Worksite hypertension as a model of stress-induced arterial hypertension


Cite item

Full Text

Abstract

The review presents a modern view on stress as a risk factor for the development of arterial hypertension (AH). A variety pathogenic mechanisms responsible for increase of blood pressure during stress exposure are described in detail. The importance of the sympathetic activation as a key link in the development of stress-induced AH and initiation of a cascade of pathophysiological reactions that realize their adverse effects at the level of the whole organism is underlined. Particular attention is paid to worksite AH as a variant of stress-induced hypertension due to its wide prevalence and association with an increased risk of cardiovascular complications, primarily myocardial infarction and stroke. Epidemiological data and results of recent metanalysis are presented, indicating the high significance of job strain as a risk factor for adverse cardiovascular events. The actual psychological stress reduction programs are described. Possibilities of using β-blockers in patients with stress-induced hypertension as drugs affecting the central pathogenetic trigger of this disease are considered. The advantages of using bisoprolol as a highly selective β-blocker are considered taking into account the available body of evidence for its effectiveness in patients with worksite AH, as well as its metabolic neutrality and target-organ protective properties.

About the authors

O D Ostroumova

A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation; I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov First Moscow State Medical University)

Email: ostroumova.olga@mail.ru
проф., д.м.н., проф. каф. фак. терапии и профболезней Московского государственного медико-стоматологического университета им. А.И. Евдокимова; проф. каф. клинической фармакологии и пропедевтики внутренних болезней Первого Московского государственного медицинского университета им. И.М. Сеченова Moscow, Russia

