Showing 2 ideas for tag "anxiety"

Goal 3: Advance Translational Research

Treating cardiovascular disease in persons with mental health disorders

How can we most effectively prevent and treat cardiovascular disease among persons with serious mental disorders?

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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Clinical anxiety disorders affects 40 million people in the US and the lifetime prevalence of PTSD is 6-8%,. The incidence of PTSD in particular is rapidly expanding in the US; this condition doubles the risk of a cardiac event.

The prevalence rates are higher in some populations; 3 out of 10 US military veterans have a diagnosis of PTSD, and many more are undiagnosed. Among patients at a VA, a diagnosis of PTSD increased the probability of circulatory problems (odds ratio 3.7). In another study, every additional PTSD symptom increased the risk of developing cardiovascular disease by 17%. Thus, the impact of developing more effective treatments adapted to the needs of this vulnerable population could be significant.

Feasibility and challenges of addressing this CQ or CC

As the incidence of many mental health disorders such as PTSD and depression increases, the need for developing and adapting treatments for this population becomes critical.

Effective treatments may not be optimal for persons with serious mental illnesses and strategies to tailor treatments to the challenges of this vulnerable population are needed.
Individuals with mental illnesses such as major depressive disorder, bipolar disorder, and anxiety disorders are at significantly higher risk for cardiovascular disease than are those without these illnesses. Those with serious mental illnesses die an average of 25 years earlier, frequently from cardiovascular disease. The incidence of PTSD is rapidly expanding in the US; this condition doubles the risk of cardiovascular events.

Name of idea submitter and other team members who worked on this idea NHLBI Staff

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Goal 1: Promote Human Health

Brain-Heart Connections

Depression and CHD will become the 2 leading causes of disability in the next decade. Chronic as well as traumatic stress increases CVD risk by about 50%. Although we understand that there are connections between psychosocial stress, affective disorders, and CVD, we do not understand the vast array of brain areas that impact the CV system and the mechanisms connecting them. Neuroscience has made great leaps in understanding... more »

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? Compelling Question (CQ)

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For example, we still do not have a comprehensive understanding of how depression increases incident CHD.

Alternative treatments for depression are needed that target disrupted pathways known to promote CVD (e.g. autonomic, inflammation).

What are the mechanisms through which PTSD doubles incident CHD within a decade?

What are the mechanisms through which exercise, sleep, and certain diet patterns mediate the effects of psychosocial stress on health?

Not all stressed people get CVD and some data suggests that coping style mediates stress effects on CVD risk. If so, perhaps we can teach coping styles. But to do so we need to know more about whether and how certain coping styles modulate stress effects on the CV system.

A major cause of psychosocial stress in modern America is social density. The higher the density, the less tolerance there is for deviance from the norm. How does increased social density effect CV physiology? Are there ways to intervene through spatial partitioning or interaction patterns that alter perceptions of crowdedness or lack of privacy?

Feasibility and challenges of addressing this CQ or CC

We have all the tools to address this over-arching area and these specific questions. They just need to be made a priority.

Name of idea submitter and other team members who worked on this idea Carol Shively

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