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Find a copy in the library Finding libraries that hold this item Reviews Editorial reviews. Publisher Synopsis This book is brave and insightful and succeeds in raising the possibility that cultural histories of health must acknowledge the distinct vocabulary and sociocultural definitions that are inherent to specific disease states. User-contributed reviews Add a review and share your thoughts with other readers.

Be the first. Add a review and share your thoughts with other readers. Medical policy -- History -- 20th century. Chronic Disease. Health Policy -- history. Public Health Practice -- history. History, 20th Century. Chronic diseases. Medical policy. Linked Data More info about Linked Data. All rights reserved. Remember me on this computer. Cancel Forgot your password? George Weisz.

Print book : English View all editions and formats. Chronic Disease in the Twentieth Century challenges the conventional wisdom that the concept of chronic disease emerged because medicine's ability to cure infectious disease led to changing patterns of disease. Chronic diseases -- History -- 20th century. View all subjects.

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Aging at Home with Chronic Illness

Get In-Stock Alert. Selye agreed with Cannon that epinephrine did have a role in the stress response but chose to focus on the adrenal cortex as a key system involved in adaptation. In the second stage of GAS, resistance , the organism resists or attempts to adapt to the noxious stimuli. The output of corticosteroids remains high, but stable, during this stage.

By the end of the resistance stage, there is usually an improvement or disappearance of symptoms. If the noxious stimuli are prolonged or sufficiently severe, the last stage of GAS, exhaustion , occurs. In this stage, the body can no longer resist or adapt to the noxious stimuli. Adaptive reserves are depleted. The anterior pituitary and the adrenal cortex lose their capacity to continue to secrete hormones, and symptoms reappear.

If the noxious stimuli continue, vulnerable organs may break down Ratcliff, Some had arthritis-like diseases and other had diseases similar to rheumatic fever. Their insides looked like those of human victims of heart and circulatory disorders Selye Selye was interested in hormones. He injected large amounts of DCA into his animals. In a short time, they developed heart and kidney disease and high blood pressure.

Their joints became swollen, inflamed, and sensitive. In determining which pituitary gland hormone might produce these symptoms, he examined the somatotropic hormone STH, growth hormone. When injected in excess, it produced a sickness like rheumatic fever, heart and artery disease, and diabetes. Cortisone was a single medicine that appeared to be effective in a whole range of seemingly unrelated diseases: gout, asthma, skin aliments, arthritis, muscular diseases, and eye diseases.

The organism returned to physiological homeostasis, and the disease magically melted away Selye , In the s, numerous scientific research articles highlighted the importance of emotions on heart attack, sudden cardiac death, and congestive heart failure e. First, science had to discover that the hypothalamus, an organ that was clearly located in the brain, 7 controlled the physiological stress response via release of corticotrophin releasing hormone CRH to the anterior pituitary Fink John W.

Mason, M. He suggests that stress is primarily a psychological rather than physiological phenomenon; thus, an organic response is secondary to the psychological one Mason In the late s, the idea of stress was merging with psychological constructs like tension. His work focused on how humans interpret the environment around them. In the appraisal process, humans make automatic, often unconscious, assessments of what is happening and what it means to them, which causes emotion and may lead to the physiological stress response depending on secondary appraisals of their resources to manage the situation Lazarus The consequence is that stress is all around us yet quite ambiguous.

It may refer to external stimuli in the environment e. Stress can be positive e. Moreover, the same term, stress, can be used to describe the mental or physical internal states that result from any of these stimuli or situations. For instance, tension, anxiety, irritation, and anger are all synonyms for stress.

Further, as Mason and Lazarus proposed, individuals can vary widely in how they interpret, experience, and hence respond to a given stimulus. What is stressful to some people may be experienced by others as merely trivial, boring, or even amusing. To further complicate matters, genetic differences, earlier experiences, education, etc. Today, in the twenty-first century, are we any closer to an answer to the question is stress a cause of heart disease? Do we know more than we knew in the mid-twentieth century?

Still today, psychology, physiology, and public health research fields are often separate areas of investigation. For over a hundred years, tension was thought to cause mental disorders, but not affect physical disease states. In , U. News and World Report interviewed Edward Jacobson regarding a new stress relaxation technique called progressive muscle relaxation. Any possible public health benefit that might have resulted from the use of this technique or other psychological interventions at the time in preventing chronic physical diseases such as heart disease was lost because the scientific evidence that fits nicely into medical paradigm was not, and some would argue still is not, available.

