Putative mechanisms Underlying Myocardial infarction onset and Emotions (PUME): a randomised controlled study protocol

Translational Research of the Acute Effects of Negative Emotions on Vascular Endothelial Health: Findings From a Randomized Controlled Study

BACKGROUND

Provoked anger is associated with an increased risk of cardiovascular disease events. The underlying mechanism linking provoked anger as well as other core negative emotions including anxiety and sadness to cardiovascular disease remain unknown. The study objective was to examine the acute effects of provoked anger, and secondarily, anxiety and sadness on endothelial cell health.

METHODS AND RESULTS

Apparently healthy adult participants (n=280) were randomized to an 8-minute anger recall task, a depressed mood recall task, an anxiety recall task, or an emotionally neutral condition. Pre-/post-assessments of endothelial health including endothelium-dependent vasodilation (reactive hyperemia index), circulating endothelial cell-derived microparticles (CD62E+, CD31+/CD42-, and CD31+/Annexin V+) and circulating bone marrow-derived endothelial progenitor cells (CD34+/CD133+/kinase insert domain receptor+ endothelial progenitor cells and CD34+/kinase insert domain receptor+ endothelial progenitor cells) were measured. There was a group×time interaction for the anger versus neutral condition on the change in reactive hyperemia index score from baseline to 40 minutes (P=0.007) with a mean±SD change in reactive hyperemia index score of 0.20±0.67 and 0.50±0.60 in the anger and neutral conditions, respectively. For the change in reactive hyperemia index score, the anxiety versus neutral condition group by time interaction approached but did not reach statistical significance (P=0.054), and the sadness versus neutral condition group by time interaction was not statistically significant (P=0.160). There were no consistent statistically significant group×time interactions for the anger, anxiety, and sadness versus neutral condition on endothelial cell-derived microparticles and endothelial progenitor cells from baseline to 40 minutes.

CONCLUSIONS

In this randomized controlled experimental study, a brief provocation of anger adversely affected endothelial cell health by impairing endothelium-dependent vasodilation.

Associations Between Habitual Sedentary Behavior and Endothelial Cell Health

Endothelial dysfunction is a mechanism that may explain the link between prolonged sedentary time and cardiovascular disease. However, the relation between habitual sedentary behavior (SED) and endothelial function has yet to be explored.

Purpose-

The purpose of this study was to examine the association of accelerometer-measured SED with markers of endothelial cell health.

Methods-

Healthy adult participants (n=83; 43.4% male; 25.5 ± 5.8 years old) were examined. SED was measured for 7-days by accelerometer. Endothelial function measures included endothelium-dependent vasodilation (EDV); endothelial microparticles (EMPs) [CD62E+ and CD31+/CD42- EMPs]; and endothelial progenitor cells (EPCs) [CD34+/CD133+/KDR+ and CD34+/KDR+EPCs]. Participants were classified as having low or high SED based on a median split.

Results-

Participants in the low and high SED group spent a mean ± SD of 8.6 ± 1.1 and 11.1 ± 1.0 h/day in SED, respectively. No significant differences between the low and high SED groups were detected in mean [95% confidence interval (CI)] EDV (2.51 [2.21-2.81] vs. 2.36 [2.07-2.64], p=0.50), EMPs (CD62E+: 6.70 [6.55-6.84] vs. 6.56 [6.42-6.69], p=0.20; CD31+/CD42‒: 6.26 [6.10-6.42] vs. 6.18 [6.03-6.33], p=0.50), or EPCs (CD34+/KDR+: 11.91 [9.23-14.48]×10^-2 vs. 14.87 [12.41-17.32]×10^-2, p=0.13); CD34+/CD133+/KDR+: 1.84 [1.28-2.39]×10^-2 vs. 2.17 [1.64-2.70]×10^-2, p=0.43).

Conclusions-

Among healthy adults, habitual SED was not associated with markers of endothelial cell health.