This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Harris, K. F. Articles by Matthews, K. A. Search for Related Content PubMed PubMed Citation Articles by Harris, K. F. Articles by Matthews, K. A. Related Collections Psychophysiology Stress and Coping Coronary Artery Disease

Interactions Between Autonomic Nervous System Activity and Endothelial Function: A Model for the Development of Cardiovascular Disease

From the Department of Psychology, University of Pittsburgh (K.F.H.), and the Departments of Psychiatry, Epidemiology, and Psychology, University of Pittsburgh School of Medicine, (K.A.M.), Pittsburgh, PA.

Address reprint requests to: Karen A. Matthews, PhD, Cardiovascular Behavioral Medicine, Department of Psychiatry, WPIC, 3811 O’Hara Street, Pittsburgh, PA 15213. E-mail: matthewska{at}umpc.edu

ABSTRACT

OBJECTIVES: Endothelial dysfunction is a new pathway in cardiovascular disease (CVD) development. Psychosocial factors have been little studied in relation to endothelial function, although they may interact via associations with the autonomic nervous system (ANS). The purpose of this review is to propose a model by which psychosocial factors are related to CVD development through interactions between the ANS and vascular endothelium.

METHODS: The literature supporting an interaction between the ANS and endothelium in healthy and disease states is reviewed. Potential mechanisms linking the two systems are explored as a pathway for CVD development.

RESULTS: Endothelial dysfunction and impaired cardiovascular ANS regulation are both markers for increased CVD risk. Sympathetic nerves and vascular endothelial cells share a functional antagonism in healthy states to maintain appropriate blood vessel tone. Alterations in sympathetic activity and endothelial cell function are both observed early in the development of CVD and may result from an inability to maintain the functional antagonism. Impairments in either ANS regulation or endothelial function may contribute to further disease development by evoking maladaptive changes in the opposing system.

CONCLUSIONS: Although interactions between cardiovascular ANS regulation and endothelial function are likely involved in CVD development, further research is needed to determine whether ANS and endothelium interactions are a plausible pathway linking psychosocial factors with increased CVD risk.

Key Words: endothelial function, • autonomic nervous system, • sympathetic nervous system, • pathophysiology, • cardiovascular disease, • psychosocial stress.

Abbreviations: CVD = cardiovascular disease;; ANS = autonomic nervous system;; SNS = sympathetic nervous system;; PSNS = parasympathetic nervous system;; NO = nitric oxide;; CAD = coronary artery disease;; FMD = flow-mediated dilation;; HRV = heart rate variability;; vWF = von Willebrand factor;; LDL = low-density lipoprotein;; NOS = nitric oxide synthase;; HPA = hypothalamic-pituitary-adrenal.

This article has been cited by other articles:

				D. C. Cooper, M. S. Milic, J. R. Tafur, P. J. Mills, W. A. Bardwell, M. G. Ziegler, and J. E. Dimsdale Adverse Impact of Mood on Flow-Mediated Dilation Psychosom Med, February 1, 2010; 72(2): 122 - 127. [Abstract] [Full Text] [PDF]

				K. L. Lavoie, R. Pelletier, A. Arsenault, J. Dupuis, and S. L. Bacon Association Between Clinical Depression and Endothelial Function Measured by Forearm Hyperemic Reactivity Psychosom Med, January 1, 2010; 72(1): 20 - 26. [Abstract] [Full Text] [PDF]

				F. Iellamo, M. Tesauro, S. Rizza, S. Aquilani, C. Cardillo, M. Iantorno, M. Turriziani, and R. Lauro Concomitant Impairment in Endothelial Function and Neural Cardiovascular Regulation in Offspring of Type 2 Diabetic Subjects Hypertension, September 1, 2006; 48(3): 418 - 423. [Abstract] [Full Text] [PDF]

				M. A. Robbins, M. F. Elias, P. K. Elias, and M. M. Budge Blood Pressure and Cognitive Function in an African-American and a Caucasian-American Sample: The Maine-Syracuse Study Psychosom Med, September 1, 2005; 67(5): 707 - 714. [Abstract] [Full Text] [PDF]

				P. J. Gianaros, K. Salomon, F. Zhou, J. F. Owens, D. Edmundowicz, L. H. Kuller, and K. A. Matthews A Greater Reduction in High-Frequency Heart Rate Variability to a Psychological Stressor is Associated With Subclinical Coronary and Aortic Calcification in Postmenopausal Women Psychosom Med, July 1, 2005; 67(4): 553 - 560. [Abstract] [Full Text] [PDF]

				M. E. Bleil, J. M. McCaffery, M. F. Muldoon, K. Sutton-Tyrrell, and S. B. Manuck Anger-Related Personality Traits and Carotid Artery Atherosclerosis in Untreated Hypertensive Men Psychosom Med, September 1, 2004; 66(5): 633 - 639. [Abstract] [Full Text] [PDF]