Cited by 302Heart Rate Variability and Autonomic ControlStress Responses and CortisolCardiac Health and Mental Health

Psychophysiological Reactivity: Mechanisms and Pathways to Cardiovascular Disease

Lovallo, William R., Gerin, William·2003·Psychosomatic Medicine

Abstract

OBJECTIVE: This article examines possible sources of heightened psychophysiological reactivity in relation to risk for hypertension and coronary artery disease. The idea that exaggerated reactions to psychological stress may predict greater risk for future disease has some support in the psychosomatic and behavioral medicine literature. However, the pathways by which exaggerated reactivity could arise in a given person and the implications of different sources of reactivity for potential disease relationships have received little attention. METHODS: This topic is approached through a selective literature review and by means of a neurophysiologically based model of individual differences in physiological reactivity. Temperament characteristics, cognitive processes, neurophysiology, and peripheral physiology are used to indicate three levels that could contribute to exaggerated physiological reactivity. RESULTS: At the top level in the model, activity of the frontal cortex and limbic system establish cognitive-emotional sources of activation that may underlie exaggerated physiological reactivity. In the absence of these influences, large responses may be more likely when exaggerated subcortical response tendencies are present via the hypothalamus or brain stem. Finally, peripheral alterations may account for larger reactions in persons who have otherwise normal emotional and hypothalamic and brainstem response tendencies. Cognitive-emotional and hypothalamic-brainstem sources of altered reactivity may cause or aggravate disease. In contrast, altered peripheral reactivity suggests that a pathophysiologic process may be present, serving as a marker for disease. CONCLUSIONS: These three levels of analysis allow for organization of existing data in the area of cardiovascular reactivity and for planning future studies in a hypothesis-building framework.

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Crossref · 10.1097/01.psy.0000033128.44101.c1

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Authors
Lovallo, W. R., & Gerin, W.
Affiliations
  • Oklahoma City VA Medical Center (US)
  • University of Oklahoma Health Sciences Center (US)
Venue
Psychosomatic Medicine
Published
2003-01
Volume
65
Issue
1
Pages
36-45
ISSN
0033-3174 (ISSN-L)
OpenAlex
W2042738252
Cited by
302
References
83
Citations by year
2026: 4 · 2025: 6 · 2024: 3 · 2023: 9 · 2022: 9 · 2021: 8 · 2020: 15 · 2019: 14 · 2018: 15 · 2017: 15 · 2016: 13 · 2015: 14 · 2014: 12 · 2013: 13 · 2012: 25
FWCI
2.29
Type
journal article
Language
en
Open access
closed
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (HL47540, HL32050, P01HL047540, R01HL032050)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
psychophysiological reactivity, cardiovascular disease, hypertension, coronary artery disease, psychological stress, individual differences, temperament, hypothalamus, brainstem, frontal cortex, limbic system, neurophysiological model
MeSH terms
Animals, Brain, Cardiovascular Diseases, Cardiovascular System, Cognition, Disease Susceptibility, Emotions, Hemodynamics, Humans, Individuality, Maternal Deprivation, Models, Biological, Neurophysiology, Pain Measurement, Risk, Stress, Psychological, Temperament, Type A Personality, Peripheral Nervous System, Rats

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