State anxiety is associated with cardiovascular reactivity in young, healthy african americans

Changes in vitality in response to acute stress: an investigation of the role of anxiety and physiological reactivity

Background: Feeling alive and invigorated, or vitality, is examined within the framework of a stress paradigm. The current study investigated whether endocrine and cardiovascular responses to acute psychological stress predict declines in vitality.Methods: A sample of 90 undergraduate students completed an in-lab stressor. We measured anxiety, state vitality, cortisol levels, heart rate, and blood pressure before the task, and measured changes in state vitality, cortisol, heart rate, and blood pressure in response to the stressor. We investigated whether pre-task anxiety predicted changes in state vitality, and whether such changes were explained by physiological responses.Results: Results indicate that cognitive and somatic anxiety preceding a stressor predict changes in vitality, which is mediated by the magnitude of diastolic (95% CI [0.017, 0.517]; [0.006, 0.454]) and systolic (95% CI [0.038, 0.705]) blood pressure responses to the task. Cortisol reactivity was associated with somatic anxiety (F(6, 83) = 3.34, p < .01, β = 0.401) but was not related to changes in vitality.Conclusions: Together, these results contribute to the understanding of how physiological reactivity to a stressor can deplete vitality.

MRI-related anxiety can induce slow BOLD oscillations coupled with cardiac oscillations

OBJECTIVE

Although about 1-2% of MRI examinations must be aborted due to anxiety, there is little research on how MRI-related anxiety affects BOLD signals in resting states.

METHODS

We re-analyzed cardiac beat-to beat interval (RRI) and BOLD signals of 23 healthy fMRI participants in four resting states by calculation of phase-coupling in the 0.07-0.13 Hz band and determination of positive time delays (pTDs; RRI leading neural BOLD oscillations) and negative time delays (nTDs; RRI lagging behind vascular BOLD oscillations). State anxiety of each subject was assigned to either a low anxiety (LA) or a high anxiety (HA, with most participants exhibiting moderate anxiety symptoms) category based on the inside scanner assessed anxiety score.

RESULTS

Although anxiety strongly differed between HA and LA categories, no significant difference was found for nTDs. In contrast, pTDs indicating neural BOLD oscillations exhibited a significant cumulation in the high anxiety category.

CONCLUSIONS

Findings may suggest that vascular BOLD oscillations related to slow cerebral blood circulation are of about similar intensity during low/no and elevated anxiety. In contrast, neural BOLD oscillations, which might be associated with a central rhythm generating mechanism (pacemaker-like activity), appear to be significantly intensified during elevated anxiety.

SIGNIFICANCE

The study provides evidence that fMRI-related anxiety can activate a central rhythm generating mechanism very likely located in the brain stem, associated with slow neural BOLD oscillation.

Cardiovascular Reactivity to Acute Mental Stress: THE IMPORTANCE OF TYPE D PERSONALITY, TRAIT ANXIETY, AND DEPRESSION SYMPTOMS IN PATIENTS AFTER ACUTE CORONARY SYNDROMES

PURPOSE

Links between psychophysiological reactions to stress stimuli and perceived mental distress, including type D personality, anxiety, and depression, are still under debate. The aim of this study was to examine associations between cardiovascular reactivity to social stress and mental distress in patients after acute coronary syndrome.

METHODS

Patients (n = 116, 86% males, 52 ± 8 yr) with coronary artery disease 2 wk after acute coronary syndrome were evaluated for sociodemographic, clinical characteristics and coronary artery disease risk factors. The Trier Social Stress Test was employed to measure cardiovascular reactions to social stress (systolic and diastolic blood pressure and heart rate). Mental distress assessment included type D personality (Type D Scale), anxiety and depressive symptoms (Hospital Anxiety and Depression Scale), and state and trait anxiety (State-Trait Anxiety Inventory).

RESULTS

Multiple linear regression analysis showed associations between type D personality and lower heart rate during Trier Social Stress Test periods of task instruction (β = -.196, P < .04), preparation time (β = -.232, P < .01), and recovery time (β = -.209, P < .029). Higher trait anxiety was linked with lower heart rate during baseline rest (β = -.287, P < .01), task instruction (β = -.286, P < .01), preparation time (β = -.241, P < .01), and recovery period (β = -.209, P < .05). Depressive symptoms were associated with higher systolic blood pressure during baseline rest (β =.187, P < .05), task instruction (β = .306 P < .01), and free speech (β = .264, P < .05).

