Access the full text.
Sign up today, get DeepDyve free for 14 days.
David Krantz, S. Hedges, F. Gabbay, J. Klein, J. Falconer, C. Merz, J. Gottdiener, H. Lutz, A. Rozanski (1994)
Triggers of angina and ST-segment depression in ambulatory patients with coronary artery disease: evidence for an uncoupling of angina and ischemia.American heart journal, 128 4
M. Burg, Diwakar Jain, R. Soufer, R. Kerns, B. Zaret (1993)
Role of behavioral and psychological factors in mental stress-induced silent left ventricular dysfunction in coronary artery disease.Journal of the American College of Cardiology, 22 2
L. Kubzansky, Ichiro Kawachi, A. Spiro, S. Weiss, P. Vokonas, D. Sparrow (1997)
Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the Normative Aging Study.Circulation, 95 4
M. Ellestad, Bernard Cooke, Paul Greenberg (1979)
Stress testing: clinical application and predictive capacity.Progress in cardiovascular diseases, 21 6
J. Muller, M. Mittleman, M. Maclure, J. Sherwood, G. Tofler (1996)
Triggering Myocardial Infarction by Sexual Activity: Low Absolute Risk and Prevention by Regular Physical ExertionJAMA, 275
F. Gabbay, David Krantz, W. Kop, S. Hedges, J. Klein, J. Gottdiener, A. Rozanski (1996)
Triggers of myocardial ischemia during daily life in patients with coronary artery disease: physical and mental activities, anger and smoking.Journal of the American College of Cardiology, 27 3
J. Blumenthal, W. Jiang, R. Waugh, D. Frid, J. Morris, R. Coleman, M. Hanson, M. Babyak, E. Thyrum, David Krantz (1995)
Mental stress-induced ischemia in the laboratory and ambulatory ischemia during daily life. Association and hemodynamic features.Circulation, 92 8
J. Leor, W. Poole, R. Kloner (1996)
Sudden Cardiac Death Triggered by an EarthquakeThe New England Journal of Medicine, 334
A. Rozanski, C. Bairey, David Krantz, J. Friedman, K. Resser, M. Morell, S. Hilton-Chalfen, L. Hestrin, J. Bietendorf, D. Berman (1988)
Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease.The New England journal of medicine, 318 16
M. Maclure (1991)
The case-crossover design: a method for studying transient effects on the risk of acute events.American journal of epidemiology, 133 2
S. Patterson, David Krantz, L. Montgomery, P. Deuster, S. Hedges, L. Nebel (1993)
Automated physical activity monitoring: validation and comparison with physiological and self-report measures.Psychophysiology, 30 3
M. Mittleman, M. Maclure, M. Maclure, J. Robins (1995)
Control sampling strategies for case-crossover studies: an assessment of relative efficiency.American journal of epidemiology, 142 1
J. Kark, S. Goldman, L. Epstein (1995)
Iraqi missile attacks on Israel. The association of mortality with a life-threatening stressor.JAMA, 273 15
Ichiro Kawachi, D. Sparrow, A. Spiro, P. Vokonas, S. Weiss (1996)
A prospective study of anger and coronary heart disease. The Normative Aging Study.Circulation, 94 9
J. Gottdiener, David Krantz, R. Howell, G. Hecht, J. Klein, J. Falconer, A. Rozanski (1994)
Induction of silent myocardial ischemia with mental stress testing: relation to the triggers of ischemia during daily life activities and to ischemic functional severity.Journal of the American College of Cardiology, 24 7
S. Hedges, David Krantz, Richard Contrada, A. Rozanski (1990)
Development of a diary for use with ambulatory monitoring of mood, activities, and physiological functionJournal of Psychopathology and Behavioral Assessment, 12
M. Mittleman, M. Maclure, J. Sherwood, Richard Mulry, G. Tofler, S. Jacobs, R. Friedman, Herbert Benson, J. Muller (1995)
Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators.Circulation, 92 7
J. Deanfield, M. Kensett, R. Wilson, M. Shea, P. Horlock, C. Landsheere, A. Selwyn (1984)
SILENT MYOCARDIAL ISCHAEMIA DUE TO MENTAL STRESSThe Lancet, 324
M. Modena, F. Corghi, G. Fantini, G. Mattioli (1989)
Echocardiographic monitoring of mental stress test in ischemic heart diseaseClinical Cardiology, 12
C. Bairey, David Krantz, V. Dequattro, D. Berman, A. Rozanski (1991)
Effect of beta-blockade on low heart rate-related ischemia during mental stress.Journal of the American College of Cardiology, 17 6
Ichiro Kawachi, David Sparrow, P. Vokonas, Scott Weiss (1994)
Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study.Circulation, 90 5
S. Gottlieb, S. Gottlieb, S. Achuff, R. Baumgardner, E. Mellits, M. Weisfeldt, G. Gerstenblith (1988)
Silent ischemia on Holter monitoring predicts mortality in high-risk postinfarction patients.JAMA, 259 7
W. Parmley (1989)
Prevalence and Clinical Significance of Silent Myocardial IschemiaCirculation, 80
Leisa Freeman, Peter Nixon, P. Sallabank, D. Reaveley (1987)
