Hypothalamic-Pituitary-Adrenal Axis
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This chapter summarizes evidence supporting a potential role for the hypothalamic-pituitary-adrenocortical (HPA) axis in cardiovascular disease (CVD) initiation and progression. We first describe the HPA axis and its measures in general before we proceed to the role of the HPA axis, in particular of its end-product cortisol, in the CVD risk factor essential hypertension and in CVD. When addressing associations between HPA axis activity and CVD, we primarily focus on coronary heart disease (CHD) and its underlying process atherosclerosis. We report data from studies in cardiac patients with and without controls and additionally describe findings of studies assessing indices of CVD severity such as coronary artery calcification. We first present cross-sectional findings and then proceed to prospective data in order to address the role of the HPA axis in incident CVD and progression of CVD. We also describe findings supporting a potential impact of psychological risk factors for CVD on HPA axis measures in cardiac patients. Finally, we will discuss potential direct and indirect mechanisms by which HPA axis alterations may influence CVD.
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WIRTZ, Petra H., 2022. Hypothalamic-Pituitary-Adrenal Axis. In: WALDSTEIN, Shari R., ed., Willem J. KOP, ed., Leslie KATZEL, ed. and others. Handbook of Cardiovascular Behavioral Medicine. New York, NY: Springer, 2022, pp. 941-974. ISBN 978-0-387-85959-0. Available under: doi: 10.1007/978-0-387-85960-6_39BibTex
@incollection{Wirtz2022Hypot-66177, year={2022}, doi={10.1007/978-0-387-85960-6_39}, title={Hypothalamic-Pituitary-Adrenal Axis}, isbn={978-0-387-85959-0}, publisher={Springer}, address={New York, NY}, booktitle={Handbook of Cardiovascular Behavioral Medicine}, pages={941--974}, editor={Waldstein, Shari R. and Kop, Willem J. and Katzel, Leslie}, author={Wirtz, Petra H.} }
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