CONCLUSIONS

Mental distress was associated with cardiovascular stress reactions independent from possible covariates, suggesting dysregulated psychophysiological reactions to acute stress.

The Maastricht Acute Stress Test (MAST): Physiological and Subjective Responses in Anticipation, and Post-stress

The Maastricht Acute Stress Test (MAST) is designed to be a simple, quick, and non-invasive procedure aimed at activating the human stress system. The MAST has been developed by combining elements from two of the most common experimental paradigms measuring stress, the Trier Social Stress Test and the Cold Pressor Test. The aim of this study was to use the MAST procedure to elicit strong autonomic and subjective stress responses that can be quantified in terms of (systolic and diastolic) blood pressure, pulse rate (PR), and state anxiety ratings. In healthy individuals, the MAST induced a significant elevation of systolic blood pressure (SBP) from baseline for up to 30 min post-MAST, while diastolic blood pressure (DBP) dropped to baseline within 10 min post-MAST. Interestingly, the presentation of instructions alerting participants to the procedure resulted in significant elevation of both SBP and DBP above baseline. However, BP measurements prior to test initiation were not as high as those measured immediately after the MAST procedure. PR data showed limited variability across time points. Self-reported state anxiety increased dramatically from baseline to immediately following the MAST procedure. Further, individuals who reported higher levels of depression and stress were more likely to demonstrate larger increases in SBP in response to the MAST. Together, these results support the use of the MAST as a useful tool to activate both acute physiological and subjective measures of the stress response in healthy adults lasting up to 30 min.

Symptoms of anxiety and depression are related to cardiovascular responses to active, but not passive, coping tasks

Objective:

Anxiety and depression have been linked to blunted blood pressure (BP) and heart rate (HR) reactions to mental stress tests; however, most studies have not included indices of underlying hemodynamics nor multiple stress tasks. This study sought to examine the relationships of anxiety and depression with hemodynamic responses to acute active and passive coping tasks.

Methods:

A total of 104 participants completed the Hospital Anxiety and Depression Scales and mental arithmetic, speech, and cold pressor tasks while BP, HR, total peripheral resistance, and cardiac output (CO) were assessed.

Results:

After adjustment for traditional risk factors and baseline cardiovascular activity, depression scores were negatively associated with systolic BP, HR, and CO responses to the mental arithmetic task, while anxiety scores were inversely related to the systolic BP response to mental arithmetic.

Conclusion:

High anxiety or depression scores appear to be associated with blunted cardiac reactions to mental arithmetic (an active coping task), but not to the cold pressor test or speech tasks. Future research should further examine potential mechanisms and longitudinal pathways relating depression and anxiety to cardiovascular reactivity.

Clinical trial registration number:

TCTR20160208004

Raiva, Stress Emocional e Hipertensão: Um Estudo Comparativo

RESUMO O estudo teve como objetivo investigar uma possível associação entre direção de expressão de raiva e stress em pessoas com hipertensão a partir da comparação com pessoas sem esse diagnóstico. Foram avaliados 112 participantes: 56 com hipertensão e 56 normotensos, pareados por escolaridade, gênero e faixa etária. Os instrumentos utilizados foram o Inventário de Sintomas de Stress para Adultos de Lipp e o Inventário de Expressão de Raiva como Estado e Traço. Participantes com hipertensão apresentaram 9,7 vezes mais chances de estarem estressados que normotensos (OR=9,7; IC95%:4,0-23,5) e 19 vezes mais chances de expressarem raiva para dentro (OR=19; IC95%:5,3-68).

Association of Type D personality with the autonomic and hemodynamic response to the cold pressor test

Mechanisms relating Type D personality to poor health are largely unknown, with autonomic nervous system function being a candidate. This study examined the physiologic response to cold stress. Undergraduates (N = 101, 84% female) underwent a cold pressor test. An electrocardiogram, impedance cardiogram, and blood pressure were recorded. Type D personality was assessed by self-report questionnaire. Type D was associated with increased systolic and diastolic blood pressure reactivity. Exploratory analyses showed Type D men to respond with increased respiratory sinus arrhythmia (i.e., higher parasympathetic activity), and decreased pre-ejection period (i.e., larger sympathetic activity), while Type D women showed a reciprocal response pattern. In conclusion, Type D personality was associated with an exaggerated hemodynamic response to cold stress, which may contribute to an increased risk of hypertension in Type D individuals.