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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Atherosclerosis is one of the most common causes of peripheral vascular disease. Complications result from arteries compromised because of focal accumulations of lipids and other materials within and between cells in the vessel walls. Factors including hyperlipidemia, hypertension, diabetes mellitus, obesity, physical inactivity, smoking, social stress, and genetic background have been implicated as promoting a higher risk of atherosclerosis and its consequences.
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PMID:Atherosclerosis: a major cause of peripheral vascular disease. 58 6

We review the use of socially housed cynomolgus monkeys (Macaca fascicularis) in biomedical research with emphasis on studies of atherosclerosis, particularly in the two specific domains of atherosclerosis investigation for which nonhuman primates are especially well-suited as animal models: gender differences and psychosocial influences. We found that the presence of normal ovarian function prevented exacerbation of diet-induced coronary artery atherosclerosis in female monkeys. However, any manipulation or condition which impaired ovarian function tended to diminish or abolish this "female" protection. Among group-housed female monkeys, low social status was accompanied by ovarian dysfunction and, not surprisingly, by exacerbated coronary artery atherosclerosis as well. Surgical menopause (ovariectomy) also induced exacerbation of coronary atherosclerosis in monkeys, a situation which was prevented by estrogen replacement therapy. Conversely, pregnancy (a hyperestrogenic state) resulted in markedly diminished atherosclerosis. A somewhat different pattern of atherogenesis emerged among socially-housed males. Here, socially dominant animals developed exacerbated coronary artery atherosclerosis, but only under conditions of social stress (viz., disruption caused by periodic reorganization of social group membership). We hypothesized that exposure to repeated group reorganizations provoked activation of the sympathetic nervous system among dominant animals; in turn, the hemodynamic and metabolic concomitants of sympathetic activation may have damaged the coronary arteries of these monkeys, potentiating atherogenesis. To test this hypothesis, males were housed in unstable social groupings, with half of the monkeys administered a beta-adrenergic blocking agent (to attenuate heart rate and blood pressure responses to stress). The beta-blocker inhibited atherosclerosis, but only among those animals behaviorally predisposed to develop exacerbated lesions (i.e. dominant monkeys). These results support the view that monkeys are suitable research models of atherosclerosis, a disease that affects millions of humans.
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PMID:Social behavior and gender in biomedical investigations using monkeys: studies in atherogenesis. 165 80

This article provides an overview of work in two areas of biobehavioural research: the effects of environmental stress and the role of psychophysiologic reactivity in the development of ischaemic heart disease. Attention is given first to evidence that low socio-economic status, low social support, and occupational settings characterized by high demands and low levels of control over the job are associated with increased coronary risk. Also discussed is a promising animal primate model of social stress and its role in development of coronary atherosclerosis. Next, we discuss physiological responsiveness (reactivity) to emotional stress, which is being studied as a marker of processes involved in the development of cardiovascular disease. Stress and psychophysiological reactivity constitute promising targets for research on biobehavioural antecedents of coronary disease and for clinical intervention studies. However, further evidence is needed before these variables can be regarded as proven coronary risk factors.
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PMID:Environmental stress, reactivity and ischaemic heart disease. 312 10

Recently the nature of the cellular and molecular events in atherogenesis have been elucidated better. Some of these findings may be important in explaining individual differences in susceptibility to atherosclerosis that are independent of known risk factors. Nonhuman primates are valuable models for the study of mechanisms of diet-induced atherosclerosis. Cynomolgus macaques are useful for studies of male-female differences in atherosclerosis, since they share with premenopausal white women a relative protection against coronary atherosclerosis compared with males. These animals are also useful for psychosocial atherosclerosis research since social status affects the extent of atherosclerosis, and experimentally induced social stress increases extent of coronary artery atherosclerosis. Nonhuman primates have also been useful for studies of individual differences in susceptibility to diet-induced atherosclerosis and its risk factors. These studies have indicated that about 75% of the variability in the plasma cholesterol response to dietary cholesterol is attributable to genetically determined differences in cholesterol absorption and lipoprotein catabolism. There is preliminary evidence suggesting the existence of "mesenchymal susceptibility" in nonhuman primates; i.e., differences in risk of atherosclerosis that are independent of exposure to known risk factors. Efforts are being made to establish colonies of rhesus monkeys that possess contrasting degrees of mesenchymal susceptibility.
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PMID:Mechanisms of atherogenesis. 329 5

