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Psychological stress and the progression of carotid artery disease.

Abstract：

BACKGROUND:We examined the relation between cardiovascular reactivity (the response of the cardiovascular system to psychological stress) and the severity and progression of carotid atherosclerosis. METHODS:Using duplex ultrasonography, we measured the change in the area of all detectable plaques in the extracranial carotid arteries during 2 years. Cardiovascular reactivity was assessed by measuring changes in hemodynamics during a frustrating cognitive task (the Stroop Color Word Interference Task). Established risk factors for atherosclerosis were measured by interviewing patients, a physical examination, and blood assays for 351 subjects with a wide range of types of atherosclerotic disease. RESULTS:Atherosclerotic plaques were present in the carotid arteries of 273 (78%) subjects. In a forward stepwise multiple regression analysis, it was found that greater age (beta = 0.46), a history of hypertension (beta = 0.20), use of lipid level-lowering agents (beta = 0.18), a longer history of smoking (beta = 0.13), a larger cholesterol:high-density lipoprotein ratio (beta = 0.13), a smaller change in heart rate during the task (beta = -0.12), and a higher resting systolic blood pressure (SBP; beta = 0.11) were associated significantly with a greater plaque area (R2 = 0.35). In 136 untreated subjects who were followed up for 2 years, a greater change in SBP during the task (beta = 0.28), a higher total cholesterol: high-density lipoprotein ratio (beta = 0.23), a shorter resting preejection period (beta = -0.19), and a lower body mass index (beta = -0.17) were significant predictors of the change in atherosclerosis, after controlling for age and initial plaque area in a stepwise multiple regression analysis (R2 = 0.24). CONCLUSIONS:These results support the hypothesis that hemodynamic responses under conditions of mental stress may influence the progression of atherosclerosis.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Barnett PA,Spence JD,Manuck SB,Jennings JR

doi

10.1097/00004872-199715010-00004

subject

Has Abstract

pub_date

1997-01-01 00:00:00

pages

49-55

issue

1

eissn

0263-6352

issn

1473-5598

journal_volume

15

pub_type

杂志文章

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