The aim of this article is to describe the protocol of a trial focusing on the psychological, anthropometric, cardiac, and psychophysiological factors contributing to increased risk of cardiovascular diseases (CVDs). As background, the article provides a short overview of research literature linking personal traits, maladaptive schemas, and coping styles with CVDs through reactivity of the autonomic nervous system.

1st Department of Internal Medicine Faculty of Medicine Pavol Josef Safarik University in Košice

Biomedical Center Martin Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic

Department of Physiology

Department of Psychiatry Faculty of Medicine and Dentistry University Palacky Olomouc University Hospital Olomouc Olomouc Czech Republic

Department of Psychology Sciences Faculty of Social Science and Health Care Constantine the Philosopher University in Nitra Nitra Slovak Republic

Internal Medicine and Cardiology Private Practice MUDr Ivan Majercak Košice

Psychagogia Liptovsky Mikulas

Zobrazit více v PubMed

Scheen AJ, Kulbertus H. Interheart: nine risk factors predict nine out of ten myocardial infarctions. Rev Med Liege. 2004;59(11):676–679. PubMed

Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases. Annu Rev Public Health. 2005;26:469–500. PubMed

Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99(16):2192–2217. PubMed

Leor J, Poole WK, Kloner RA. Sudden cardiac death triggered by an earthquake. N Engl J Med. 1996;334(7):413–419. PubMed

Mostofsky E, Maclure M, Sherwood JB, Tofler GH, Muller JE, Mittleman MA. Risk of acute myocardial infarction after the death of a significant person in one’s life: the Determinants of Myocardial Infarction Onset Study. Circulation. 2012;125(3):491–496. PubMed PMC

Gullette EC, Blumenthal JA, Babyak M, et al. Effects of mental stress on myocardial ischemia during daily life. JAMA. 1997;277(19):1521–1526. PubMed

Iso H, Date C, Yamamoto A, et al. Perceived mental stress and mortality from cardiovascular disease among Japanese men and women: the Japan collaborative cohort study for evaluation of cancer risk sponsored by Monbusho (JACC Study) Circulation. 2002;106(10):1229–1236. PubMed

Edmondson D, Cohen BE. Posttraumatic stress disorder and cardiovascular disease. Prog Cardiovasc Dis. 2013;55(6):548–556. PubMed PMC

Aboa-Eboulé C, Brisson C, Maunsell E, et al. Job strain and risk of acute recurrent coronary heart disease events. JAMA. 2007;298(14):1652–1660. PubMed

Bugajska J, Widerszal-Bazyl M, Radkiewicz P, et al. Perceived work-related stress and early atherosclerotic changes in healthy employees. Int Arch Occup Environ Health. 2008;81(8):1037–1043. PubMed PMC

Hintsanen M, Kivimäki M, Elovainio M, et al. Job strain and early atherosclerosis: the cardiovascular risk in Young Finns Study. Psychosom Med. 2005;67(5):740–747. PubMed

Lynch J, Kaplan GA, Salnone R, Salonen JT. Socioeconomic status and progression of carotid atherosclerosis. Prospective evidence from the Kuopio Ischemic Heart Diseases Risk Factor Study. Arterioscler Thromb Vasc Biol. 1997;17(3):513–519. PubMed

Michikawa T, Nishiwaki Y, Nomiyama T, Uemura T, et al. Job strain and arteriosclerosis in three different types of arteries among male Japanese factory workers. Scand J Work Environ Health. 2008;34(1):48–54. PubMed

Nomura K, Nakao M, Karita K, Nishikitani M, Yano E. Association between work-related psychological stress and arterial stiffness measured by brachial-ankle pulse-wave velocity in young Japanese males from an information service company. Scand J Work Environ Health. 2005;31(5):352–359. PubMed

Nordstrom CK, Dwyer KM, Merz CN, Shircore A, Dwyer JH. Work-related stress and early atherosclerosis. Epidemiology. 2001;12(2):180–185. PubMed

Kivimäki M, Head J, Ferrie JE, et al. Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study. Int J Obes (Lond) 2006;30(6):982–987. PubMed

