Cardiovascular reactivity to psychological stress and carotid intima‐media thickness in children

Abstract

The relationship between cardiovascular stress reactivity and carotid artery intima-media thickness (IMT) has been established in adults, but not yet studied in children. Cardiovascular reactivity to an ad lib speech was measured in 20 boys and 20 girls age 11.0 +/- 1.4 years. Measures included heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure reactivity, and mean common carotid artery IMT. Sequential regression analyses were used to establish the incremental increase in R(2) for the prediction of IMT due to cardiovascular reactivity independent of age, socioeconomic status, race, percentage body fat, and baseline BP or HR. SBP reactivity (beta=0.002, , p<.05), but not DBP reactivity (p=.12) or HR reactivity (p=.82), independently predicted carotid artery IMT. This study provides initial evidence that SBP reactivity is associated with IMT and perhaps the early pathogenesis of cardiovascular disease in childhood.

Stress-induced cardiovascular reactivity and atherogenesis in adolescents

“…These results replicate previous research that stress-induced SBP reactivity to preparing and then given an interpersonal speech is associated with subclinical cardiovascular disease in children. 10 Moreover, the present study extends earlier work by demonstrating that an aggregate stress reactivity measure that provides a more reliable reflection of ‘trait’. cardiovascular reactivity, 13 predicts greater intima-media thickness.…”

“…9 Until recently the relationships between psychological stress-induced cardiovascular reactivity and intima-media thickness had not been investigated in youth. Roemmich and colleagues 10 presented initial evidence that systolic blood pressure (SBP) reactivity, but not diastolic BP (DBP) or heart rate (HR) reactivity, was associated with carotid artery intima-media thickness in children. A more recent study found that children who displayed greater DBP reactivity increases over the course of 3 years exhibited greater intima-media thickness.…”

Daytime Sleep Accelerates Cardiovascular Recovery after Psychological Stress

“…One has reliably associated suboptimal nocturnal sleep with increased cardiovascular morbidity and mortality and total mortality [5,6,22,23] while the other has reliably established cardiovascular reactivity and recovery as a risk factor for cardiovascular morbidity [7][8][9][10]17]. By allotting participants an interval for daytime sleep and assessing same-day cardiovascular response, we were able to create a situation where daytime sleep could be quantitatively assessed for its recuperative and protective cardiovascular benefits.…”

“…For example, nocturnal sleep length has been associated with increased risk of pre-hypertension and hypertension in adolescents [5] and adults [6]. A separate literature implicates exaggerated cardiovascular reactivity to psychological stress in the laboratory [7] with increased risk for cardiovascular disease in adolescents [8] and adults [9]. Further, recent longitudinal studies suggested that blunted post-stress blood pressure recovery was associated with increased risk of acute myocardial infarction [10], carotid intima-media thickening [11], and hypertension [12].…”

A review of neuroimaging studies of stressor-evoked blood pressure reactivity: Emerging evidence for a brain-body pathway to coronary heart disease risk

“…As noted above, some individuals have a reliable tendency to express relatively large rises in blood pressure that are viewed to exceed the metabolic demands of a given stressor (Obrist, 1981). Indeed, this exaggerated cardiovascular response tendency appears to be a trait-like dispositional characteristic of some individuals (Allen et al, 1987; Cohen and Hamrick, 2003; Fauvel et al, 1996; Gerin et al, 1993; Kamarck et al, 1994; Kamarck and Lovallo, 2003; Llabre et al, 1991; Manuck et al, 1995a; Sherwood et al, 1990), which may be partially heritable (De Geus et al, 2007; Turner and Hewitt, 1992) and predictive of atherosclerotic and CHD risk early in development (Matthews et al, 2006; Roemmich et al, 2009). Moreover, individuals expressing exaggerated stressor-evoked cardiovascular reactions, particularly exaggerated blood pressure reactions, appear to be at elevated risk for precursors to CHD and related endpoints in later life.…”