Stress Anger and Cardiovascular Disease A Comprehensive Model

The model at the end of this appendix (page 283) details the theoretical relationship between stress, anger, and cardiovascular disease. Stress is often defined as the response of the body to threats or demands. The stress response is called a neuroendocrine response; the brain acts like a conductor and orchestrates a cascade of neural (nerves) and endocrine (hormonal) messages that target various organs. Anger/hostility is thought to be a risk factor for cardiovascular disease because all of the major stress pathways (A to E in the model) are theoretically activated when a person becomes aroused. This model depicts stress as not only a response but also a process that involves continuous interactions and adjustments (transactions) between an individual and the environment. In part, this book is about making those interactions and adjustments as "appropriate" and healthy as possible, thereby enabling a person to become an active agent in his or her well-being rather than a passive victim of the world's unpleasantries.

The upper portion of the model is based on Ellis's A-B-C theory of emotional arousal. The stressor (anger hook) is the Activating event. The thoughts or Beliefs that follow are influenced by one's self-esteem and deeply held core beliefs. Hot thoughts lead to anger (emotional Consequences) and subsequent angry behaviors. Certain behaviors can feed back to increase anger and further erode self-esteem.

Thoughts take place in the level of the brain called the neocortex. The nature of the thoughts elicits one's emotions, which are regulated by the brain's limbic system. When angry, a person's brain prepares the body for fight or flight by sending neuroendocrine "commands" through the hypothalamus to the body via various pathways. These commands are adaptive in the short term because they energize a person. In the long run, however, chronic anger may exact a toll on the body.

Certain behavioral and psychophysiological factors, though not depicted in the model, may have a buffering effect on the stress response. These factors include:

• Female gender

• Good coping skills

• Hardy personality

• Adequate nutrition, rest, and exercise

Relaxation skills

• Social support

• Belief in a higher power and worship

• Internal locus of control

In contrast, numerous factors may exacerbate the stress response, including elevated cardiovascular reactivity (being a hot reactor); lack of social support; poor coping skills; male gender; poor diet, exercise, and sleep habits; and genetics (e.g., family history of hypertension and/or other cardiovascular risks).

Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

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