Rate of rise in diastolic blood pressure influences vascular sympathetic response to mental stress
Key result
Negative MSNA responders to mental stress exhibited a significantly greater rate of rise in diastolic blood pressure compared with positive responders (1.3 vs 0.4 mmHg/s; P=0.03).
Why the study?
Does the early blood pressure response to mental stress differ between positive and negative muscle sympathetic nerve activity responders in healthy young males?
Population
21 healthy young males
Comparison
2 min mental stressors and physical stressors vs Positive vs negative responders
Design
Other
Authors
Discussion
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Implication
Differential BP reactivity by MSNA phenotype merits exploration in stress hypertension; leaves open clinical relevance pending prospective validation.
Key Points
- This study investigates how the rate of rise in diastolic blood pressure during mental stress affects muscle sympathetic nerve activity responses.
- 21 healthy young males were assessed during mental and physical stressors including mental arithmetic and cold pressor tasks.
- Participants were classified as positive or negative responders based on changes in muscle sympathetic nerve activity (MSNA).
- Changes in blood pressure and MSNA were recorded continuously and compared between the responder groups.
- Negative responders had a significantly higher rate of rise in diastolic blood pressure (1.3 ± 0.5 mmHg s−1) compared to positive responders (0.4 ± 0.1 mmHg s−1; P = 0.03) during mental arithmetic.
- Similar results for the Stroop test indicated that rapid diastolic pressure rise is linked to MSNA reduction in negative responders.
- Physical stressors caused similar increases in both blood pressure and MSNA regardless of responder classification.
Study Design
Type
Observational (n=21)
Structured PICO
Does the early blood pressure response to mental stress differ between positive and negative muscle sympathetic nerve activity responders in healthy young males?
P
Population
21 healthy young males undergoing 2-minute mental and physical stressors to evaluate blood pressure and muscle sympathetic nerve activity responses.
E
Exposure
2 min mental stressors (mental arithmetic, Stroop test) and physical stressors (cold pressor, handgrip exercise, post-exercise ischaemia)
C
Comparator
Positive vs negative responders (classified according to the direction of the mean change in muscle sympathetic nerve activity during stressor tasks)
O
Outcome
Early blood pressure response (peak changes, time of peak, and rate of changes in blood pressure)surrogate
Main Result
Absolute Event Rate: 1.3% vs 0.4%
p-value: p=0.03
The direction of muscle sympathetic nerve activity change during mental stress appears to be dependent upon the early rate of rise in diastolic blood pressure, suggesting a baroreflex-mediated mechanism.
Cite This Study
Sayed et al. (2016) conducted an observational in Healthy (n=21). Negative MSNA response to mental stress vs. Positive MSNA response to mental stress was evaluated on Rate of rise in diastolic blood pressure in the first minute of mental arithmetic (p=0.03). Negative MSNA responders to mental stress exhibited a significantly greater rate of rise in diastolic blood pressure compared with positive responders (1.3 vs 0.4 mmHg/s; P=0.03).