Why the study?
Does local beta-blockade, alpha-blockade, or neurogenic blockade prevent mental stress-induced impairment of endothelial vasodilatory function in young healthy volunteers?
Does local beta-blockade, alpha-blockade, or neurogenic blockade prevent mental stress-induced impairment of endothelial vasodilatory function in young healthy volunteers?
Mental stress impairs endothelial vasodilatory function via a beta-adrenergic mechanism, which can be prevented by local beta-blockade or neurogenic blockade.
Local beta-blockade may mitigate mental stress effects on endothelial function in healthy volunteers; extends mechanistic understanding but leaves open clinical translation.
Mental stress has been shown to impair endothelium-dependent vasodilation (EDV) in the human forearm. The aim of this study was to investigate if this response could be blunted by local infusions of beta-blockade (propranolol), alpha-blockade (phentolamine), or neurogenic blockade. Thirty-one young healthy volunteers underwent forearm blood flow (FBF) measurements, using venous occlusion plethysmography, during local intra-arterial infusions of metacholine (MCh; inducing EDV) and sodium nitroprussid (SNP; inducing endothelial-independent vasodilation [EIDV]), respectively. These measurements were repeated during a 5-min mental arithmetic stress test without (n = 8) or with concomitant local infusion of propranolol (n = 7) or phentolamine (n = 8) in the forearm or during axillary plexus blockade (n = 8). An index of endothelial vasodilatory function (EFI) was calculated as the EDV to EIDV ratio. Mental stress impaired EDV significantly (p < .05), and as a result, EFI was significantly reduced (p = .02). This effect on EFI could be blocked by propranolol and neurogenic blockade but not by phentolamine (p < .05). Thus, impairment of endothelial vasodilatory function induced by mental stress could be blocked by beta-adrenergic, but not alpha-adrenergic, receptor blockade.
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Eriksson et al. (2007) studied this question.
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