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Kuo CY, Chung CH, Wang CH, Chien WC, Chen HC. Increased incidence in hospitalised patients with sudden sensorineural hearing loss: a 14-year nationwide population-based study. Int J Audiol 2019; 58:769-773. [PMID: 31195853 DOI: 10.1080/14992027.2019.1627009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To conduct a 14-year nationwide study on the epidemiologic incidence in patients with sudden sensorineural hearing loss (SSNHL). Design: Retrospective cross-sectional design. Study sample: Data of patients hospitalised with the diagnosis of SSNHL from 2000 to 2013, extracted from the Taiwan National Health Insurance Research Database. Results: In total, 31,258 patients were included. The mean age was 50.30 ± 16.70 years. Males (53.5%) were more commonly diagnosed with SSNHL than females (46.5%). The patients most commonly presented with SSNHL were in the age group of 45-64 years. The crude incidence of SSNHL from 2000 to 2013 was 9.76 per 100,000 people per year. The annual incidence rate shows a steady increased from 5.15 in 2000 to 13.97 per 100,000 people in 2013 with a statistical significance (p < 0.001). Conclusion: This 14-year nationwide study indicated an increased incidence rate of SSNHL. This necessitates the development of additional treatment modalities to enhance the prognosis and the clarification of the underlying mechanism of this enigmatic disease.
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Affiliation(s)
- Chao-Yin Kuo
- Department of Otolaryngology-Head and Neck surgery, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan.,School of Public Health, National Defense Medical Center , Taipei , Taiwan
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck surgery, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan.,School of Public Health, National Defense Medical Center , Taipei , Taiwan
| | - Hsin-Chien Chen
- Department of Otolaryngology-Head and Neck surgery, Tri-Service General Hospital, National Defense Medical Center , Taipei , Taiwan
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Challenge and threat states: examining cardiovascular, cognitive and affective responses to two distinct laboratory stress tasks. Int J Psychophysiol 2018; 126:42-51. [DOI: 10.1016/j.ijpsycho.2018.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/15/2018] [Accepted: 02/07/2018] [Indexed: 10/17/2022]
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Underlying inflammation has no impact on the oxidative stress response to acute mental stress. Brain Behav Immun 2014; 40:182-90. [PMID: 24675034 DOI: 10.1016/j.bbi.2014.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/06/2014] [Accepted: 03/13/2014] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Mental stress is considered to be a trigger for acute myocardial infarction (MI), with inflammation thought to provide a mechanism. Inflammation is reciprocally linked to oxidative stress, which has also been implicated in MI. The purpose of this study was to assess the effects of experimentally-induced inflammation on the oxidative stress response to mental stress in healthy participants. METHODS Healthy males undertook one of two inflammatory stimuli: typhoid vaccination (Vaccination paradigm, N=17) or eccentric exercise (Eccentric exercise paradigm, N=17). All participants completed a mental arithmetic stress task twice (within-subject design): 6h after the inflammatory stimulus, and during a control non-inflammation condition. Blood samples were taken before, immediately and 30min after the stress task. Plasma was assessed for interleukin-6 (IL-6), protein carbonyls (PC), lipid hydroperoxides (LOOH), total antioxidant capacity (TAC) and nitric oxide metabolites (NOx). RESULTS Vaccination paradigm: IL-6, PC and NOx were significantly higher in the vaccination condition, relative to the control condition (p<.05). PC, TAC, LOOH and NOx were unchanged in response to mental stress in both the vaccination and control conditions. Eccentric Exercise paradigm: IL-6 and TAC were significantly higher in the eccentric exercise condition (p<.05), relative to the control condition. PC, TAC and NOx were unchanged in response to mental stress in both the eccentric exercise and control conditions. CONCLUSIONS Two different inflammatory paradigms were successful in increasing selective plasma markers of inflammation and oxidative stress prior to a mental stress task. However, experimentally induced transient inflammation had no impact on mental stress-induced changes in plasma LOOH, PC, TAC or NOx in young healthy participants.