Motor car racing is representative of concentrative sporting activities, as well as instructive for mental-concentrative and psycho-emotional stress, which predominates with lower intensity, but longer duration in occupational work of today. A group of 20 car racing drivers was investigated both during car races (Formula Ford and Renault-5-Cup) and during progressive bicycle ergometry in the laboratory. Heart rate during car racing reached a mean level of 174.3 +/- 14.1 min-1 (mean +/- SD), corresponding to 90% of the maximal heart rate achieved at the end of exhaustive ergometry (n = 12). Catecholamine excretion in urine (adrenaline + noradrenaline) on average was 252.3 +/- 77.9 ng min-1 during car racing and 121.9 +/- 37.3 ng min-1 during exhaustive ergometry (n = 10). Most of the other metabolic parameters determined in blood (lactate, glucose, FFA = free fatty acids, plasma protein, insulin, HGH = human growth hormone) also showed significant differences between car racing and bicycle ergometry (n = 20). Therefore it is possible to distinguish between psychical and physical strain and the quantify their specific level. Especially blood lactate can be considered as a metabolic indicator of physical strain and FFA of psycho-emotional strain. Furthermore, significant negative correlations could be found between heart rate, FFA level, and catecholamine excretion during car racing and some measures of physical fitness determined on the bicycle ergometer (n = 12 or 10). This suggests a reduced cardiocirculatory and metabolic strain reaction in response to psychical stress situations with increased fitness. Moreover, HDL (high density lipoprotein) was found increased and oral glucose tolerance test was improved with elevated physical fitness (n = 20, respectively 16). From the results of this study it can be concluded that physical activity counteracts atherosclerosis and CHD (coronary heart disease), which are promoted by psycho-emotional and psycho-social stress.
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PMID:Heart rate, metabolic and hormonal responses to maximal psycho-emotional and physical stress in motor car racing drivers. 331 41

Blue-collar workers suffering from chronic occupational stress exhibit significantly higher values of an atherogenic index (ratio between low density and high density lipoprotein cholesterol assessed by quantitative lipoprotein electrophoresis) as compared to men exposed to less stress at work. Chronic occupational stress is defined by interactions of objective (job instability, shift work) and subjective (perceived job insecurity, perceived increase of work load) indicators as assessed by structured interviews. Findings from a prospective epidemiologic study on 416 middle-aged men at entry covering a 2-year period of observation hold true after controlling for several confounding factors such as body weight, age, cigarette smoking and chronic alcohol consumption. Results are in line with experimental animal studies on the influence of chronic social stress on the development of atherosclerosis.
Atherosclerosis 1988 Feb
PMID:Atherogenic risk in men suffering from occupational stress. 334 42

Multiple factors contributing to coronary heart disease (CHD) and underlying atherosclerosis have been identified. Biologic factors include aging, gender, and family history. Potentially modifiable risk factors are: cigarette smoking; high blood pressure; elevated levels of plasma total and low density lipoprotein and low levels of high density lipoprotein cholesterol; diabetes mellitus; obesity; dietary habits; physical inactivity and poor physical fitness; and perhaps response to psycho-social stress. CHD risk increases with the number of risk factors and their levels. Resting and exercise ECG abnormalities further increase risk. Because of differences in levels of these risk factors, a great deal of variability exists in probability of CHD at any age. Using age alone to predict risk of heart attack results in high rates of false positives. Favorable alterations in modifiable risk factors by the American public appears to be primarily responsible for the progressive decline in CHD mortality rates in this country since 1968. This decline has occurred at all ages during a period of dramatic increase in prevalence of people over 65 yr of age in the United States. This confirms that modifiable risk factors are much more important than age in the etiology of CHD, and clearly demonstrates that CHD is not an inevitable part of the aging process.
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PMID:Age and other predictors of coronary heart disease. 357 48

