肌梗死）的可能性之间的关系并非呈线性。此外，将提供证据表明，社会心理因素与心脏事件风险之间的年龄依赖性关联至少部分是通过潜在CAD的严重程度介导的。最后，将总结支持慢性社会心理因素（如低社会经济地位和/或高敌意）以及发作性心理困扰综合征（如倦怠和抑郁）重要性的研究。在回顾这些文献时，将聚焦两个观点：（1）社会心理因素与进展性CAD之间的关系；（2）有关潜在病理生理机制的证据。