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Paine NJ, Ring C, Bosch JA, Drayson MT, Aldred S, Veldhuijzen van Zanten JJCS. Vaccine-induced inflammation attenuates the vascular responses to mental stress. Int J Psychophysiol 2014; 93:340-8. [PMID: 24998644 DOI: 10.1016/j.ijpsycho.2014.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 06/27/2014] [Accepted: 06/28/2014] [Indexed: 01/08/2023]
Abstract
Inflammation is associated with poorer vascular function, with evidence to suggest that inflammation can also impair the vascular responses to mental stress. This study examined the effects of vaccine-induced inflammation on vascular responses to mental stress in healthy participants. Eighteen male participants completed two stress sessions: an inflammation condition having received a typhoid vaccination and a control (non-inflamed) condition. Tumor necrosis factor-alpha and interleukin-6 (p's<.001) increased following vaccination, confirming modest increases in inflammation. Mental stress increased blood flow, blood pressure, heart rate, and cardiac output in both conditions (all p's<.001), but the blood flow response to stress was attenuated having received the vaccination compared to the control condition (p's<.05). These results further implicate the interaction between inflammation and the vasculature as a mechanism through which stress may trigger myocardial infarction.
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Affiliation(s)
- Nicola J Paine
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, 27710, NC, USA.
| | - Christopher Ring
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Jos A Bosch
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom; Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands; Mannheim Institute of Public Health, Social and Preventive Medicine (MIPH), Mannheim Medical Faculty, University of Heidelberg, Germany
| | - Mark T Drayson
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom; School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Sarah Aldred
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
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Nater UM, Ditzen B, Strahler J, Ehlert U. Effects of orthostasis on endocrine responses to psychosocial stress. Int J Psychophysiol 2013; 90:341-6. [DOI: 10.1016/j.ijpsycho.2013.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 08/20/2013] [Accepted: 10/18/2013] [Indexed: 10/26/2022]
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Abstract
OBJECTIVE To assess whether a life-style physical activity intervention improved antibody response to a pneumococcal vaccination in sedentary middle-aged women. METHODS Eighty-nine sedentary women completed a 16-week exercise (physical activity consultation, pedometer, telephone/e-mail prompts; n = 44) or control (advisory leaflet; n = 45) intervention. Pneumococcal vaccination was administered at 12 weeks, and antibody titers (11 of the 23 contained in the pneumococcal vaccine) were determined before vaccination and 4 weeks and 6 months later. Physical activity, aerobic fitness, body composition, and psychological factors were measured before and after the intervention. RESULTS The intervention group displayed a greater increase in walking behavior (from mean [standard deviation] = 82.16 [90.90] to 251.87 [202.13]) compared with the control condition (111.67 [94.64] to 165.16 [117.22]; time by group interaction: F(1,68) = 11.25, p = .001, η(2) = 0.14). Quality of life also improved in the intervention group (from 19.37 [3.22] to 16.70 [4.29]) compared with the control condition (19.97 [4.22] to 19.48 [5.37]; time by group interaction: F(1,66) = 4.44, p = .039, η(2) = 0.06). However, no significant effects of the intervention on antibody response were found (time by group η(2) for each of the 11 pneumococcal strains ranged from 0.001 to 0.018; p values all >.264). CONCLUSIONS Participation in a life-style physical activity intervention increased subjective and objective physical activity levels and quality of life but did not affect antibody response to pneumococcal vaccination.
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Paine NJ, Ring C, Bosch JA, McIntyre D, Veldhuijzen van Zanten JJCS. The effect of acute mental stress on limb vasodilation is unrelated to total peripheral resistance. Psychophysiology 2013; 50:680-90. [PMID: 23656692 DOI: 10.1111/psyp.12054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 03/26/2013] [Indexed: 01/01/2023]
Abstract
Mental stress can trigger myocardial infarction, with poor vascular responses to stress implicated as a pathway. Vascular stress reactivity can be assessed by different methods, such as total peripheral resistance (TPR) and forearm blood flow (FBF). Little is known about how these vascular assessments are linked. This was examined in two separate studies. Healthy men (Study 1: N = 29, Study 2: N = 23) completed rest and mental arithmetic (Study 1: 8 min, Study 2: 16 min). In both studies, heart rate, mean arterial pressure, and FBF increased in response to stress. In Study 1, no changes in TPR were seen, but Study 2 found stress-induced increases in TPR. FBF was not linked to TPR at any time (all ps > .05). It appears that limb vasculature and TPR responses to stress do not give the same information about impairments of the vasculature. These findings are relevant to the interpretation of prior research findings and the design of future studies on stress and vascular responses.