To study the effects of dietary and social manipulations on lesion progression in male monkeys with established atherosclerosis, 83 animals fed a diet containing 1 mg cholesterol per kcal for 14 months were either necropsied (baseline group, n = 21) or assigned to one of three experimental conditions: 1) a diet containing a high amount of fat and cholesterol and a stressful social situation (HiFC-stress, n = 18); 2) a diet lower in fat and cholesterol and a stressful social situation (LoFC-stress, n = 21); or 3) the low-fat, low-cholesterol diet and a nonstressful social situation (LoFC-no stress, n = 23). After 28 months, all animals were necropsied. Coronary atherogenesis was arrested among monkeys in the LoFC-stress and LoFC-no stress conditions compared with that of animals in the baseline condition (plaque areas of 0.35 mm2, 0.30 mm2, and 0.38 mm2, respectively). Lesions in animals fed the LoFC diet (both stress and no-stress groups) were significantly smaller than those in monkeys in the HiFC-stress condition (0.96 mm2). Furthermore, aortic cholesterol content was significantly decreased and luminal areas were relatively larger among monkeys in both LoFC conditions compared with animals in the baseline and HiFC-stress conditions (p < 0.05 for all). The results demonstrate that a low-fat, low-cholesterol diet can halt plaque development, reduce arterial cholesterol content, and permit compensatory arterial enlargement, processes that were unaffected by social stress in this investigation.
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PMID:Plaque changes and arterial enlargement in atherosclerotic monkeys after manipulation of diet and social environment. 842 60

Until recently, there has been little evidence substantiating the belief that mental stress provokes myocardial infarction and stroke, and aggravates atherosclerosis. However, recent advances in methodology for demonstrating effects of stress are now beginning to build a foundation of evidence that supports those beliefs. In monkeys, social stress doubles coronary atherosclerosis, and increases coronary spasm, and treatment with oestrogen, which improves endothelial function, reduces coronary spasm in relation to stress. In human beings, mental stress provokes myocardial ischaemia, and haemodynamic responses to mental stress predict progression of left ventricular enlargement, and progression of carotid atherosclerosis. These findings suggest that it may not be safe to withhold treatment of high office pressures in patients with white coat hypertension. There is now some evidence that stress management in the form of individualized cognitive behavioural interventions reduces blood pressure. Further work is needed to determine whether it is safe to withhold treatment in white-coat syndrome, and whether stress management can reduce atherosclerosis and ischaemic events.
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PMID:Neurocardiology. Stress and atherosclerosis. 948 93

Social environment influences the progression of atherosclerosis in an important experimental model of disease, the Watanabe Heritable Hyperlipidemic rabbit (WHHL). Although the hypothalamic-pituitary-adrenocortical (HPA) system is likely to play an important role in the behavioral modulation of disease, relatively little is known about the glucocorticoid responses in these animals, or in other strains of rabbits. The purpose of the present study was to: (1) evaluate the rabbit glucocorticoid circadian rhythm, (2) compare plasma cortisol and corticosterone responses to social stress, and (3) examine strain differences (i.e., WHHL vs. New Zealand White (NZW)) in rabbit glucocorticoid responses to assess whether WHHLs have an aberrant HPA system. It was found that male rabbits secrete both corticosterone and cortisol in a circadian rhythm that peaks in the afternoon and reaches a nadir at 0600 h, i.e., approximately 12 h out-of-phase with the human glucocorticoid rhythm. Both glucocorticoids responded similarly to social stress induced by repeated daily 4 h pairings with another male rabbit; after 10 days of pairings, glucorticoid values were significantly correlated with the amount of defensive agonistic behavior exhibited. Finally, there were no significant strain differences in glucocorticoid circadian rhythms, baselines, or responses to social stress. These data suggest that glucocorticoid responses (i.e., circadian rhythms, responses to social stress) in the WHHL are similar to glucocorticoid responses in standard laboratory white rabbits.
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PMID:Circulating levels of glucocorticoid hormones in WHHL and NZW rabbits: circadian cycle and response to repeated social encounter. 1517 1


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