Todays clinician is keenly aware of the role that stress plays in patient health and the challenges that come with assessing, identifying and managing stress. And even though the effects of stress can be linked with most chronic illnesses, only a small percentage of clinicians understand how dysfunction within the stress management system (HPA axis) alters pathophysiology. Nearly a century of research on stress and its physiologic and metabolic complications has provided invaluable insight and increased our understanding. However, the clinical consequences of stress in chronic disease management is still a great challenge. Tis review explores how current research, spanning from epidemiology to epigenetics, is beginning to reveal specific patterns and pathways in the stress management system, allowing clinicians to effectively identify and treat many stress-related chronic illnesses.
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