Arterial stiffness and chronic stress: role of gender – Rigidità arteriosa e stress cronico: ruolo del genere

Abstract

AimEvaluate whether exposure to chronic stress is associated with early vascular aging in hypertensive patients and possible gender differences in this relationship.MethodsPatients where recruited in a Hypertension outpatient clinic during a visit for the evaluation of subclinical organ damage. Aortic stiffness was measured as carotid-femoral pulse wave velocity (PWV) by applanation tonometry; common carotid intima-media thickness (IMT) and distensibility were evaluated by automated analysis of carotid ultrasound clips. Chronic stress was assessed using three different standardized scales: Perceived Stress Score 4 (PSS4), Depression Anxiety Stress Scale (DASS) and Chronic Stress Burden (CSB).ResultsData from 125 patients (age 56.7 ± 12.5years) were analyzed. No significant differences were found between men and women in terms of PWV [8.90 (1.9) vs 8.55 (1.8) m/s, p = 0.14], carotid distensibility (22.34 ± 8.79 vs 21.17±8.74 kPa−1, p = 0.545) and IMT (0.74 ± 0.12 vs 0.70 ± 0.13 mm, p = 0.132). Women presented significantly higher scores of PSS4 (7(3) vs 5(3), p = 0.007) and CSB (1.42 ± 1.24 vs 0.59 ± 0.85, p = 0.004). In the linear multiple regression analysis, CBS was correlated with PWV in the general population (beta = 0.37, p = 0.050) being responsible for 4% of the variance of PWV, without significant gender differences. Among the components of CBS, difficulties in relationships with someone close to the participant were associated with increased PWV only in women (p = 0.01). In a multiple regression model, this variable tended to be an independent predictor of PWV (beta = 0.37, p = 0.057), responsible for 7% of the PWV variance.ConclusionsIn hypertensive patients, chronic stress burden is associated with greater arterial stiffness; in particular, stress related to difficulties in relationships seems to be associated with greater vascular stiffness only in women.