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(Circulation. 2002;106:2634.)
© 2002 American Heart Association, Inc.

Editorial

Stress and the Metabolic Syndrome

An Interesting but Enigmatic Association

Paul Hjemdahl, MD, PhD

From the Department of Medicine, Division of Clinical Pharmacology, Karolinska Hospital and Institute, Stockholm, Sweden.

Correspondence to Professor Paul Hjemdahl, Department of Medicine, Division of Clinical Pharmacology, Karolinska Hospital and Institute, SE-171 76 Stockholm, Sweden. E-mail Paul.Hjemdahl@ks.se

Key Words: Editorials • metabolism • stress • nervous system, autonomic

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Modern society has brought with it profound changes in lifestyle and an increased incidence of atherosclerotic vascular disease. Body weights are on the rise, diets are becoming less healthy, and people are becoming increasingly sedentary, resulting in elevations of blood pressure and metabolic alterations that increase atherothrombotic risk. In fact, obesity, insulin resistance, and diabetes are becoming a public health problem of epidemic proportions.^1,2 In addition, modern society imposes demands on many that lead to difficulties in coping with their situations and more chronic "stress." Stress engages the central nervous system and activates behavioral and physiological response patterns, such as the "defense" and "defeat" reactions, which have been beneficial for the survival of the individual and the species but may become maladaptive when stress is chronic.^3–5 The concepts of "allostasis," ie, adaptation to physiological states and the environment, and "allostatic load" are helpful in understanding how responses to stress may become maladaptive and damaging.⁵

See p 2659

Stress activates the sympathoadrenal system and the hypothalamic-pituitary-adrenocortical (HPA) axis. Defense reactions involve catecholamine release, vagal withdrawal, cortisol secretion, and activation of the renin-angiotensin system; the less well characterized defeat reaction is a stimulus for cortisol production.^3,4 These mediators subserve functions that help the individual during short-term stress. When stress is frequent, adaptation (coping) is lacking, the ability to shut off the stress response is deficient, or the responses to stress are inadequate and compensatory mechanisms are activated, the allostatic load may become overwhelming and the adaptive processes become maladaptive.⁵ Stress is involved . . . [Full Text of this Article]

Related Article:

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Circulation 2002 106: 2659-2665. [Abstract] [Full Text]

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