Hemingway H, Malik M, Marmot M. Social and psychosocial influences on sudden cardiac death, ventricular arrhythmia, and cardiac autonomic function. Eur Heart J. 2001;22(10):82–101. PubMed

Krantz DS, Manuck SB. Measures of acute physiologic reactivity to behavioral stimuli: assessment and critique. Psychol Bull. 1984;96:435–464. PubMed

Fontes MA, Xavier CH, de Menezes RC, DiMicco JA. The dorsomedial hypothalamus and the central pathways involved in the cardiovascular response to emotional stress. Neuroscience. 2011;184:64–74. PubMed

Zanstra YJ, Johnston DW. Cardiovascular reactivity in real life settings: measurement, mechanisms, and meaning. Biol Psychol. 2011;86(2):98–105. PubMed PMC

Jones-Webb R, Jacobs DR, Jr, Flack JM, Liu K. Relationship between depressive symptoms, anxiety, alcohol consumption, and blood pressure: results from the CARDIA study. Alcohol Clin Exp Res. 1996;20(3):420–427. PubMed

Prasko J, Latalova K, Diveky T, et al. Panic disorder, autonomic nervous system, and dissociation – changes during therapy. Neuro Endocrinol Lett. 2011;32(5):641–651. PubMed

Latalova K, Prasko J, Diveky T, et al. Autonomic nervous system in euthymic patients with bipolar affective disorder. Neuro Endocrinol Lett. 2010;31(6):829–836. PubMed

Diveky T, Prasko J, Kamaradova D, et al. Comparison of heart rate variability in patients with panic disorder during cognitive behavioral therapy program. Psychiatr Danub. 2013;25(1):62–67. PubMed

Joyner MJ, Charkoudian N, Wallin BG. A sympathetic view of the sympathetic nervous system and human blood pressure regulation. Exp Physiol. 2008;93(6):715–724. PubMed PMC

Johnston DW, Tuomisto MT, Patching GR. The relationship between cardiac reactivity in the laboratory and in real life. Health Psychol. 2008;27(1):34–42. PubMed

Treiber FA, Kamarck T, Schneiderman N, Sheffield D, Kapuku G, Taylor T. Cardiovascular reactivity and development of preclinical and clinical disease states. Psychosom Med. 2003;65(1):46–62. PubMed

Lampert R, Tuit K, Hong KI, Donovan T, Lee F, Sinha R. Cumulative stress and autonomic dysregulation in a community sample. Stress. 2016;19(3):269–279. PubMed PMC

Lovallo WR, Gerin W. Psychophysiological reactivity: mechanisms and pathways to cardiovascular disease. Psychosom Med. 2003;65(1):36–45. PubMed

Grassi G, Bombelli M, Brambilla G, Trevano FQ, Dell’oro R, Mancia G. Total cardiovascular risk, blood pressure variability and adrenergic overdrive in hypertension: evidence, mechanisms, and clinical implications. Curr Hypertens Rep. 2012;14(4):333–338. PubMed

Light KC. Psychosocial precursors of hypertension: experimental evidence. Circulation. 1987;76(1 Pt 2):67–76. PubMed

James SA. Psychosocial precursors of hypertension: a review of the epidemiologic evidence. Circulation. 1987;76(1 Pt 2):I60–I66. PubMed

Buck CW, Donner AP. Blood pressure control in hypertensives – a model for the study of life events. J Chronic Dis. 1984;37(4):247–253. PubMed

Sloan RP, Shapiro PA, Baggiela E, Myers MM, Gorman JM. Cardiac autonomic control buffers blood pressure variability response to challenge: a psychophysiologic model of coronary artery disease. Psychosom Med. 1999;61(1):58–68. PubMed

Visnovcova Z, Calkovska A, Tonhajzerova I. Heart rate variability and electrodermal activity as noninvasive indices of sympathovagal balance in response to stress. Acta Med Martiniana. 2013;13(1):5–13.