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Affiliation(s)
- Nicola J Paine
- School of Sport and Exercise Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK, B15 2TT.
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Paine NJ, Ring C, Aldred S, Bosch JA, Wadley AJ, Veldhuijzen van Zanten JJCS. Eccentric-exercise induced inflammation attenuates the vascular responses to mental stress. Brain Behav Immun 2013; 30:133-42. [PMID: 23376168 DOI: 10.1016/j.bbi.2013.01.082] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 01/15/2013] [Accepted: 01/23/2013] [Indexed: 10/27/2022] Open
Abstract
Mental stress has been identified as a trigger of myocardial infarction (MI), with inflammation and vascular responses to mental stress independently implicated as contributing factors. This study examined whether inflammation moderates the vascular responses to mental stress. Eighteen healthy male participants completed a stress task under two counter balanced conditions. In the exercise condition, a morning bout of eccentric exercise (12×5 repetitions of unilateral eccentric knee extension at 120% intensity of concentric one repetition maximum) was used to increase levels of inflammatory-responsive cytokines during an afternoon stress session scheduled 6h later. In the control condition, participants sat and relaxed for 45min, 6h prior to the afternoon stress session. Forearm blood flow, calf blood flow (measured in the leg which completed the exercise task), blood pressure, heart rate and cardiac output were assessed at rest and in response to mental stress. As expected, interleukin-6 was higher (p=.02) 6h post exercise, i.e., at the start of the stress session, as compared to the no-exercise control condition. Mental stress increased forearm blood flow, calf blood flow, blood pressure, heart rate, and cardiac output in both conditions (p's<.001). Stress-induced calf blood flow was attenuated in the exercise condition compared to the control condition (p<.05) which was not the case for forearm blood flow. This study found that the inflammatory response to eccentric exercise attenuated the vascular responses to mental stress locally at the site of eccentric exercise-induced inflammation. The observed impairment in vascular responses to stress associated with increased levels of inflammation suggests a mechanism through which inflammation might increase the risk for MI.
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Affiliation(s)
- Nicola J Paine
- School of Sport and Exercise Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom.
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Austin AW, Patterson SM, von Känel R. Hemoconcentration and hemostasis during acute stress: interacting and independent effects. Ann Behav Med 2012; 42:153-73. [PMID: 21562905 DOI: 10.1007/s12160-011-9274-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Acute psychological stress can produce significant hemoconcentration as well as prothrombotic changes in blood, both of which may have potentially harmful effects on the cardiovascular system. It is unclear whether these effects are independent or have influence on each other. PURPOSE This review discusses research investigating the effects of acute psychological stress on hemoconcentration and hemostasis and explores future directions for psychohematology research. Physiology, associations with cardiovascular disease, and relationships between acute psychological stress are discussed independently for hemoconcentration and hemostasis, followed by an examination of the effects of stress-hemoconcentration on hemostasis. CONCLUSIONS Traditional methods of adjusting for stress-hemoconcentration effects (e.g., calculated plasma volume or hematocrit level corrections) may not be appropriate when examining stress-induced changes in hemostasis. The effects of acute stress on hemostasis should be examined in conjunction with hemoconcentration.
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Cooke A, Kavussanu M, McIntyre D, Ring C. Psychological, muscular and kinematic factors mediate performance under pressure. Psychophysiology 2011; 47:1109-18. [PMID: 20409012 DOI: 10.1111/j.1469-8986.2010.01021.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It is well established that performance is influenced by pressure, but the underlying mechanisms of the pressure-performance relationship are poorly understood. To address this important issue, the current experiment evaluated psychological, physiological, and kinematic factors as mediators of the pressure-performance relationship. Psychological, physiological, and kinematic responses to three levels of competitive pressure were measured in 23 males and 35 females during a golf putting task. Pressure manipulations impaired putting performance. Self-reported anxiety, effort, and perceived pressure were increased. Heart rate, heart rate variability, muscle activity, and lateral clubhead acceleration were also elevated. Mediation analyses revealed that effort, muscle activity, and lateral acceleration partially mediated the decline in performance. Results confirmed that pressure elicits effects on performance through multiple pathways.
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Affiliation(s)
- Andrew Cooke
- School of Sport & Exercise Sciences, University of Birmingham, Birmingham, UK.
