Mental stress reduced the pre-ejection period by 9.6 ms in young healthy subjects and by 6.4 ms in aging subjects with coronary artery disease, with no statistically significant difference in stress reactivity between the groups.
Observational (n=50)
No
Does mental arithmetic stress alter autonomic reactivity (PEP and HF HRV) differently in young healthy subjects compared to aging subjects with coronary artery disease?
Mental stress induces sympathetic activation regardless of age or CAD status, but parasympathetic withdrawal is more consistently observed in aging patients with CAD, suggesting impaired autonomic regulation.
Absolute Event Rate: -9.6% vs -6.4%
p-value: p=>0.05
BACKGROUND: The autonomic response to acute emotional stress can be highly variable, and pathological responses are associated with increased risk of adverse cardiovascular events. We evaluated the autonomic response to stress reactivity of young healthy subjects and aging subjects with coronary artery disease to understand how the autonomic stress response differs with aging. METHODS: Physiologic reactivity to arithmetic stress in a cohort of 25 young, healthy subjects ( 55 years) with CAD was evaluated using electrocardiography, impedance cardiography, and arterial pressure recordings. Stress-related changes in the pre-ejection period (PEP), which measures sympathetic activity, and high frequency heart rate variability (HF HRV), which measures parasympathetic activity, were analyzed as primary outcomes. RESULTS: Mental stress reduced PEP in both groups (p<0.01), although the decrease was 50% greater in the healthy group. Mean HF HRV decreased significantly in the aging group only (p = 0.01). DISCUSSION: PEP decreases with stress regardless of health and age status, implying increased sympathetic function. Its decline with stress may be attenuated in CAD. The HF HRV (parasympathetic) stress reactivity is more variable and attenuated in younger individuals; perhaps this is related to a protective parasympathetic reflex. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02657382.
Gurel et al. (2019) conducted an observational in Coronary artery disease (n=50). Mental stress (arithmetic stress) vs. Rest was evaluated on Change in pre-ejection period (PEP) from rest to mental stress (ms) (p=>0.05). Mental stress reduced the pre-ejection period by 9.6 ms in young healthy subjects and by 6.4 ms in aging subjects with coronary artery disease, with no statistically significant difference in stress reactivity between the groups.
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