Visnovcova Z, Mestanik M, Gala M, Mestanikova A, Tonhajzerova I. The complexity of electrodermal activity is altered in mental cognitive stressors. Comput Biol Med. 2016;79:123–129. PubMed

Jelenova D, Ociskova M, Prasko J, et al. Heart rate variability in children with inflammatory bowel diseases. Neuro Endocrinol Lett. 2015;36(1):72–79. PubMed

Lovallo WR. Do low levels of stress reactivity signal poor states of health? Biol Psychol. 2011;86(2):121–128. PubMed PMC

Benarroch EE. The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc. 1993;68(10):988–1001. PubMed

Thayer JF, Lane RD. A model of neurovisceral integration in emotional regulation and dysregulation. J Affect Disord. 2000;61(3):201–216. PubMed

Thayer JF, Lane RD. Claude Bernard and the heart–brain connection: further elaboration of a model of neurovisceral integration. Neurosci Biobehav Rev. 2009;33(2):81–88. PubMed

Colhoun HM, Francis DP, Rubens MB, Underwood SR, Fuller JH. The association of heart-rate variability with cardiovascular risk factors and coronary artery calcification: a study in type 1 diabetic patients and the general population. Diabetes Care. 2001;24(6):1108–1114. PubMed

Hillebrand S, Gast KB, de Mutsert R, et al. Heart rate variability and first cardiovascular event in populations without known cardiovascular disease: meta-analysis and dose-response meta-regression. Europace. 2013;15(5):742–749. PubMed

Fabre B, Grosman H, Mazza O, et al. Relationship between cortisol, life events and metabolic syndrome in men. Stress. 2013;16(1):16–23. PubMed

Prospective Studies Collaboration Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083–1096. PubMed PMC

Chen Z, Yang G, Zhou M, et al. Body mass index and mortality from ischaemic heart disease in a lean population: a 10-year prospective study of 220,000 adult men. Int J Epidemiol. 2006;35(1):141–150. PubMed

Kim JA, Park YG, Cho KH, et al. Heart rate variability and obesity indices: emphasis on the response to noise and standing. J Am Board Fam Pract. 2005;18(2):97–103. PubMed

Rabbia F, Silke B, Conterno A, et al. Assessment of cardiac autonomic modulation during adolescent obesity. Obes Res. 2003;11(4):541–548. PubMed

Chethan HA, Niranjan M, Basavaraju K. Comparative study of heart rate variability in normal and obese young adult males. Int J Biol Med Res. 2012;3:1621–1623.

Slepecky M, Kotianova A, Prasko J, et al. Which psychological, psychophysiological, and anthropometric factors are connected with life events, depression, and quality of life in patients with cardiovascular disease. Neuropsychiatr Dis Treat. 2017;13:2093–2104. PubMed PMC

Farsky S. Vyšetrovanie arteriálnej tuhosti [Investigation of arterial stiffness] Via Pract. 2009;6(4):153–156. Slovak [with English abstract]

Young JE. Cognitive therapy for personality disorders: a schema-focused approach. 2nd ed. Sarasota, FL: Proffesional Resource Exchange; 1994.

Young JE, Weishaar ME, Klosko JS. Schema Therapy: A Practitioner’s Guide. New York, Ny: Guilford; 2003.

Cecero JJ, Nelson JD, Gillie JM. Tools and tenets of schema therapy: toward the construct validity of the early maladaptive schema questionnaire – research version (EMSQ-R) Clin Psychol Psychother. 2004;11:344–357.

Soygüt G, Karaosmanoğlu A, Çakir Z. Assessment of early maladaptive schemas: a psychometric study of the Turkish Young schema questionnaire-short form-3. Turk Psikiyatri Derg. 2009;20(1):75–84. PubMed

Kriston L, Schäfer J, Jacob GA, Härter M, Hölzel LP. Reliability and validity of the German version of the Young Schema Questionnaire-Short Form 3 (YSQ-S3) Eur J Psychol Assess. 2013;29(3):197–204.

Young JE, Rygh J. Young-Rygh Avoidance Inventory. New York: Cognitive Therapy Center of New York; 1994.

Bayrami M, Bakhshipor A, Esmaeili A. The relationship between coping styles and early maladaptive schemas in disconnection-rejection and over vigilance – inhibition in Young’s schema model. J Life Sci Biomed. 2012;2(4):178–181.