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Cooke A, Kavussanu M, McIntyre D, Boardley ID, Ring C. Effects of competitive pressure on expert performance: Underlying psychological, physiological, and kinematic mechanisms. Psychophysiology 2011; 48:1146-56. [DOI: 10.1111/j.1469-8986.2011.01175.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Veldhuijzen van Zanten JJCS, Ring C, Carroll D, McIntyre D, Brown MD. Hemoconcentration during a prolonged stress task: associations with hemodynamic reactivity and microvascular permeability. Biol Psychol 2009; 82:260-6. [PMID: 19699776 DOI: 10.1016/j.biopsycho.2009.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Revised: 08/13/2009] [Accepted: 08/16/2009] [Indexed: 11/30/2022]
Abstract
This study explored the association between stress-induced hemoconcentration and plasma colloid osmotic pressure, hemodynamic reactivity, and microvascular permeability during a protracted stress task in 26 healthy, young participants. Microvascular permeability was measured during rest using venous congestion plethysmography in a subsample of 13 participants. The task increased hematocrit, colloid osmotic pressure, blood pressure, and heart rate and decreased R-wave to pulse interval. Resting microvascular permeability was not correlated with hemoconcentration. Colloid osmotic pressure and diastolic blood pressure were associated with stress-induced hemoconcentration throughout the task. The association with systolic blood pressure as well as heart rate, however, was more evident during the initial 8min of the task than throughout the total task duration. These findings suggest that factors associated with hemoconcentration vary with task duration.
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Patterson SM, VanderKaay MM, Shanholtzer BA, Patterson CA. Influence of acute fluid loading on stress-induced hemoconcentration and cardiovascular reactivity. J Behav Med 2008; 31:319-30. [DOI: 10.1007/s10865-008-9162-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 06/04/2008] [Indexed: 10/21/2022]
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Ring C, Patterson SM, Bacon SL, Veldhuijzen van Zanten JJ, Willemsen G, Carroll D. Reliability of hematocrit during rest and stress in healthy adults. Biol Psychol 2008; 77:63-8. [DOI: 10.1016/j.biopsycho.2007.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 09/11/2007] [Accepted: 09/11/2007] [Indexed: 10/22/2022]
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Ring C, Veldhuijzen van Zanten JJCS, McIntyre D, Kavussanu M. Hypervolemic hyperalgesia in healthy young adults. J Behav Med 2007; 30:449-54. [DOI: 10.1007/s10865-007-9137-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2007] [Accepted: 10/17/2007] [Indexed: 11/29/2022]
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Thrall G, Lane D, Carroll D, Lip GY. A Systematic Review of the Prothrombotic Effects of an Acute Change in Posture. Chest 2007; 132:1337-47. [DOI: 10.1378/chest.06-2978] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Increase in systemic vascular resistance during acute mental stress in patients with rheumatoid arthritis with high-grade systemic inflammation. Biol Psychol 2007; 77:106-10. [PMID: 17949887 DOI: 10.1016/j.biopsycho.2007.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Revised: 09/05/2007] [Accepted: 09/05/2007] [Indexed: 11/20/2022]
Abstract
Patients with rheumatoid arthritis are at increased risk for myocardial infarction. It has been hypothesized that mental stress-induced cardiovascular reactions may play a role in the triggering of myocardial infarction. Cardiovascular activity was measured during rest, stress, and recovery in rheumatoid arthritis patients with high systemic inflammation (C-reactive protein >8 mg/l), rheumatoid arthritis patients with low systemic inflammation (C-reactive protein <or= 8 mg/l), and osteoarthritis patients. Systemic vascular resistance increased only in rheumatoid arthritis patients with high systemic inflammation. Heart rate and mean arterial pressure increased during the stress task in all groups. Thus, acute cardiovascular events in rheumatoid arthritis patients may be related to stress-induced increases in systemic vascular resistance, particularly in patients with high levels of systemic inflammation.
