Andrew Steptoe

a.steptoe@ucl.ac.uk
www.ucl.ac.uk/epidemiology/staff/steptoea.htm

CV

Andrew Steptoe graduated with a first in Natural Sciences from the University of Cambridge in 1972, and completed his DPhil at the University of Oxford in 1975. After two years as an MRC research fellow, he was appointed lecturer in psychology at St. George's Hospital Medical School. He remained at St. George's until 2000, becoming professor and head of the Department of Psychology in 1988. Professor Steptoe was awarded a DSc by the University of London in 1995, and was President of the Society for Psychosomatic Research from 1983-1985, and President of the International Society of Behavioral Medicine from 1994-1996. He was founding co-editor (with Professor Jane Wardle) of the British Journal of Health Psychology from 1996-2001. Andrew Steptoe was appointed British Heart Foundation Professor of Psychology in the Department of Epidemiology and Public Health in 2000.

Research Interest

• Psychobiology of health and disease. This programme of research is being carried out in conjunction with Professor Sir Michael Marmot. It was initially funded by the Medical Research Council and is currently supported by the British Heart Foundation The purpose is to understand the biological processes through which social status and other psychosocial factors influence disease risk. It involves laboratory studies of the influence of psychosocial factors on cardiovascular, neuroendocrine and immune function, and naturalistic studies of blood pressure, cortisol and other measures during everyday life. An innovative aspect of this research is the study psychosocial influences on inflammatory processes, with measures of inflammatory markers, cytokines, endothelial function and other measures relevant to the early stages of coronary heart disease. The Whitehall Psychobiology Study carried out between 1999 and 2003 demonstrated associations between lower socioeconomic position and cardiovascular, neuroendocrine, haemostatic and inflammatory responses. A newer study involving another subgroup from the Whitehall II cohort (the Heart Scan Study) is assessing associations of these psychobiological responses with coronary artery calcification.
• Psychophysiology of coronary heart disease – A second major theme of work concerns the influence of behaviour and emotional factors on patients with advanced coronary artery disease. The purpose is to understand the role of emotional factors in the triggering of coronary ischaemia and acute coronary syndromes, to understand the evolution of depression in patients following acute coronary syndromes, and to investigate the influence of psychosocial factors on long-term adjustment and quality of life in coronary heart disease. The ACCENT (Acute Coronary Syndrome, Emotion and Trigger) study involves interviews with patients soon after admission to coronary care with heart attacks, investigating the circumstances surrounding the onset of symptoms, and the development of depression, anxiety and posttraumatic stress disorder and quality of life up to three years post-admission. A feature of this study is the combination of clinical and psychosocial data with biological measures such as salivary cortisol, and psychophysiological stress testing in a subgroup.
• Health behaviour change - Behaviours such as dietary choice, smoking and physical exercise are important determinants of health and disease risk. We have carried out a number of studies of behaviour counselling to modify risk behaviours and are currently involved in the development of internet-based programmes to modify diet and physical activity, and encourage weight loss in overweight and obese individuals.

Selected Publications

1. Strike, P.C., Magid, K., Whitehead, D.L., Brydon, L., Bhattacharyya, M.R. and Steptoe, A. (2006) Pathophysiological processes underlying emotional triggering of acute cardiac events. Proc. Natl. Acad. Sci. USA 103, 4322-4327
2. Steptoe, A., Wardle, J. and Marmot, M. (2005) Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes. Proc. Natl. Acad. Sci. USA 102, 6508-6512.
3. Strike, P.C. and Steptoe, A. (2005) Behavioral and emotional triggers of acute coronary syndromes: a systematic review and critique. Psychosomatic Medicine 67, 179-186.
4. Wardle, J. and Steptoe, A. (2005) Public health psychology. The Psychologist 18, 672-675.
5. Lewthwaite, J., Owen, N., Coates, A., Henderson, B. and Steptoe A. (2002) Circulating human heat shock protein 60 in the plasma of British civil servants: relationship to physiological and psychosocial stress. Circulation 106, 196-201.