Kubzansky L D, Kawachi I, Weiss S T, Sparrow D
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA.
Ann Behav Med. 1998 Spring;20(2):47-58. doi: 10.1007/BF02884448.
The purpose of this review is to examine the epidemiological, psychological, and experimental evidence for an association between anxiety and coronary heart disease (CHD). Papers published during the years 1980-1996 on anxiety and CHD and relevant publications from earlier years were selected for this review. Epidemiologic evidence suggests that anxiety may be a risk factor for the development of CHD. Chronic anxiety may increase the risk of CHD by: (a) influencing health behaviors (e.g. smoking); (b) promoting atherogenesis (e.g. via increased risk of hypertension); and (c) triggering fatal coronary events, either through arrhythmia, plaque rupture, coronary vasospasm, or thrombosis. Electrophysiologic evidence is particularly compelling: anxiety appears to be associated with abnormal cardiac autonomic control, which may indicate increased risk of fatal ventricular arrhythmias. The strength, consistency, and dose-response gradient of the association between anxiety and CHD, together with the biologic plausibility of the experimental evidence, suggest that anxiety may contribute to risk of CHD and that the relationship warrants further investigation.
本综述的目的是研究焦虑与冠心病（CHD）之间关联的流行病学、心理学及实验证据。本综述选取了1980年至1996年间发表的关于焦虑与冠心病的论文以及早年的相关出版物。流行病学证据表明，焦虑可能是冠心病发病的一个危险因素。慢性焦虑可能通过以下方式增加冠心病风险：（a）影响健康行为（如吸烟）；（b）促进动脉粥样硬化形成（如通过增加高血压风险）；以及（c）通过心律失常、斑块破裂、冠状动脉痉挛或血栓形成引发致命性冠状动脉事件。电生理证据尤其具有说服力：焦虑似乎与心脏自主神经控制异常有关，这可能表明致命性室性心律失常风险增加。焦虑与冠心病之间关联的强度、一致性和剂量反应梯度，以及实验证据的生物学合理性，表明焦虑可能会增加冠心病风险，这种关系值得进一步研究。