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Schwabe L, Szinnai G, Keller U, Schachinger H. Dehydration does not influence cardiovascular reactivity to behavioural stress in young healthy humans. Clin Physiol Funct Imaging 2007; 27:291-7. [PMID: 17697025 DOI: 10.1111/j.1475-097x.2007.00750.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Enhanced hydration increases the human cardiovascular reactivity to mental stress. If reduced water intake has the opposite effect, this would suggest controlling for water deprivation when studying such responses. Blood pressure, heart rate and parasympathetically dominated beat-to-beat heart rate fluctuations were assessed during resting baseline and mental stress. Two challenging cognitive-motor tasks, a 5-Choice Reaction Time Task (CRTT) and a Paced Auditory Serial Addition Task (PASAT), served as mental stress tests. Eight female and eight male volunteers were examined twice, after 24 h of water deprivation and after normal water intake (counterbalanced order, 7-day interval). Water deprivation resulted in moderate dehydration with a mean 2.6% decrease of total body weight. Dehydration did neither affect baseline blood pressure, heart rate, nor blood pressure reactivity to mental stress. However, dehydration slightly (-1.2 bpm) diminished heart rate reactivity to the PASAT (P = 0.03) and increased beat-to-beat heart rate fluctuations in response to the CRTT (P = 0.05). Dehydration intensified CRTT- and PASAT-induced reductions of beat-to-beat heart rate fluctuations in females (gender x dehydration interactions: P = 0.04-0.05). Moderate dehydration induced by water restriction has no effect on blood pressure reactivity to mental stress. The effects on heart rate reactivity are small. However, stress-induced parasympathetic withdrawal may be fortified during dehydration in females, which suggests controlling for water intake when studying such responses.
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Affiliation(s)
- Lars Schwabe
- Department of Clinical Physiology, Institute of Psychobiology, University of Trier, Johanniterufer 15, 54290 Trier, Germany
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de Boer D, Ring C, Wood M, Ford C, Jessney N, McIntyre D, Carroll D. Time course and mechanisms of mental stress-induced changes and their recovery: hematocrit, colloid osmotic pressure, whole blood viscosity, coagulation times, and hemodynamic activity. Psychophysiology 2007; 44:639-49. [PMID: 17521375 DOI: 10.1111/j.1469-8986.2007.00536.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The mechanisms for stress-induced changes in hematocrit and blood viscosity are unclear. Twenty-two males completed experimental (30 min baseline, 10 min mental stress, 30 min recovery) and no-stress control conditions (70 min). Hemostatic and hemodynamic activity were measured throughout. Hematocrit, colloid osmotic pressure, and blood viscosity displayed parallel patterns: a progressive increase with stress, followed by a gradual recovery. Correlational and covariance analyses indicated that the increase in hematocrit may be mediated by arterial pressure whereas recovery may be mediated by colloid osmotic pressure. Analyses also indicated that acute changes in blood viscosity may depend on hematocrit. These data suggest that stress disturbs hematocrit, colloid osmotic pressure, and blood viscosity through arterial pressure. Poststress, elevated colloid osmotic pressure may drive its own recovery and that of hematocrit and blood viscosity.
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Affiliation(s)
- Dolf de Boer
- Behavioural Medicine Group, School of Sport and Exercise Sciences, University of Birmingham, Birmingham, UK.
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Thrall G, Lane D, Carroll D, Lip GYH. A systematic review of the effects of acute psychological stress and physical activity on haemorheology, coagulation, fibrinolysis and platelet reactivity: Implications for the pathogenesis of acute coronary syndromes. Thromb Res 2007; 120:819-47. [PMID: 17321571 DOI: 10.1016/j.thromres.2007.01.004] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Revised: 09/28/2006] [Accepted: 01/01/2007] [Indexed: 12/18/2022]
Abstract
Physical activity and psychological stress are two potential triggers for the onset of acute coronary syndromes (ACS). To examine the mechanisms underlying this association, we systematically reviewed the literature to determine the effects of acute psychological stress and physical activity on haemorheology and haemostasis. Studies examining the haemorheological and haemostatic response to an acute bout of physical activity (i.e. <60 min) or laboratory psychological stress task were eligible for inclusion. The experimental evidence, although compromised by various methodological weaknesses, suggests that low and moderate intensity physical activity may be cardio-protective through beneficial effects on fibrinolytic system. High levels of physical activity, and psychological to a lesser extent, have been consistently associated with robust changes in haemorheology and haemostasis. Such findings imply that such activities may have the potential to trigger the onset of ACS, although in reality this may be limited sedentary individual and/or those with pre-existing vascular disease. In addition, the data also suggest that individuals may be at a greatest risk of stress-induced thrombogenesis in the period immediately following physical activity or psychological stress, rather than during the activity per se. In conclusion, psychological stress and physical activity may act as potential triggers for the onset of ACS via effects on haemostasis and haemorheology.