A I Kochetkov

A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation

к.м.н., ассистент каф. фак. терапии и профболезней Moscow, Russia

References

  1. Li R, Gao X, Liu B, Ge H, Ning L, Zhao J, Liu J. Prospective Cohort Study to Elucidate the Correlation between Occupational Stress and Hypertension Risk in Oil Workers from Kelamayi City in the Xinjiang Uygur Autonomous Region of China. Int J Environ Res Public Health. 2016;14(1). pii: E1. doi: https://doi.org/10.3390/ijerph14010001
  2. Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn S.Y, Alvarado M, Anderson H.R, Anderson L.M, Andrews K.G, Atkinson C, Baddour L.M, Barker-Collo S, Bartels D.H, Bell M.L, Benjamin E.J, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh S.S, Coffeng L.E, Colan S.D, Colquhoun S, Colson K.E, Condon J, Connor M.D, Cooper L.T, Corriere M, Cortinovis M, de Vaccaro K.C, Couser W, Cowie B.C, Criqui M.H, Cross M, Dabhadkar K.C, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais D.C, Dharmaratne S.D, Dorsey E.R, Driscoll T, Duber H, Ebel B, Erwin P.J, Espindola P, Ezzati M, Feigin V, Flaxman A.D, Forouzanfar M.H, Fowkes F.G, Franklin R, Fransen M, Freeman M.K, Gabriel S.E, Gakidou E, Gaspari F, Gillum R.F, Gonzalez-Medina D. et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2095-128. doi: https://doi.org/10.1016/S0140-6736(12)61728-0
  3. Puzserova A, Bernatova I. Blood pressure regulation in stress: focus on nitric oxide - dependent mechanisms. Physiol Res. 2016;65(Suppl 3): S309-S42.
  4. Esch T, Stefano G.B, Fricchione G.L, Benson H. Stress in cardiovascular diseases. Med Sci Monit. 2002;8(5):RA93-RA101.
  5. Franco G.P, de Barros A.L, Nogueira-Martins L.A, Michel J.L. Stress influence on genesis, onset and maintenance of cardiovascular diseases: literature review. J Adv Nurs. 2003;43(6):548-54. https://doi.org/ 10.1046/j.1365-2648.2003.02753.x
  6. Mravec B, Ondicova K, Valaskova Z, Gidron Y, Hulin I. Neurobiological principles in the etiopathogenesis of disease: when diseases have a head. Medical Science Monitor. 2008;15(1):RA6-RA16.
  7. Marvar P.J, Harrison D.G. Stress-Dependent Hypertension and the Role of T Lymphocytes. Experimental physiology. 2012;97(11):1161-7. https://doi.org/10.1113/expphysiol.2011.061507
  8. Golbidi S, Frisbee J.C, Laher I. Chronic stress impacts the cardiovascular system: animal models and clinical outcomes. Am J Physiol Heart Circ Physiol. 2015;308(12):H1476-498. https://doi.org/10.1152/ajpheart.00859.2014
  9. Mc Ewen B.S. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87(3):873-904. https://doi.org/10.1152/physrev.00041.2006
  10. Grassi G, Seravalle G, Quarti-Trevano F. The 'neuroadrenergic hypothesis' in hypertension: current evidence. Exp Physiol. 2010;95(5):581-6. https://doi.org/10.1113/expphysiol.2009.047381
  11. Esler M. Looking at the sympathetic nervous system as a primary source. In: Zanchetti A, Robertson J.I.S, Birkenhager W.H, eds, Handbook of Hypertension:Hypertension Research in the Twentieth Century. Amsterdam: Elsevier, 2004:81-103.
  12. Davern P.J, Head G.A. Fos - related antigen immunoreactivity after acute and chronic angiotensin II - induced hypertension in the rabbit brain. Hypertension. 2007;49(5):1170-7. https://doi.org/10.1161/HYPERTENSIONAHA.106.086322
  13. Ganta C.K, Lu N, Helwig B.G, Blecha F, Ganta R.R, Zheng L, Ross C.R, Musch T.I, Fels R.J, Kenney M.J. Central angiotensin II - enhanced splenic cytokine gene expression is mediated by the sympathetic nervous system. Am J Physiol Heart Circ Physiol. 2005;289(4):H1683-91. https://doi.org/10.1152/ajpheart.00125.2005
  14. Sanders V.M, Straub R.H. Norepinephrine, the beta - adrenergic receptor, and immunity. Brain Behav Immun. 2002;16(4):290-332. https://doi. org/10.1006/brbi.2001.0639
  15. Shi P, Raizada M.K, Sumners C. Brain cytokines as neuromodulators in cardiovascular control. Clin Exp Pharmacol Physiol. 2010;37(2):e52-7. https://doi.org/10.1111/j.1440-1681.2009.05234.x
