Abstract
BackgroundAcute mental stress may contribute to the cardiovascular disease progression via autonomic nervous system controlled negative effects on the endothelium. The joint effects of stress-induced sympathetic or parasympathetic activity and endothelial function on atherosclerosis development have not been investigated. The present study aims to examine the interactive effect of acute mental stress-induced cardiac reactivity/recovery and endothelial function on the prevalence of carotid atherosclerosis.MethodsParticipants were 81 healthy young adults aged 24-39 years. Preclinical atherosclerosis was assessed by carotid intima-media thickness (IMT) and endothelial function was measured as flow-mediated dilatation (FMD) using ultrasound techniques. We also measured heart rate, respiratory sinus arrhythmia (RSA), and pre-ejection period (PEP) in response to the mental arithmetic and speech tasks.ResultsWe found a significant interaction of FMD and cardiac RSA recovery for IMT (p = 0.037), and a significant interaction of FMD and PEP recovery for IMT (p = 0.006). Among participants with low FMD, slower PEP recovery was related to higher IMT. Among individuals with high FMD, slow RSA recovery predicted higher IMT. No significant interactions of FMD and cardiac reactivity for IMT were found.ConclusionsCardiac recovery plays a role in atherosclerosis development in persons with high and low FMD. The role of sympathetically mediated cardiac activity seems to be more important in those with impaired FMD, and parasympathetically mediated in those with relatively high FMD. The development of endothelial dysfunction may be one possible mechanism linking slow cardiac recovery and atherosclerosis via autonomic nervous system mediated effect.
Highlights
Acute mental stress may contribute to the cardiovascular disease progression via autonomic nervous system controlled negative effects on the endothelium
Associations between the study parameters Linear regression analyses showed that baseline heart rate (HR), baseline respiratory sinus arrhythmia (RSA), and baseline pre-ejection period (PEP) were unrelated to intima-media thickness (IMT) (N = 75, p = 0.893; N = 76, p = 0.363; N = 75, p = 0.324, respectively) and flow-mediated dilatation (FMD) (N = 69, p = 0.114; N = 70, p = 0.969; N = 69, p = 0.177, respectively)
Our results showed that RSA recovery following acute mental stress was related to atherosclerosis development in young adults with a high level of FMD, whereas, for PEP recovery the association with atherosclerosis development emerged in participants with low FMD
Summary
Acute mental stress may contribute to the cardiovascular disease progression via autonomic nervous system controlled negative effects on the endothelium. The joint effects of stress-induced sympathetic or parasympathetic activity and endothelial function on atherosclerosis development have not been investigated. The present study aims to examine the interactive effect of acute mental stress-induced cardiac reactivity/recovery and endothelial function on the prevalence of carotid atherosclerosis. Acute mental stress may induce myocardial infarction [2] or sudden cardiac death [3]. Mechanisms through which mental stress induces harmful changes in vascular system functioning and influences atherosclerosis development are not fully clear. It has been suggested that chronic stress may promote atherogenesis through the mechanism of autonomic neuropathycaused sympathetic hyperactivity [12]
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