Anxiety increases the blood pressure response during exercise

Diana De Medeiros Andrade,Josária Ferraz Amaral,Patrícia Fernandes Trevizan,Lilian Pinto Da Silva,Mateus Camaroti Laterza,Daniel Godoy Martinez,Edgar Toschi-Dias

doi:10.1590/s1980-6574201900030016

Abstract

Abstract Aim: The hypothesis that higher levels of anxiety promote greater blood pressure (BP) responses during physical exercise is tested. The hypothesis that metaborreflex response is increased in an anxious individual is tested as well. Methods: There were 43 volunteers divided by anxiety level: 12 volunteers with mild, moderate and severe symptoms (anxious-group) and 31 volunteers with a minimum level of anxiety (control-group). Arterial BP, heart rate, and forearm blood flow were measured simultaneously during handgrip exercise and post-exercise ischemia, and forearm vascular resistance (FVR) was calculated. Results: Anxious group present higher systolic, diastolic and mean BP at rest when compared with control group (130±11 vs. 122±12 mmHg, p=0.048; 70±6 vs. 65±8 mmHg, p=0.033; 90±7 vs. 84±9 mmHg, p=0.033, respectively) and higher response of systolic, diastolic and mean BP and FVR during exercise when compared with control group (20±9 vs. 13±7 mmHg, p=0.009; 17±8 vs. 11±6 mmHg, p=0.006; 18±8 vs. 11±6 mmHg, p=0.005; and 0±13 vs. -7±9 units, p=0,003, respectively). During post-exercise ischemia, the anxious group also present higher response of diastolic BP, mean BP and FVR when compared with a control group (11±12 vs. 3±4 mmHg, p=0,001, 10±8 vs. 3±5 mmHg, p=0,002; 9±11 vs. -2± 8 units, p=0,03, respectively). Conclusion: Anxious individuals present higher BP responses during physical exercise when compared with those with minimal anxiety symptoms. This increased response may be explained, in part, by increased peripheral vascular resistance due to the greater metaborreflex response.

Highlights

Anxiety, a transient and normal emotional state throughout life, promotes feelings of discontent, discomfort, or worry about an event with an uncertain outcome[1]
Individuals with mild, moderate, and severe anxiety levels were allocated to the anxiety group (AG) (n=12), while those with minimal anxiety were allocated to the control group (CG) (n=31)
The main findings of the present study are those anxious individuals present, in addition to higher resting blood pressure levels, greater reflex pressor of the exercise when compared with individuals with minimal anxiety symptoms. Another important finding was the positive relationship between anxiety level and blood pressure both at rest and during exercise

Summary

Introduction

A transient and normal emotional state throughout life, promotes feelings of discontent, discomfort, or worry about an event with an uncertain outcome[1]. Lipman, Grossman, Bridges, Hamner, Taylor[4] suggested an effect of anticipatory anxiety on hemodynamic variables such as mean blood pressure and heart rate, that increase early in the preparation phase and throughout the execution of two mental stress tests (math and speech), as a way of preparing the body for coping or running away, known as “fight or flight”[4]. Even though all of these hemodynamic adjustments occur simultaneously to favor increased blood flow to the skeletal muscles during exercise, it has been reported in the literature that exacerbated increases for these hemodynamic responses are associated with a high risk of adverse events on the cardiovascular system[12,13,14]

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Conclusion