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Affiliation(s)
- Graham Thrall
- Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, England
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de Boer D, Ring C, Curlett AC, Ridley M, Carroll D. Mental stress-induced hemoconcentration and its recovery: A controlled study of time course and mechanisms. Psychophysiology 2007; 44:161-9. [PMID: 17241152 DOI: 10.1111/j.1469-8986.2006.00485.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hemoconcentration to mental stress has been implicated in acute cardiovascular events. Participants were exposed to a 30-min baseline, a 4-min stress task, and a 40-min recovery; they also undertook a 74-min no-stress control session. Hemodynamic activity was recorded and blood sampled regularly and analyzed for hematocrit, colloid osmotic pressure, and coagulation time. Hematocrit increased with stress and fully recovered after 20 min. Colloid osmotic pressure showed a similar time course. No such changes occurred in the control session. Coagulation time was not perturbed by stress. The pattern of increase in hematocrit correlated with contemporary colloid osmotic pressure and blood pressure. In recovery, only colloid osmotic pressure was strongly associated with hematocrit. The mechanisms of stress-induced hemoconcentration may differ from those responsible for recovery, which may depend primarily on colloid osmotic pressure.
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Affiliation(s)
- Dolf de Boer
- Behavioural Medicine Group, School of Sport and Exercise Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
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de Boer D, Ring C, Carroll D. Time course and mechanisms of hemoconcentration in response to mental stress. Biol Psychol 2006; 72:318-24. [PMID: 16448738 DOI: 10.1016/j.biopsycho.2005.12.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2005] [Revised: 12/16/2005] [Accepted: 12/23/2005] [Indexed: 11/20/2022]
Abstract
Hemoconcentration with mental stress exposure may be involved in the triggering of acute cardiovascular events. In the present study, hematocrit was measured repeatedly at baseline, during a 4 min mental stress task and during 20 min of recovery. Blood was sampled every 1-2 min throughout. Blood pressure, heart rate and R-wave to pulse interval, a measure of cardiac contractility, were measured with the same periodicity. The stress task elicited a 1.3% increase in hematocrit, which was sustained with full return to baseline level occurring only after 16 min of recovery. Between-subject correlations between hematocrit and hemodynamic activity were low. Aggregate within-subject coefficients were more impressive; the temporal profile of hematocrit correlated significantly with all hemodynamic variables. Similar within-subject analyses indicated that whereas cardiac contractility was correlated with hematocrit both during stress-related increase and subsequent recovery, blood pressure was related to hematocrit only during the increase. This suggests that stress-induced hemoconcentration may driven by different mechanisms than those which underlie its recovery.
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Affiliation(s)
- Dolf de Boer
- Behavioural Medicine Group, School of Sport and Exercise Sciences, University of Birmingham, B15 2TT Birmingham, UK.
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Veldhuijzen van Zanten JJCS, Ring C, Carroll D, Kitas GD. Increased C reactive protein in response to acute stress in patients with rheumatoid arthritis. Ann Rheum Dis 2005; 64:1299-304. [PMID: 15708880 PMCID: PMC1755638 DOI: 10.1136/ard.2004.032151] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess the effects of acute stress on inflammatory, haemostatic, rheological, and haemodynamic activity in patients with rheumatoid arthritis (RA) in comparison with patients with osteoarthritis (OA). METHODS 21 patients with RA and 10 with OA underwent a brief mental stress task while standing. Inflammatory, haemostatic, rheological, and haemodynamic variables were measured at baseline, during the task, and at recovery. RESULTS At baseline, erythrocyte sedimentation rate and fibrinogen were higher in RA than OA. White blood cell count, fibrinogen, blood pressure, and pulse rate increased, whereas prothrombin time and plasma volume decreased during the task in both patient groups. The stress task increased C reactive protein (CRP) only in patients with RA, and more specifically in those patients with RA with high disease activity. CONCLUSIONS The increase in the inflammatory marker CRP, which was specific to patients with RA, combined with the haemostatic, rheological, and haemodynamic reactions to the stress task, over and above the already high baseline levels, could underlie the increased risk for myocardial infarction in this vulnerable patient group.
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