Rijkeboer MM, van den Bergh H, van den Bout J. Stability and discriminative power of the Young Schema-Questionnaire in a Dutch clinical versus non-clinical population. J Behav Ther Exp Psychiatry. 2005;36(2):129–144. PubMed

Lee CW, Taylor G, Dunn J. Factor structure of schema questionnaire in a large clinical sample. Cognit Ther Res. 1999;23:441–451.

Baranoff J, Oei TP, Cho SH, Kwon SM. Factor structure and internal consistency of the Young Schema Questionnaire (Short Form) in Korean and Australian samples. J Affect Disord. 2006;93(1–3):133–140. PubMed

Farmer RF, Goldberg LR. A psychometric evaluation of the revised Temperament and Character Inventory (TCI-R) and the TCI-140. Psychol Assess. 2008;20(3):281–291. PubMed PMC

Gillespie NA, Cloninger CR, Heath AC, Martin NG. The genetic and environmental relationship between Cloninger’s dimensions of temperament and character. Pers Individ Dif. 2003;35(8):1931–1946. PubMed PMC

Preiss M, Klose J. Diagnostika poruch osobnosti pomocí teorie C.R. Cloningera [Diagnostic of personality disorders using theory of C.R. Cloninger] Psychiatrie. 2001;5:226–231. Czech [with English abstract]

Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. J Nerv Ment Dis. 1986;174(12):727–735. PubMed

Spitzer C, Freyberger H, Brähler E, Beutel ME, Stieglitz R. Psychometric evaluation of the Dissociative Experiences Scale-Taxon (DES-T) Psychother Psychosom Med Psychol. 2015;65(3–4):134–139. PubMed

Waller NG, Ross CA. The prevalence and biometric structure of pathological dissociation in the general population: taxometric and behavior genetic findings. J Abnorm Psychol. 1997;106(4):499–510. PubMed

Ptacek R, Bob P, Paclt I. Škála disociativních zkušeností – česká verze [Dissociative Experiences Scale – Czech version] Česk Psychol. 2006;50(3):262–272. Czech [with English abstract]

Denollet J. Standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med. 2005;67(1):89–97. PubMed

Denollet J. Personality and coronary heart disease: the type-D scale-16 (DS16) Ann Behav Med. 1998;20(3):209–215. PubMed

Ďurka R. [Osobnosť typu D]. Personality Type D. In: Selko D, editor. Psychologie zdravia. Bratislava: Mauro; 2006. pp. 86–93. Slovak.

Ďurka R. Osobnosť typu D u dospelých [Personality Type D in adults] In: Heller D, Michalek P, editors. Cesty psychologie a psychologie cest. Praha: Českomoravská psychologická společnost; 2011. pp. 532–543. Slovak.

Ďurka R, Ruch W. Osobnosť typu D v populácii Slovenských univerzitných študentov: psychometrické kvality dotazníka DS14 [Personality of Type D population of Slovak University students: psychometric quality of the questionnaire DS14] Československá psychológie. 2014;58(1):62–71. Slovak [with English abstract]

Lipsitz LA, Mietus J, Moody GB, Goldberger AL. Spectral characteristics of heart rate variability before and during a postural tilt: relations to aging and risk of syncope. Circulation. 1990;81:1803–1810. PubMed

Weise F, Heydenreich F, Runge U. Contributions of sympathetic and vagal mechanisms to the genesis of heart rate fluctuations during orthostatic load: a spectral analysis. J Auton Nerv Syst. 1987;21(2–3):127–134. PubMed

Ponikowski P, Chua TP, Piepoli M, et al. Chemoreceptor dependence of very low frequency rhythms in advanced chronic heart failure. Am J Physiol. 1997;272(1 Pt 2):H438–H447. PubMed

Javorka K. Heart Rate Variability. Mechanisms, Classification, Clinical Utilization. Martin: Osveta; 2008.

European Medicines Agency Reflection paper on ethical and GCP aspects of clinical trials of medicinal products for human use conducted in third countries and submitted in marketing authorisation applications to the EMA [Draft] [Accessed October 5, 2017]. Available from: http://www.ema.europa.eu/pdfs/human/ich/013595en.pdf.

Relation of personality factors and life events to waist/height ratio and percentage of visceral fat in women and men