Stress-induced pulse pressure change predicts women's carotid atherosclerosis

• Published in: Stroke (1970) Vol. 29; no. 8; pp. 1525 - 1530
• Main Authors: MATTHEWS, K. A, OWENS, J. F, KULLER, L. H, SUTTON-TYRRELL, K, LASSILA, H. C, WOLFSON, S. K
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.08.1998; American Heart Association, Inc
• Subjects: Arteriosclerosis - diagnostic imaging; Arteriosclerosis - epidemiology; Arteriosclerosis - physiopathology; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiovascular System - physiopathology; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases - physiopathology; Female; Heart Rate; Humans; Medical sciences; Middle Aged; Postmenopause; Predictive Value of Tests; Risk Factors; Stress, Psychological - physiopathology; Ultrasonography; Vascular disease; Human; Carotid; Atherosclerosis; Risk factor; Postmenopause; Cardiovascular disease; Exploration; Female; Stress
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.str.29.8.1525

Individuals who exhibit large increases in blood pressure and heart rate during mental stress may be at risk for accelerated atherosclerosis. This report evaluates the association between stress-induced hemodynamic responses and carotid atherosclerosis in 254 healthy postmenopausal women. The magnitude of change in blood pressure and heart rate from rest to public speaking and mirror image tracing, two stressful tasks, was measured. Average intima-media thickness (IMT) and focal plaque in the common carotid artery, bulb, and internal carotid artery were measured with the use of duplex ultrasonography on average 2.3 years later. The average IMT was 0.77 mm, with a range of 0.60 to 1.37; 52.5% had at least one plaque. Correlational analysis showed that greater IMT was associated with greater pulse pressure change during mental stress (r = 0.17, P < 0.01). Statistical adjustments for possible confounders (age, hormone replacement therapy use, resting pulse pressure, smoking status, and triglyceride levels) did not alter the results. The plaque index was associated with greater pulse pressure change during the mirror image tracing task (odds ratio = 1.47, P = 0.01) for women with a plaque score of > or = 2 versus 1 or 0, adjusted for possible confounders. Mental stress-induced pulse pressure changes may influence the development of early atherosclerosis in the carotid artery of women. Widening of pulse pressure during stress, as well as at rest, may be a marker of compromised compliance in the vessel wall.