Bearing allostatic load: insights into a more equitable future within cardio-oncology. Issue 12 (December 2022)

• Record Type: Journal Article
• Authors: Barrett, Matthew; Wilcox, Nicholas S.; Huang, Anran; Levy, Richard; Demissei, Biniyam; Narayan, Vivek; Ky, Bonnie
• Is Part Of: Trends in molecular medicine. Volume 28:Issue 12(2022)
• Page Start: 1040
• Page End: 1049
• Publication Date: 2022-12
• Subjects: allostatic load -- biomarkers -- cardio-oncology -- cardiotoxicity -- healthcare disparities -- social determinants of health; Molecular biology -- Periodicals; Pathology, Molecular -- Periodicals; Physiology, Pathological -- Periodicals; 572.8
• DOI: 10.1016/j.molmed.2022.09.006
• Languages: English
• ISSNs: 1471-4914

Abstract

Abstract : Chronic stress is often regarded as a significant cause of morbidity and mortality; however, the mechanistic link between stress and various disease states has not yet been fully characterized. We explore the concept of allostatic load, a measurement of the physiological burden of chronic stress, as well as its potential role in disease pathogenesis as it relates to cardiovascular disease, cancer, and health-related disparities. Building from this framework, we then posit the potential implications of allostatic load on patient care and research in cardio-oncology. We identify allostatic load as a potential clinically actionable tool to improve health equity in cardio-oncology. Highlights: The physiological burden of chronic stress is governed by both physical stressors and social determinants of health. Allostatic load serves as a measure of chronic stress through the utilization of an array of stress-related biomarkers. Higher allostatic load has been associated with adverse cardiovascular and cancer outcomes. Black and Hispanic individuals tend to have a higher allostatic load than non-Hispanic White individuals. Several studies have suggested that Black patients are also more susceptible to the cardiotoxic effects of several cancer therapies; allostatic load may explain this susceptibility.