DESCRIPTION:
The main aim of this book is to evaluate the concept of stress and provide tools for physicians to identify patients who might benefit from stress management. This will incorporate a detailed description of the physiological and pathophysiological consequences of acute and chronic stress that might lead to cardiovascular disease. The book will aim to critically evaluate interventional research (behavioural and other therapies) and provide evidence based recommendations on how to manage stress in the cardiovascular patient. Our intentions are to define and highlight stress as an etiological factor for cardiovascular disease, and to describe an evidence based "tool box" that physicians may use to identify and manage patients in whom stress may be an important contributing factor for their disease and their risk of suffering cardiovascular complications.
CONTENTS:
Psychosocial factors and stress
What is "stress":How did the concept develop? (studies by Selye, Henry, Folkow, etc.)
Acute vs. chronic stress
"Positive" and "negative" stress?
Demands, coping, homeostasis, allostasis
Psychosocial factors (divided into psychological and social)
Personality factors, social demands & support, life events, etc.?
Work stress
Demands in modern society
Karasek model of control
Sleep disturbances
An important symptom and a mediator in stress
Physiological adaptation to stress
Defence reactions (arousal fight or flight) - defeat rections
Acute vs. chronic
Can be divided in different ways, should include: cardiovascular responses, neurohormonal responses, immunology/inflammation, metabolism, haemostatic responses
Pathophysiological Mechanisms
Triggering of acute events
Dysfunctional mechanisms activated by chronic stress
Clinical studies
Methodological aspects - this may be written jointly by us to "set the stage", and should give readers a "toolbox" with which they can identify scientifically good and weak studies
Epidemiology
Observational studies
Interventional studies
Triggering of cardiovascular events by short-term stress
Earth quakes, soccer etc
Diagnostic aspects in chronic stress
Diagnostic tools (structured interviews, questionnaires, rating scales,laboratory?)
Differential diagnoses
Chronic stress - epidemiology
Cardiovascular disease and its risk factors (obesity, diabetes, hypertension)
Landmark studies
Whitehall
Interheart, other studies (to be decided)
Overview of observational studies on interventions
Overview of experimental (randomized, controlled) studies on interventions
Recommendations based on the best available evidence
"Hands on" recommendations regarding evidence based care of "stressed" patients.
