Abstract
The exposure to psychological stress can increase the risk of cardiovascular disease due to impaired endothelial function. Mediators such as glucocorticoids, catecholamines, angiotensin II and/or pro-inflammatory cytokines, induced by stress, can contribute to endothelial dysfunction due to increased levels of oxidative stress. The endothelial dysfunction induces reduced expression and/or endothelial nitric oxide synthase enzyme functionality, as well as the impairment of the actions triggered by its metabolite, nitric oxide. Chronic psychological stress leads to atherosclerosis development, which has an endothelial dysfunction at early stages. The oxidative damage and inflammatory mediators, induced by chronic psychological stress, play a key role in this process. Furthermore, chronic psychological stress can contribute to the formation of unstable atherosclerotic lesions as a result of immune system cells accumulation and molecules adhesion, leading to thrombosis and cardiac complications. According to what was stated above, we aim to discuss about the endothelial function impairment mediated by psychological stress, and the involvement of mediators such as glucocorticoids, catecholamines, angiotensin II and pro-inflammatory cytokines in this response. This review covers current advancements to understand how chronic psychological stress could lead to atherosclerosis development.
Highlights
Chronic exposure to stressful situations is associated with increased risk of cardiovascular diseases [1], including acute myocardial infarction [2], coronary artery disease [3,4,5], myocardial ischemia [6] and atherosclerosis [7,8]
The odds for acute myocardial infarction have increased more than twice in individuals who were exposed to psychosocial factors associated with exposure to multiple risk factors, such as hypertension, smoking, diabetes mellitus and obesity, in comparison to those who were not exposed to psychosocial factors [2]
Soares-Filho et al [11] discussed about the endothelial dysfunction and microvascular disease present in mental stress response and suggest that mechanisms from the perspective of endothelial dysfunction and microvascular disease might be involved in mental stress
Summary
Endothelial Dysfunction Induced by Chronic Psychological Stress: A Risk Factor for Atherosclerosis. Hariane Côco1,2* and Ana Maria de Oliveira2 1Departamento de Farmacologia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Avenida do Café s/n, Brazil 2Laboratório de Injúria Vascular, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, USP; Avenida do Café s/n, Monte Alegre, Brazil
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