Psychoneurobiological mechanisms in essential hypertension and coronary heart disease

“Psychoneurobiological mechanisms in essential hypertension and coronary heart disease (CHD)”

Project leader: Petra Wirtz
Project duration: 2011 - 2017
Funding: Swiss National Science Foundation (PP00P1-128565/1 to PW)

Coronary heart disease (CHD) is among the most common causes of death in modern industrial nations. Although essential hypertension (i.e. high blood pressure that has no identifiable cause) belongs to the main risk factors leading to CHD, the mechanisms that connect essential hypertension both to an increased occurrence of CHD and to the basic processes underlying arteriosclerosis remain at least partly unexplored.
Besides classic (e.g. hypertension, smoking, obesity) and intermediary biological risk factors (e.g. blood lipids, inflammation activity, raised levels of blood clotting), there is a growing body of evidence that psychosocial factors, too, are independent risk factors for CHD.  These include, among others, stress, low levels of social support as well as emotional factors such as raised anger levels or hostility. Especially strong physiological responses to stress are important risk factors that may result in CHD in the future. Researchers therefore suspect that physiological hyperresponsiveness to stress in hypertensive individuals could play a mechanistic role in the relationship between hypertension and an increased risk of CHD.
The project is comprised of a longitudinal survey as well as two cross-sectional studies and aims to explore the biopsychological mechanisms underlying CHD and essential hypertension in some detail. The three-year longitudinal survey examines if CHD patients, hypertensive and healthy individuals differ from one another as regards various psychosocial factors and, if so, if these differences are connected to an increased risk of developing CHD. The projected cross-sectional studies will seek to uncover neuroendocrine mechanisms that might be responsible for the observed hyperresponsiveness to stress in patients suffering from essential hypertension. Both cross-sectional studies will also investigate psychobiological responsiveness to a lab stressor in both hypertensive and healthy individuals.