  16. Yu Y, Zhang Z.H, Wei S.G, Serrats J, Weiss R.M, Felder R.B. Brain perivascular macrophages and the sympathetic response to inflammation in rats after myocardial infarction. Hypertension. 2010;55(3):652-9. https://doi.org/10.1161/HYPERTENSIONAHA. 109.142836
  17. Paton J.F, Waki H. Is neurogenic hypertension related to vascular inflammation of the brainstem? Neurosci Biobehav Rev. 2009;33(2):89-94. https://doi.org/10.1016/j.neubiorev.2008.05.020
  18. Marrero A.F, al'Absi M, Pincomb G.A, Lovallo W.R. Men at risk for hypertension show elevated vascular resistance at rest and during mental stress. Int J Psychophysiology. 1997;25(3):185-92. http://dx.doi.org/10.1016/S0167-8760(96)00737-4
  19. Regecová V, Kellerová E. Ambulatory blood pressure monitoring in relation to daily routine activities. Cardiology Lett. 2015;24:251-6.
  20. Malyshev I.Y, Manukhina E.B. Stress, adaptation, and nitric oxide. Biochemistry (Mosc). 1998;63(7):840-53.
  21. Gulati K, Joshi J.C, Ray A. Recent advances in stress research: Focus on nitric oxide. Eur J Pharmacol. 2015;765:406-14. https://doi.org/10. 1016/j.ejphar.2015.08.055
  22. Pechánová O, Varga Z.V, Cebová M, Giricz Z, Pacher P, Ferdinandy P. Cardiac NO signalling in the metabolic syndrome. British J Pharmacol. 2015;172(6):1415-33. https://doi.org/10.1111/bph.12960
  23. Pechánová O, Dobesová Z, Cejka J, Kunes J, Zicha J. Vasoactive systems in L-NAME hypertension: the role of inducible nitric oxide synthase. J Hypertens. 2004;22(1):167-73.
  24. Babal P, Pechanova O, Bernatova I, Stvrtina S. Chronic inhibition of NO synthesis produces myocardial fibrosis and arterial media hyperplasia. Histology and Histopathology.1997;12(3):623-9.
  25. Bobrovskaya L, Beard D, Bondarenko E, Beig M.I, Jobling P, Walker F.R, Day T.A, Nalivaiko E. Does exposure to chronic stress influence blood pressure in rats? Auton Neurosci. 2013;177(2):217-23. https://doi.org/10.1016/j.autneu.2013.05.001
  26. Muller J.R, Le K.M, Haines W.R, Gan Q, Knuepfer M.M. Hemodynamic response pattern predicts susceptibility to stress - induced elevation in arterial pressure in the rat. Am J Physiol Regul Integr Comp Physiol. 2001;281(1):R31-R37. https://doi.org/10.1152/ajpregu.2001.281.1. R31
  27. Esler M, Eikelis N, Schlaich M, Lambert G, Alvarenga M, Dawood T, Kaye D, Barton D, Pier C, Guo L, Brenchley C, Jennings G, Lambert E. Chronic mental stress is a cause of essential hypertension: presence of biological markers of stress. Clin Exp Pharmacol Physiol. 2008;35(4):498-502. https://doi.org/10.1111/j.1440-1681.2008.04904.x
  28. Sparrenberger F, Fuchs S.C, Moreira L.B, Fuchs F.D. Stressful life events and current psychological distress are associated with self - reported hypertension but not with true hypertension: results from a cross - sectional population - based study. BMC Public Health. 2008;8:357. https://doi.org/10.1186/1471-2458-8-357
  29. Karasek R. Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Quaterly. 1979;24:285-308. http://dx.doi.org/10.2307/2392498
  30. Siegrist J. Adverse health effects of high - effort/low - reward conditions. J Occup Health Psychol. 1996;1(1):27-41. http://dx.doi.org/10. 1037/1076-8998.1.1.27
  31. Gilbert-Ouimet M, Trudel X, Brisson C, Milot A, Vézina M. Adverse effects of psychosocial work factors on blood pressure: systematic review of studies on demand - control - support and effort - reward imbalance models. Scand J Work Environ Health. 2014;40(2):109-32. https://doi.org/10.5271/sjweh.3390
  32. Johnson J.V, Hall E.M, Theorell T. Combined Effects of Job Strain and Social Isolation on Cardiovascular Disease Morbidity and Mortality in a Random Sample of the Swedish Male Working Population. Scand J Work Environ Health. 1989;15:271-9. http://dx.doi.org/ 10.5271/sjweh.1852