Psychological stress and silent myocardial ischemia.American heart journal, 114 3
K. Cohn (1976)
Interpretation and limitations in stress testing.Advances in cardiology, 17
E. Nabel, J. Barry, Michael Ba, Stephen Rocco, Kimberely Campbell, Terence Mead, E. Fenton, Andrew Orav, Selwyn, Andrew Selwyn (1988)
Variability of transient myocardial ischemia in ambulatory patients with coronary artery disease.Circulation, 78 1
J. Barefoot (1983)
Hostility, CHD incidence, and total mortality: a 25-year follow-up study of 255 physicians.Psychosomatic medicine, 45 1
S. Schang, C. Pepine (1977)
Transient asymptomatic S-T segment depression during daily activity.The American journal of cardiology, 39 3
M. Mittleman, M. Maclure, G. Tofler, J. Sherwood, R. Goldberg, J. Muller (1993)
Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators.The New England journal of medicine, 329 23
L. Tavazzi, E. Bosimini, R. Giubbini, M. Galli, G. Mazzuero (1990)
Silent ischemia during mental stress: scintigraphic evidence and electrocardiographic patterns.Advances in cardiology, 37
N. Frasure-smith, F. Lespérance, M. Talajic (1995)
The impact of negative emotions on prognosis following myocardial infarction: is it more than depression?Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 14 5
J. Barry, A. Selwyn, E. Nabel, M. Rocco, K. Mead, Stephen Campbell, George Rebecca (1988)
Frequency of ST-segment depression produced by mental stress in stable angina pectoris from coronary artery disease.The American journal of cardiology, 61 13
A. Rozanski, D. Berman (1987)
Silent myocardial ischemia: II. Prognosis and implications for the clinical assessment of patients with coronary artery disease.American heart journal, 114 3
Objective. —To determine the relative risk of myocardial ischemia triggered by specific emotions during daily life. Design and Setting. —Relative risk was calculated by the recently developed case-crossover method, in which the frequency of a presumed trigger during nonischemic, or control, hours is compared with the trigger's frequency during ischemic, or case, hours. Outpatients at Duke University Medical Center, Durham, NC, underwent 48 hours of ambulatory electrocardiographic (ECG) monitoring with concurrent self-report measures of activities and emotions. Occurrences of negative emotions in the hour before the onset of myocardial ischemia were compared with their usual frequency based on all hours in which ischemia did not occur. Subjects. —From a sample of 132 patients with coronary artery disease and recent evidence of exercise-induced ischemia who underwent 48 hours of ambulatory ECG monitoring, 58 patients exhibited ambulatory ischemia and were included in the analysis. Outcome Measures. —Myocardial ischemia during 48-hour ECG monitoring was defined as horizontal or downsloping ST-segment depression of 1 mm (0.1 mV) or more for 1 minute or longer compared with resting baseline. The ECG data were cross-tabulated with subjects' concurrent diary ratings of 3 negative emotions— tension, sadness, and frustration—and 2 positive emotions—happiness and feeling in control—on a 5-point scale of intensity. Results. —The unadjusted relative risk of occurrence of myocardial ischemia in the hour following high levels of negative emotions was 3.0 (95% confidence interval [CI], 1.5-5.9; P<.01) for tension, 2.9 (95% CI, 1.0-8.0; P<.05) for sadness, and 2.6 (95% CI, 1.3-5.1; P<.01) for frustration. The corresponding risk ratios adjusted for physical activity and time of day were 2.2 (95% CI, 1.1-4.5; P<.05) for tension, 2.2 (95% CI, 0.7-6.4; P=.16) for sadness, and 2.2 (95% CI, 1.1-4.3; P<.05) for frustration. Conclusions. —Mental stress during daily life, including reported feelings of tension, frustration, and sadness, can more than double the risk of myocardial ischemia in the subsequent hour. The clinical significance of mental stress—induced ischemia during daily life needs to be further evaluated.
JAMA – American Medical Association
Published: May 21, 1997
Read and print from thousands of top scholarly journals.
Already have an account? Log in
Bookmark this article. You can see your Bookmarks on your DeepDyve Library.
To save an article, log in first, or sign up for a DeepDyve account if you don’t already have one.
Copy and paste the desired citation format or use the link below to download a file formatted for EndNote
Access the full text.
Sign up today, get DeepDyve free for 14 days.
All DeepDyve websites use cookies to improve your online experience. They were placed on your computer when you launched this website. You can change your cookie settings through your browser.