Allostatic Load And Cardiovascular Disease: A Systematic Review.

Introduction: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality. In the past three decades, allostatic load - a physiological representation of cumulative life stress - has been associated with increased risk of CVD incidence and mortality. Additionally, differences in allostatic load may partially explain persistent disparities in CVD outcomes. However, there is notable variation in CVD types and subsequent impairments suggesting this association may not be similar across CVD types and demographic characteristics.

Methods: This study is a systematic review conducted in 2024 of current knowledge on the relationship between allostatic load and CVD. A literature search using the electronic databases PubMed, SCOPUS, and Web of Science and the keywords 'allostatic load' and 'cardiovascular disease' was conducted. 233 articles were identified in initial review and 22 studies were identified for inclusion in this review.

Results: This review found that allostatic load was associated with a composite score of CVD incidence but there was less clarity on the relationship with CVD mortality and other CVD outcomes. Additionally, there was some variation between CVD types and the relationship with allostatic load as well as intersectional race and gender differences.

Conclusions: This review revealed notable gaps in the current knowledge of the relationship between CVD and allostatic load. Future research is necessary to evaluate how this relationship differs across demographic characteristics, CVD types, CVD outcomes such as impairment, and disease processes. Future research should also identify standardized measures of allostatic load and determine how the social determinants impact allostatic load across the lifespan.