How mental stress affects endothelial function

Abstract

Mental stress is an important factor contributing to recognized mechanisms underlying cardiovascular events. Among these, stress-related endothelial dysfunction is an early risk factor that predicts future development of severe cardiovascular disorders. Acute mental stress by a variety of tests impairs endothelial function in humans, although the opposite results have been reported by some investigators. Chronic stress always deteriorates endothelial function in humans and experimental animals. Stress hormones, such as glucocorticoids and pro-inflammatory cytokines, and endothelin-1 liberated in response to mental stress participate in endothelial dysfunction possibly via downregulation of endothelial nitric oxide synthase (eNOS) expression, eNOS inactivation, decreased nitric oxide (NO) actions, and increased NO degradation, together with vasoconstriction counteracting against NO-induced vasodilatation. Catecholamines do not directly affect endothelial function but impair its function when blood pressure elevation by the amines is sustained. Endogenous opioids favorably affect endothelial function, which counteract deteriorating effects of other stress hormones and mediators. Inhibition of cortisol and endothelin-1 production, prevention of pro-inflammatory mediator accumulation, hypnotics, mirthful laughter, humor orientation, and lifestyle modification would contribute to the prevention and treatment for stress-related endothelial dysfunction and future serious cardiovascular disease.

Abnormal endothelial function in ED patients with normal nocturnal penile tumescence and rigidity: is it the role of psychogenic factors?

“…Stress-related hormones and mediators affect vascular actions possibly via downregulation of endothelial nitric oxide synthase expression, endothelial nitric oxide synthase inactivation, decreased nitric oxide (NO) actions and increased NO degradation, together with vasoconstriction counteracting against NO-induced vasodilatation. 28 Our study also showed that psychological causes may be unfavourable factors affecting endothelial function in ED patients.…”

Chronic stress impacts the cardiovascular system: animal models and clinical outcomes

“…On the other hand, NO appears to be involved in triggering catecholamine surges in stressed animals, as N G -nitro-L-arginine methyl ester administration decreased stressrelated responses (340). Collectively, it seems unlikely that stress-induced increases in catecholamines are directly responsible for endothelial dysfunction (334).…”

Endothelial function and sleep: Associations of flow-mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep

“…Stress [Exploratory Analyses]-Analyses explored the impact of adjusting for perceived stress, because of the literature suggesting that stress may influence both sleep and endothelial function (Åkerstedt,2006;Toda & Nakanishi-Toda 2011). Self-reported stress levels in the past 30 days were measured with the Perceived Stress Scale(PSS) (Cohen et al, 1983).…”