  33. Siegrist J, Starke D, Chandola T, Godin I, Marmot M, Niedhammer I, et al. The measurement of effort - reward imbalance at work: European comparisons. Social Sience & Medicine. 2004;58:1483-99. http://dx.doi.org/10.1016/S0277-9536(03)00351-4
  34. Остроумова О.Д., Первичко Е.И., Зинченко Ю.П. Психологические особенности больных со стресс - индуцированной артериальной гипертонией: нарушение регуляции эмоций как центральное звено патогенеза. Кардиология. 2016;56(9):40-9. https://dx.doi.org/10.18565/cardio.2016.9. 40-49
  35. Vale S. Psychosocial stress and cardiovascular diseases. Postgrad Med J. 2005;81(957):429-35. http://dx.doi.org/10.1136/pgmj.2004.028977
  36. Lambert E, Lambert G. Stress and its role in sympathetic nervous system activation in hypertension and the metabolic syndrome. Curr Hypertens Rep. 2011;13(3):244-8. http://dx.doi.org/10.1007/s11906-011-0186-y
  37. Brunner E.J, Chandola T, Marmot M.G. Prospective effect of job strain on general and central obesity in the Whitehall II Study. Am J Epidemiol. 2007 Apr;165(7):828-37. http://dx.doi.org/10.1093/aje/kwk058
  38. Chandola T, Britton A, Brunner E, Hemingway H, Malik M, Kumari M, et al. Work stress and coronary heart disease: what are the mechanisms? Europ Heart J. 2008 Mar;29(5):640-8. http://dx.doi.org/ 10.1093/eurheartj/ehm584
  39. Piazza P.V, Le Moal M. Glucocorticoids as a biological substrate of reward: physiological and pathophysiological implications. Brain Res Brain Res Rev. 1997 Dec;25(3):359-72. http://dx.doi.org/10.1016/ S0165-0173(97)00025-8
  40. Brisson C, Larocque B, Moisan J, Vezina M, Dagenais G.R. Psychosocial factors at work, smoking, sedentary behavior and body mass index: a prevalence study among 6995 white collar workers. J Occup Environ Med. 2000;42(1):40-6. http://dx.doi.org/10.1097/00043764-200001000-00011
  41. Fodor J.G, Lietava J, Rieder A, Sonkodi S, Stokes H, Emmons T, Turton P. Work - site hypertension prevalence and control in three Central European Countries. J Hum Hypertens. 2004;18(8):581-5. https://doi. org/10.1038/sj.jhh.1001685
  42. Duprez D, Van Helshoecht P, Van den Eynde W, Leeman M. Prevalence of hypertension in the adult population of Belgium: report of a worksite study, Attention Hypertension. J Hum Hypertens. 2002;16(1):47-52. https://doi.org/10.1038/sj.jhh.1001293
  43. Landsbergis P.A, Diez-Roux A.V, Fujishiro K, Baron S, Kaufman J.D, Meyer J.D, Koutsouras G, Shimbo D, Shrager S, Stukovsky K.H, Szklo M. Job Strain, Occupational Category, Systolic Blood Pressure, and Hypertension Prevalence: The Multi-Ethnic Study of Atherosclerosis. J Occup Environ Med. 2015;57(11):1178-84. https://doi.org/10.1097/ JOM.0000000000000533
  44. Trudel X, Milot A, Gilbert-Ouimet M, Duchaine C, Guénette L, Dalens V, Brisson C. Effort-Reward Imbalance at Work and the Prevalence of Unsuccessfully Treated Hypertension Among White-Collar Workers. Am J Epidemiol. 2017;186(4):456-62. https://doi.org/10.1093/ aje/kwx116
  45. Kobayashi Y, Hirose T, Tada Y, Tsutsumi A, Kawakami N. Relationship between two job stress models and coronary risk factors among Japanese part - time female employees of a retail company. J Occup Health. 2005;47(3):201-10. https://doi.org/10.1539/joh.47.201
  46. Остроумова О.Д., Первичко Е.И., Зинченко Ю.П. «Гипертония на рабочем месте»: фокус на эмоционально - личностные особенности пациентов. Системные гипертензии. 2016;13(3):13-20
  47. Schnall P.L, Pieper C, Schwartz J.E, Karasek R.A, Schlussel Y, Devereux R.B, Ganau A, Alderman M, Warren K, Pickering T.G. The relationship between 'job strain,' workplace diastolic blood pressure, and left ventricular mass index. Results of a case - control study. JAMA. 1990;263(14):1929-35. https://doi.org/10.1001/jama.1990.034401400 55031
