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Clinical investigation of subclinical vascular disease in psychosocial stress and dyslipidaemia

Ellins, Elizabeth Anne 2016. Clinical investigation of subclinical vascular disease in psychosocial stress and dyslipidaemia. PhD Thesis, Cardiff University.
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Abstract

Cardiovascular disease is a major cause of death and ill health across the world. Psychosocial factors are increasingly being recognised as potential cardiovascular risk factors, contributing to the development and progression of atherosclerotic disease. However, the pathways between psychosocial factors and cardiovascular disease are not yet fully understood. The aims of this thesis were to explore the associations between psychosocial factors (both chronic and acute stress) and measures of subclinical vascular disease, and to further develop and validate, a new method of assessing vasomotor function. Women with both depression and anxiety were found to have increased carotid intima-media thickness and this relationship was found to be influenced by the presence of dyslipidaemia. When looking at the inflammatory responses to an acute mental stress challenge it was shown that those participants who had an elevated fibrinogen response 45 minutes after the stress challenge had poorer endothelial function 3 years later, as assessed by flow-mediated dilatation. These findings suggest that both chronic and acute stress may play a role in the development of cardiovascular disease. Good reproducibility was demonstrated with the new method for assessing vasomotor function following further development of the protocol for the method. The technique was able to detect differences in vasomotor function between a group of patients with Familial Hypercholesterolaemia compared with age and gender matched controls. In addition it was also able to detect improvement in vasomotor function following a single lipoprotein apheresis treatment in patients with Familial Hypercholesterolaemia undergoing long-term treatment. These studies demonstrated the potential of this method for use in non-specialist vascular research laboratories and out in the field for the assessment of vasomotor function.

Item Type: Thesis (PhD)
Date Type: Publication
Status: Unpublished
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Date of First Compliant Deposit: 8 December 2016
Last Modified: 04 Jun 2017 09:33
URI: http://orca-mwe.cf.ac.uk/id/eprint/96729

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