ABSTRACT
The stress response is an essential adaptive process that is activated when faced with adversity in the form of one or more stressors. This response is designed to combat and successfully overcome the stressor(s), endogenous or exogenous, but the response can be imprecise and inaccurate. When a stress response is mismatched or disproportionate to the stressor, pathology can ensue. For example, since stress responses require endogenous substrates, an exaggerated or inappropriately prolonged (e.g., failure to downregulate) response can lead to allostatic overload and irreversible physiological impairment. There are many types of stressors that can have this adverse effect on overall health, including environmental, physical, psychological, and endogenous (inflammation, infection, and injury). The focus of this chapter will be psychologically based stress and its role in the pathophysiology of developing cardiometabolic-based chronic disease (CMBCD; consisting of component metabolic drivers [mainly abnormal adiposity and dysglycemia, and their complications] and cardiovascular disease). In addition, the effect of lifestyle intervention and behavioral modification on CMBCD, and the central role of physicians in successful implementation of these interventions will be discussed.
