It is known that psychological stress is already associated with heart disease.
In a new study, researchers found stress-induced problems with blood flow in the heart can also be found in blood vessels in the rest of the body.
The research was conducted by a team from Emory University School of Medicine.
The hypothesized mechanism underlying the link between stress and cardiovascular events is a stress-induced impairment in how the endothelial lining of blood vessels, which helps vessels relax and adjust to changes in blood flow, functions.
The team found the presence of this defect can predict the likelihood of future adverse heart events in patients with coronary artery disease (CAD).
They studied 569 people with known CAD who were asked to undergo a mental stress test consisting of public speaking on an uncomfortable topic.
After the mental stress test, 360 of them displayed transient endothelial dysfunction.
Over the next three years, those with transient dysfunction showed a 78% higher risk for major adverse cardiovascular events (heart attacks, hospitalizations for heart failure, or heart death).
The team says the stress-induced change in endothelial function was valuable in predicting patient outcomes, over and above a list of other risk factors.
Psychological stress is thought to affect blood vessels via the sympathetic nervous system.
Researchers observed that patients on beta-blockers, which control activation of the sympathetic nervous system, were less likely to display stress-induced transient endothelial function.
This suggests possible avenues for clinical or behavioral interventions that may mitigate the effects of the stress response on blood vessels and ultimately the heart.
This is the first study to show the prognostic value of transient endothelial dysfunction induced by mental stress in patients with coronary artery disease.
The lead author of the study is Viola Vaccarino, MD, Ph.D., Wilton Looney professor of cardiovascular research.
The study is published in JAMA Cardiology.
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