Large scale, prospective epidemiologic studies, meta-analyses, and systematic reviews, as well as smaller scale basic science studies, have established the relationship between stress and depressive symptoms in particular and heart disease development and progression. For instance, a scientific statement from the American Heart Association in concluded that a preponderance of evidence supports depression after a heart attack as a risk factor for death and nonfatal cardiac events Lichtman et al.

Largely as a result of multidisciplinary training in cardiovascular behavioral medicine, many researchers are now equipped with a strong background in scientific methods and knowledge of advancements in human physiology, heart disease processes, and psychology. Their research examines biobehavioral mechanisms underlying this relationship. Stress, and depression specifically, is associated with traditional risk factors for heart disease such as hypertension, diabetes, and insulin resistance, as well as changes in platelet reactivity and inflammatory responses, and autonomic nervous system and hypothalamic pituitary adrenal axis dysregulation.

Behavioral factors associated with stress are also risk factors for heart disease, such as smoking, heavy alcohol use, sedentary behavior, and poor adherence to medical recommendations. However, randomized controlled trials of medication and nonpharmacologic treatments for depression have not demonstrated improved survival.

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See review in Wang et al. Thus, still today, the development of prevention and intervention strategies that will improve stress and simultaneously improve outcomes in heart disease is sorely needed. To accomplish this goal, professionals in the medical, psychological, and public health fields can no longer work separately approaching these problems from their individual paradigms. Health professionals must do more than collaborate together in working groups.

More researchers in more countries need multidisciplinary training in order to advance the field and further our understanding of the link between psychosocial factors and chronic disease. Scientific and medical breakthroughs must translate into health policies and population-level prevention strategies so that, by the end of the current century, chronic diseases such as heart disease are no longer leading causes of death.

Successful prevention measures helped control communicable diseases at the turn of the twentieth century.

The challenge for twenty-first century health professionals is to control chronic diseases as well. Research and implementation science are crucial tools to understand how interventions that might work in one setting might transfer across socio-cultural contexts. The real question is: Are we up for the challenge? In , rules for ranking the leading causes of death were developed by NCHS and the states. Harrison, Dept. Previous to , stress, strain, and tension were seen as causes of hysteria and other mental illnesses. The pituitary was considered to have developed from part of the mouth, thus, was not part of the brain.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The author completed a Ph. Skip to main content Skip to sections. Advertisement Hide. Download PDF. Heart disease and the stress hypothesis in the mid-twentieth century: a historical review.

Open Access. First Online: 30 November Part of the following topical collections: Health psychology. Background In the s, heart disease a noncommunicable disease , was the new leading cause of death in the USA. Conclusions Since then, large scale, prospective epidemiological studies, meta-analyses, and systematic reviews, as well as smaller scale basic science studies, have established the relationship between stress and heart disease development and progression.

Introduction At the end of the nineteenth century and in the early twentieth century, the prevailing paradigm in medicine was that of etiological specificity of disease. History of heart disease as a public health problem According to the National Center for Health Statistics , 1 the top two leading causes of death in the USA from to were pneumonia and tuberculosis.

Scientific advancements in the detection of heart disease Scientific advancements in the objective detection of disease markers did not occur until the late s. Mediating mechanisms linking white, middle class males to heart disease: stress By the s, it was clear that not all segments of society were equally affected by heart disease. Homeostasis and the fight or flight response of the body to threat At the turn of the century, although a vital bodily function, scientists knew very little about the mechanics of digestion.

The physiological stress reaction as a cause of disease Hans Selye was an Austrian-born endocrinologist who received his M. Dennison Manufacturing made paper goods and products. Acknowledgements None Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Competing interests The author declares that she has no competing interests. A new approach to tensions , Newsweek, 3 December, pp. Google Scholar. Buff, I. The ballistocardiogram after a heavy meal: diagnostic value in patients with suspected coronary artery disease. The american journal of cardiology, 1 , — CrossRef Google Scholar. Campbell, M. Main cause of increased death rate from diseases of the heart: — British medical journal, 2 , Death rate from diseases of the heart to The mortality rate from heart disease.

American heart journal, 68 , 1. Cannon, W. The wisdom of the body.