What is the clinical evidence from this study?

Study design: RCT. Intervention: Mental stress and emotional stress (negative pictures) vs. Neutral pictures. Primary outcome: Mean arterial pressure (MAP), heart rate (HR), muscle sympathetic nerve activity (MSNA), and perceived stress levels (p=<0.001).

September 10, 2008AJP Regulatory Integrative and Comparative PhysiologyOpen Access

Neural and cardiovascular responses to emotional stress in humans

Q: What are the key findings of this study?

Mental stress significantly increased mean arterial pressure and heart rate (P<0.001), whereas emotional stress from negative pictures did not, and neither condition altered MSNA.

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Key result

Mental stress significantly increased mean arterial pressure and heart rate (P<0.001), whereas emotional stress from negative pictures did not, and neither condition altered MSNA.

Why the study?

Does emotional stress evoked by negative pictures increase cardiovascular and sympathetic neural responses compared to neutral pictures in healthy men?

Population

18 healthy male subjects, mean age 22 ± 2 years, nonsmokers, not taking any medication

Comparison

Viewing negative pictures and mental arithmetic… vs Viewing neutral pictures for 3 minutes

Design

Other, randomized order of the three trials

Authors

Jason R. CarterCross-Cutting Cardiology JDJohn J. DurocherPurdue University Northwest RKRosalie P. KernMichigan Technological University

Discussion

Member takes

Implication

Negative emotional images do not increase MAP or HR in healthy men; leaves open sympathetic responses in clinical populations.

Study Design

Type

RCT (n=18)

Randomization

Randomized order of trials

Structured PICO

Does emotional stress evoked by negative pictures increase cardiovascular and sympathetic neural responses compared to neutral pictures in healthy men?

Population

18 men evaluated for neural and cardiovascular responses during randomized trials of neutral pictures, negative pictures, and mental stress.

Intervention

Viewing negative pictures (emotional stress) and mental arithmetic (mental stress), each for 3 minutes

Comparator

Viewing neutral pictures for 3 minutes

Outcome

Changes in mean arterial pressure (MAP), heart rate (HR), muscle sympathetic nerve activity (MSNA), and perceived stress levelssurrogate

Main Result

p-value: p=<0.001

Mental stress, but not emotional stress from negative pictures, elicits robust increases in heart rate and blood pressure, and perceived stress levels do not appear to modulate muscle sympathetic nerve activity.

Limitations

Stressors (mental arithmetic vs. negative pictures) were not of comparable intensity
Small sample size insufficient to classify responders vs nonresponders

Cite This Study

Carter et al. (2008) reported an RCT. Mental stress and emotional stress (negative pictures) vs. Neutral pictures was evaluated on Mean arterial pressure (MAP), heart rate (HR), muscle sympathetic nerve activity (MSNA), and perceived stress levels (p=<0.001). Mental stress significantly increased mean arterial pressure and heart rate (P<0.001), whereas emotional stress from negative pictures did not, and neither condition altered MSNA.

synapsesocial.com/papers/6a231bbe4067f161e4fb16f4 https://doi.org/10.1152/ajpregu.90646.2008

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