  48. Everson S.A, Lynch J.W, Chesney M.A, Kaplan G.A, Goldberg D.E, Shade S.B, Cohen R.D, Salonen R, Salonen J.T. Interaction of workplace demands and cardiovascular reactivity in progression of carotid atherosclerosis: population based study. BMJ. 1997;314(7080):553-558. https://doi.org/10.1136/bmj.314.7080.553
  49. Bosma H, Marmot M.G, Hemingway H, Nicholson A.C, Brunner E, Stansfeld S.A. Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ. 1997;314(7080):558-65. https://doi.org/10.1136/bmj.314.7080.558
  50. Selander J, Bluhm G, Nilsson M, Hallqvist J, Theorell T, Willix P, Pershagen G. Joint effects of job strain and road - traffic and occupational noise on myocardial infarction. Scand J Work Environ Health. 2013;39(2):195-203. https://doi.org/10.5271/sjweh.3324
  51. Fransson E.I, Nyberg S.T, Heikkilä K, Alfredsson L, Bjorner J.B, Borritz M, Burr H, Dragano N, Geuskens G.A, Goldberg M, Hamer M, Hooftman W.E, Houtman I.L, Joensuu M, Jokela M, Knutsson A, Koskenvuo M, Koskinen A, Kumari M, Leineweber C, Lunau T, Madsen I.E, Hanson L.L, Nielsen M.L, Nordin M, Oksanen T, Pentti J, Pejtersen J.H, Rugulies R, Salo P, Shipley M.J, Steptoe A, Suominen S.B, Theorell T, Toppinen-Tanner S, Vahtera J, Virtanen M, Väänänen A, Westerholm P.J, Westerlund H, Zins M, Britton A, Brunner E.J, Singh-Manoux A, Batty G.D, Kivimäki M. Job strain and the risk of stroke: an individual - participant data meta - analysis. Stroke. 2015;46(2):557-9. https://doi.org/10.1161/ STROKEAHA.114.008019
  52. Huang Y, Xu S, Hua J, Zhu D, Liu C, Hu Y, Liu T, Xu D. Association between job strain and risk of incident stroke: A meta - analysis. Neurology. 2015;85(19):1648-54. https://doi.org/10.1212/WNL.000000000000 2098
  53. Julius M, Harburg E, Cottington E.M, Johnson E.H. Anger - coping types, blood pressure, and all - cause mortality: a follow - up in Tecumseh, Michigan (1971-1983). Am J Epidemiol. 1986;124(2):220-33. http://dx.doi.org/10.1093/oxfordjournals.aje.a114380
  54. Fan L.B, Blumenthal J.A, Hinderliter A.L, Sherwood A. The effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure. Scand J Work Environ Health. 2013;39(1):112-9. https://doi.org/10.5271/sjweh.3294
  55. Dolan E, Stanton A, Thijs L, Hinedi K, Atkins N, Mc Clory S, Den Hond E, Mc Cormack P, Staessen J.A, O'Brien E. Superiority of ambulatory over clinic blood pressure measurement in predicting mortality: the Dublin outcome study. Hypertension. 2005;46:156-61. https://doi.org/10.1161/01.HYP.0000170138.56903.7a
  56. Boggia J, Li Y, Thijs L, Hansen T.W, Kikuya M, Björklund-Bodegård K, Richart T, Ohkubo T, Kuznetsova T, Torp-Pedersen C, Lind L, Ibsen H, Imai Y, Wang J, Sandoya E, O'Brien E, Staessen J.A; International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes (IDACO) investigators. Prognostic accuracy of day vs. night ambulatory blood pressure: a cohort study. Lancet. 2007;370:1219-29. https://doi.org/10.1016/S0140-6736(07)61538-4
  57. Fagard R.H, Thijs L, Staessen J.A, Clement D.L, De Buyzere M.L, De Bacquer D.A. Prognostic significance of ambulatory blood pressure in hypertensive patients with history of cardiovascular disease. Blood Press Monit. 2008;13:325-32. https://doi.org/10.1097/MBP.0b013e 32831054f5
  58. Fagard R.H, Thijs L, Staessen J.A, Clement D.L, De Buyzere M.L, De Bacquer D.A. Night - day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension. J Hum Hypertens. 2009;23:645-53. https://doi.org/10.1038/jhh.2009.9
  59. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K, Michimata M, Matsubara M, Hashimoto J, Hoshi H, Araki T, Tsuji I, Satoh H, Hisamichi S, Imai Y. Prognostic significance of the nocturnal decline in blood pressure: the Ohasama study. J Hypertension. 2002;20:2183-9. http://dx.doi.org/10.1097/00004872-200211000-00017
  60. Rainforth M.V, Schneider R.H, Nidich S.I, Gaylord-King C, Salerno J.W, Anderson J.W. Stress reduction programs in patients with elevated blood pressure: a systematic review and meta - analysis. Curr Hypertens Rep. 2007;9(6):520-8. http://dx.doi.org/10.1007/s11906-007-0094-3
