Stress and Disease
Stress is a typical response to internal and environmental pressures and affects multiple physiological processes. Short-term stress can be beneficial, while prolonged stress leads to dire health complications. It compromises the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system (ANS), and immune system, leading to metabolic, cardiovascular, and immune disorders. Advanced practice nurses must be knowledgeable about stress throughout their lifespan to enhance decision-making and implement effective interventions: Stress and Disease.
Effects of Stress on the HPA Axis
The HPA axis modulates cortisol, the body’s principal stress hormone. Stress triggers the production of adrenocorticotropic hormone from the hypothalamus in the pituitary gland to initiate cortisol production from the adrenal glands. While cortisol modulates inflammation and metabolism, long-term stimulation results in metabolic disorders, hypertension, insulin resistance, and immune dysfunction (Mbiydzenyuy & Qulu, 2024). Notably, infants who have been exposed to high cortisol levels during pregnancy can develop impaired brain development and vulnerability to mood disorders.
Stress negatively affects emotion regulation, learning, and cognitive function in children. In adults, repeated activation of HPA causes obesity, diabetes, and cardiovascular disease. In older adults, chronic stress causes brain aging and makes them vulnerable to neurodegenerative diseases such as Alzheimer’s.
Effects of Stress on the ANS
The sympathetic nervous system, or ANS, regulates the body’s acute stress response. Activation of ANS leads to the release of epinephrine and norepinephrine, causing heart rate and blood pressure to increase and glucose release. While these responses prepare the body to react to short-term stressors, long-term activation leads to hypertension, atherosclerosis, and increased cardiac workload (Goldstein, 2021).
In infants and children, long-term stimulation of the ANS can result in problems with the regulation of emotions and increased susceptibility to anxiety disorders. Overactivation in adults can result in long-term hypertension and risks for myocardial infarction and stroke. In older adults, unbalanced ANS can result in orthostatic hypotension with increased fall risk and morbidity.
Role of the Immune System
Chronic stress leads to immune dysregulation by altering inflammatory responses and impairing immune cell function. Higher cortisol levels suppress immune system activity, impair T-cells, and leave the body susceptible to infections, autoimmune diseases, and inflammatory diseases. Repeated stress-induced inflammation has been linked with asthma, rheumatoid arthritis, and inflammatory bowel disease. Stress’s impact on the immune system varies across the lifespan.
During infancy, stress-induced immune suppression can lead to high susceptibility to repeated infections and a defective vaccine response (Alotiby, 2024). Ongoing stress in children can lead to inflammatory diseases and increased allergy susceptibility. In adults, continued immune dysfunction increases susceptibility to cancer and autoimmune diseases. In older adults, immune resilience impairment leads to a high infection rate, defective wound healing, and a poor vaccine response.
Clinical Implications for Advanced Practice Nurses (APNs)
This knowledge improves clinical diagnostic reasoning by enabling advanced practice nurses to diagnose stress-related diseases such as hypertension, metabolic disorders, and immune dysfunction. It allows targeted interventions by recognizing HPA axis dysregulation, autonomic nervous system hyperactivation, and immune suppression. For example, a patient with uncontrolled high blood pressure can be aided by techniques for managing stress, such as cognitive-behavioral therapy in combination with antihypertensive medications (Sic et al., 2025).
Another example includes an older adult with repeated infections who may require immune-boosting interventions such as nutrition optimization, vaccination, and stress reduction. By integrating stress-related information into practice, APNs can provide holistic, patient-centered care, improving both body and mind.
Conclusion
Conclusively, chronic stress negatively affects multiple physiological systems and leads to severe health complications. HPA axis, ANS, and the immune system play central roles in stress responses in the body, and HPA axis dysregulation leads to metabolic, cardiovascular, and immune disorders. The impact of stress varies in different stages of life.
It plays a role in neurodevelopment in infants, regulation in children, risk for chronic diseases in adults, and cognitive impairment in older adults. Advanced practice nurses must identify stress-related pathophysiology and apply targeted interventions to promote patient health and quality of life.
References
Alotiby, A. (2024). Immunology of stress: A review article. Journal of Clinical Medicine, 13(21), 6394–6394. https://doi.org/10.3390/jcm13216394
Goldstein, D. S. (2021). Stress and the “extended” autonomic system. Autonomic Neuroscience, 236, 102889. https://doi.org/10.1016/j.autneu.2021.102889
Mbiydzenyuy, N. E., & Qulu, L. (2024). Stress, hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-gonadal axis, and aggression. Metabolic Brain Disease, 39(8), 1613–1636. https://doi.org/10.1007/s11011-024-01393-w
Sic, A., Bogicevic, M., Brezic, N., Nemr, C., & Knezevic, N. N. (2025). Chronic stress and headaches: The role of the HPA axis and autonomic nervous system. Biomedicines, 13(2), 463. https://doi.org/10.3390/biomedicines13020463
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Question 
For this journal, you will address the underlying pathophysiology of stress.
- Key points to address are stress systems including: Hypothalamic-Pituitary – Adrenal Axis effects, the Autonomic nervous system effects, and the role of the Immune system.
- Include content with considerations across the lifespan, infant, child, adult and elder adult.
- Consider how this knowledge will impact clinical diagnostic reasoning and practice implications for the advanced practice nurse providing 2 Examples. cite every paragraph. Assignment should follow APA 7th ed.
Stress and Disease
- Provide 3 references.
- Provide a brief introduction and conclusion.
- Structure of the journal is clear and transitions are logical
- Rules of grammar, usage, and punctuation are followed.
- Spelling is correct.
Textbook:
- McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis