Stress-induced cardiovascular reactivity and atherogenesis in adolescents

Abstract

Objective To examine the association between cardiovascular reactivity to a set of psychological stressors and carotid artery intima-media thickness, a marker of subclinical cardiovascular disease in healthy adolescents. Methods Participants were 25 boys and 23 girls age 14.2±0.9 years who were measured for heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure reactivity to mirror-tracing, reaction time, speech preparation and ad lib speech tasks and for common carotid artery intima-media thickness. Sequential regression analyses were used to establish the incremental increase in R2 (R2inc) for the prediction of intima-media thickness due to cardiovascular reactivity independent of age, BMI percentile, sex, socioeconomic status, and resting HR or BP. Results SBP reactivity while preparing (β= 0.0019, R2inc = 0.09) and giving the speech (β = 0.0014, R2inc = 0.10) and an aggregate reactivity score based on all 4 tasks (β= 0.0026, R2inc = 0.11) independently predicted (p ≤ 0.05) mean carotid artery intima-media thickness. Neither DBP reactivity nor HR reactivity during any task were independent predictors of intima-media thickness. Conclusion Stress-induced cardiovascular reactivity, and especially SBP reactivity, is associated with carotid intima-media thickness and the early pathogenesis of cardiovascular disease. The use of an aggregate stress reactivity index provides a more reliable reflection of trait SBP reactivity to psychological stress and increases the confidence that youth with greater cardiovascular stress reactivity may indeed have greater progression of subclinical cardiovascular disease.

The Carotid Artery Atherosclerosis Burden and Its Relation to Cardiovascular Risk Factors in Black and White Africans with Established Rheumatoid Arthritis: A Cross-sectional Study

“…Vascular reactivity to psychological stress is enhanced in black compared to white subjects and is associated with an increased susceptibility to atherosclerosis and incident CV events 49,50,51 . Stress reduction was shown to reduce carotid atherosclerosis and CV mortality in black Americans 52 .…”

Racial Differences in Aortic Stiffness in Children

“…A substantial body of literature, however, has focused on the cardiovascular reactivity to physical (cold-pressor test, exercise) and psychological (speech, arithmetic, video games) stressors as the potential substrate for detrimental vascular remodeling and target-organ damage. Indeed, cardiovascular reactivity is associated with the development of hypertension 53 and carotid atherosclerosis (assessed as IMT) in adults, 54 adolescents, 55 and children. 56 Moreover, racial differences in cardiovascular reactivity have been noted.…”

Hypertension among Tunisian adults: results of the TAHINA project

“…1 Although the exact causes and mechanisms of hypertension are not known, it is generally believed that both genetic 12,13 and environmental factors, such as dietary salt, adiposity, cigarette smoking and mental stress were involved in determining the levels of BP and the prevalence of hypertension. [14][15][16] Knowledge of the prevalence of hypertension and the extent to which it is being detected, treated and controlled are essential to understand the magnitude of the problem and how well it is being addressed. In Tunisia, there were limited data about the prevalence of hypertension, 11,17,18 with no national estimates and no information about the levels of awareness, treatment and control of hypertension.…”