  61. Ospina M.B, Bond T.K, Karkhaneh M, et al. Meditation Practices for Health: State of the Research. Agency for Healthcare Research and Quality; Rockville, MD: 2007. Evidence report/technology assessment no. 155
  62. Nakao M, Yano E, Nomura S, Kuboki T. Blood pressure - lowering effects of biofeedback treatment in hypertension: a meta - analysis of randomized controlled trials. Hypertens Res. 2003;26(1):37-46. https://doi.org/10.1291/hypres.26.37
  63. Лукина Ю.В, Марцевич С.Ю. Бисопролол - высокоселективный бета - адреноблокатор с позиции доказательной медицины. Рациональная фармакотерапия в кардиологии. 2010;6(1):103-7
  64. Оганезова Л.Г. Бисопролол - оптимальный бета - адреноблокатор для лечения сердечно - сосудистых заболеваний. Русский медицинский журнал. 2012;11:560-2
  65. Neurotic, stress - related and somatoform disorders. In: Johnstone E, Cunningham D, Lawrie S, Mc Intosh A, Sharpe M, eds. Companion to psychiatric studies, 8th edition. Churchill Livingstone, 2010:466. https://doi.org/10.1016/B978-0-7020-3137-3.00017-6
  66. Gosse P, Roudaut R, Herrero G, Dallocchio M. Beta - blockers vs. angiotensin - converting enzyme inhibitors in hypertension: effects on left ventricular hypertrophy. J Cardiovasc Pharmacol. 1990;16(Suppl 5):S145-S150.
  67. de Teresa E, González M, Camacho-Vázquez C, Tabuenca M.J. Effects of bisoprolol on left ventricular hypertrophy in essential hypertension. Cardiovasc Drugs Ther. 1994 Dec;8(6):837-843.
  68. Yang J, Liu Y, Fan X, Li Z, Cheng Y. A pathway and network review on beta - adrenoceptor signaling and beta blockers in cardiac remodeling. Heart Fail Rev. 2014;19(6):799-814. https://doi.org/10.1007/s 10741-013-9417-4
  69. Heineke J, Molkentin J.D. Regulation of cardiac hypertrophy by intracellular signalling pathways. Nature reviews Molecular cell biology. 2006;7(8):589-600. http://dx.doi.org/10.1038/nrm1983
  70. Janka H.U, Ziegler A.G, Disselhoff G, Mehnert H. Influence of bisoprolol on blood glucose, glucosuria, and haemoglobin A1 in noninsulin - dependent diabetics. J Cardiovasc Pharmacol. 1986;8:S96-S99.
  71. Fogari R, Zoppi A, Tettamanti F, Poletti L, Lazzari P, Pasotti C, Corradi L. Beta - blocker effects on plasma lipids in antihypertensive therapy: importance of the duration of treatment and the lipid status before treatment. J Cardiovasc Pharmacol. 1990;16(Suppl 5):S76-S80.
  72. Rosenfeld M. Lipid Digestion and Absorption, Fatty Acid Synthesis and Oxidation, Triglyceride Synthesis, Adipose Tissue Lipoprotein Metabolism, Cholesterol, Lipid Metabolism in Pregnancy and Lactation. Presented at Nutrition and Metabolism II, University of Washington, Seattle WA 2012.
  73. Adam T.C, Epel E.S. Stress, eating and the reward system. Physiol Behav. 2007;91(4):449-58. https://doi.org/10.1016/j.physbeh.2007.04. 011
  74. Epel E.S, Mc Ewen B, Seeman T, Matthews K, Castellazzo G, Brownell K.D, Bell J, Ickovics J.R. Stress and body shape: stress - induced cortisol secretion is consistently greater among women with central fat. Psychosom Med. 2000;62(5):623-32. http://dx.doi.org/10.1097/00006842-200009000-00005
  75. Brindley D.N, Mc Cann B.S, Niaura R, Stoney C.M, Suarez E.C. Stress and lipoprotein metabolism: modulators and mechanisms. Metabolism. 1993;42(9 Suppl 1):3-15. https://doi.org/10.1016/0026-0495(93) 90255-M
  76. Niaura R, Stoney C.M, Herbert P.N. Lipids in psychological research: the last decade. Biol Psychol. Netherlands, 1992:1-43.
  77. Taskinen M.R, Nikkilä E.A, Pelkonen R, Sane T. Plasma lipoproteins, lipolytic enzymes, and very low density lipoprotein triglyceride turnover in Cushing's syndrome. J Clin Endocrinol Metab. 1983;57(3):619-26. https://doi.org/10.1210/jcem-57-3-619

Copyright (c) 2018 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies