Bearing allostatic load: insights into a more equitable future within cardio-oncology

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. 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. 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. a measurable molecule or parameter within an organism that is utilized to characterize a biological condition, including disease states. an interdisciplinary field of medicine centered on the study of cancer therapy and its effects on cardiovascular function by utilizing an array of imaging modalities and biophysical assays. a family of neurotransmitters and hormones produced by the brain, nerve tissue, and adrenal glands in response to emotional or physical stresses. These include dopamine, epinephrine, and norepinephrine. small proteins or biological molecules produced by specific cells of the immune system that are crucial for maintaining communication and interactions between cells. an androgenic steroid hormone that is predominantly produced by the cortex of the adrenal glands and helps to regulate sexual function and development. a group of corticosteroids, a class of steroid hormone produced by the cortex of the adrenal glands, that are responsible for the metabolism of various macronutrients and have anti-inflammatory activity. systemic differences in health outcomes and the distribution and quality of healthcare resources between different groups of people based on social, racial, ethnic, and environmental factors. a neuroendocrine system with negative feedback that consists of various biological pathways involving the hypothalamus, pituitary gland, and adrenal glands that are activated in response to stress. the conditions in the environment in which one is born and function that impact on various aspects of health. These conditions include economic resources, education, access to healthcare, cultural values, and housing and neighborhood resources. part of the autonomic nervous system that is activated by stressors and is responsible for initiating the 'fight or flight' response.