Epidemiological studies show the existence of the negative linear correlation between low plasma high density lipoprotein (HDL) and frequency of coronary heart disease (CHD). The low HDL concentration is connected also with the increasing risk of vascular crash in central nervous system. Probably the main mechanism of antiatherogenic action of HDL is its participate in the reserve cholesterol transport. Four stages are included in this process: the transport of free cholesterol from cells to extracellular acceptors (HDL); estrification of HDL cholesterol; transport of cholesterol esters from HDL to VLDL and LDL and uptake of these lipoproteins and cholesterol esters in the liver. Tke key role in selective uptake in liver and its transport to cells plays scavenger receptor BI. It seems probably that it is also applied in mechanism of efflux of cholesterol from cells. To other properties of antiatherogenic action of HDL belongs its antithrombotic effect: inhibition of adhesion and aggregation of platelets and inactivation of plasma Va and VIIIa factors resulting from participation of HDL as cofactor in protein C activation. HDL prevents also atherogenic modification of LDL by connected with paraoxonase (PON1) activity.
Paper presents the studies veryfying the model of potential personality risk factors of lung cancer and coronary heart disease, in which the new questionnaire - Inventory of Personality Patterns as applied. On the basis of the theoretical model it was assumed that depresiveness may be concerned as a common risk factor for both diseases, but hostility is specific for coronary heart disease and submissiveness for lung cancer. The process of development of the inventory as well as analysis of its psychometric properties (factorial structure, intercorrelations of scales, their construct-oriented and criterion-related validity) were planned with the aim to verify hypotheses, based on the theoretical model. The findings obtained in the whole series of empirical studies do not allow to fully confirm the assumptions of the theoretical model as well as the validity of the new inventory. The most results generally supported the model, but some findings were in contradiction with theoretical expectations. In the discussion, the necessity of further studies, aimed on verification of the model of common and specific personality risk factors of lung cancer and coronary heart disease, was suggested.
According to the recent preventive and therapeutic strategies, the evaluation of global cardiovascular risk, including the psychosocial risk factors, has been recommended to each patient, using the integrative biopsychosocial approach. This paper will show that there are the significant differences between a group of 45 patients suffering from coronary heart disease and 45 healthy persons with several psychosocial characteristics. Using the examination of heart rate variability- (HRV) we observed the different responses in the patients suffering from coronary heart disease and the healthy persons to the orthostatic and psychical load. These findings indicate a higher risk level in these patients. We conclude that the heart rate variability examination can be useful in clinical psychology in the global risk estimation under contemporary influence of the cluster of the biological, psychical and social risk factors.
The aim of this study is to emphasize the importance of an integrative bio-behavioral approach to coronary heart disease. We explored relationships between psychological characteristics and traditional biomedical risk factors of coronary heart disease, by using specific methods not commonly used in Slovakia (VCE interview, RIA serotonin levels assessment). A structured interview was conducted with 89 patients, who were divided into 4 diagnostic groups: 1) cardiac patients after myocardial infarction (MI), 2) patients suffering from metabolic syndrome, 3) patients with depression, and 4) participants with growth hormone insufficiency. The VCE interview (Friedman, Ghandour, 1993) was used to assess the levels of free-floating hostility and time urgency. Beck's questionnaires (BDI, BAI) and Zung's inventory were employed in order to explore depression and anxiety. The B.P.A.I. questionnaire was used as the measure of anger and hostility. The medical and biochemical examinations were also performed (e.g., BMI, blood pressure, Doppler, EKG, cholesterol, serotonin). ANOVA, Pearson's coefficients and factor analysis were used as the statistical methods. Cardiac patients after MI scored significantly higher in free-floating hostility, time urgency and total score of the VCE interview compared to all other groups. It has been shown that results of the VCE structured interview are efficient in distinguishing patients with coronary heart disease from patients without this disorder. The cardiac patients also had higher levels of anxiety and depression, which were significantly associated with the lowest serotonin levels in this group. The group of patients with metabolic syndrome had higher levels of the above-mentioned variables compared to the group with depression and growth hormone insufficiency, which illustrates on the psychological level that metabolic syndrome might be perceived as an antecedent of future coronary heart disease. The trend of higher cardiac risk in patients suffering from depression was also partially confirmed. The results of the present study showed that psychosocial factors, especially free-floating hostility and time urgency, are strongly connected to the somatic risk factors which play an important role in the origin and development of coronary heart disease. More attention should be paid to psychosocial factors when considering the treatment and prevention of coronary heart disease.
The activation of the renin-angiotensin system has been proposed as a very important step in the pathogenesis of atherosclerosis. Accordingly, ACE-inhibitors and angiotensin II receptors antagonists showed their ability to reduce the atherosclerotic process in animals. Inhibition of renin-angiotensin system reduces the development of atherosclerotic lesion either in cholesterol-fed animals and in animals after vascular injury. The precise mechanism for this action may depend on the inhibition of other than hypertensive property of angiotensin II.
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