Effect of Mental Stress on Platelet Function in Normal Subjects and in Patients with Coronary Artery Disease

Abstract

We studied the effect of emotional stress (mental arithmetic for 10 min) in 10 postinfarction patients and in 10 age-matched apparently healthy subjects as controls. Blood samples for platelet function studies and for the determination of epinephrine levels in serum were taken in basal conditions, at the end of mental stress and after 30 min of recovery. Patients were studied twice, in washout of medications and after oral administration of dipyridamole, 200 mg twice a day for 6 consecutive days. Mental stress induced in patients significant increments in different hemodynamic parameters (heart rate, systolic blood pressure and diastolic blood pressure) and in serum epinephrine levels. Concomitantly, the test produced a significant increase in platelet aggregation (induced by 3 µM ADP or 1 µg/ml collagen), the formation of circulating platelet aggregates and an increase in plasma thromboxane B₂ levels. Hemodynamic parameters and platelet function tests returned to baseline values after 30 min. Similar activation of hemodynamic parameters, similar increase in epinephrine levels and lower increase in platelet function by emotional stress were observed in control subjects. Treatment of patients with dipyridamole had no effect on stress-induced increase in hemodynamic parameters and epinephrine levels, but decreased stress-related platelet activation. These data can contribute to a better understanding of the complex relationships between psychosocial factors, the hemostatic system and vascular disease.

Social Support and Stroke and Coronary Heart Disease

“…Stress activates neuroendocrine components including the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. 12 The long-term activation of these axes may induce a sustained increase in cortisol, 12 norepinephrine secretions, 21 inflammatory proteins, 22 platelet abnormalities, 23 and endothelial dysfunction, 24 which may in turn exacerbate other cardiovascular risk factors such as hypertension, 12,25 heart rate, 26 hyperlipidemia, 12 diabetes, 12 and the progression of atherosclerosis. 12 By promoting more benign appraisals of stress, social support may reduce the intensity or duration of these neuroendocrine responses.…”

Recommendations for the standardization of light transmission aggregometry: a consensus of the working party from the platelet physiology subcommittee of SSC/ISTH

“…After review of the full manuscripts by the panel members, fifteen further studies were excluded. These 12 manuscripts, coupled with two extra studies identified by manual review and by consultation among members of the working group, resulted in a total of only 14 relevant studies [17][18][19][20][21][22][23][24][25][26][27][28][29][30] that were used to help refine the RAND survey and write the present recommendations ( Fig. 1).…”

A Prospective Cohort Study of Perceived Noise Exposure at Work and Cerebrovascular Diseases among Male Workers in Japan

“…Although the biological mechanism of this association is complex, noise-induced cardiovascular diseases and increased blood change are considered a consequence of stress 6) . Stress may lead to increased ambulatory blood pressure levels and pulse rates 7) , reduced insulin sensitivity 8) , increased platelet aggregation 9) , and endothelial dysfunction 10) , as a result of activating the sympathetic nerve system.…”