What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Essential hypertension (n=58). Intervention: Mental stress vs. Healthy normotensive subjects. Primary outcome: Percent change in carotid artery diameter in response to mental stress (p=<0.0001).

What does this research mean for the field?

Mental stress induces carotid artery vasodilation and increased cerebral blood flow in healthy individuals, but this cerebrovascular reactivity is absent or impaired in patients with essential hypertension. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 3, 2009Cardiovascular UltrasoundOpen Access

Cerebrovascular mental stress reactivity is impaired in hypertension

Q: What are the key findings of this study?

Mental stress produced carotid artery vasodilation in healthy subjects (5% increase) but this response was absent in hypertensive subjects (-2% change), indicating impaired cerebrovascular endothelial function.

Q: What does this research mean for the field?

Mental stress induces carotid artery vasodilation and increased cerebral blood flow in healthy individuals, but this cerebrovascular reactivity is absent or impaired in patients with essential hypertension. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Mental stress fails to induce carotid vasodilation in hypertensives, indicating impaired cerebrovascular endothelial function.

P<0.0001
n=58

Why the study?

Does mental stress induce different carotid artery vasodilation and blood flow responses in hypertensive patients compared to healthy volunteers?

Population

58 subjects including 10 young healthy volunteers, 20 older healthy volunteers, and 28 patients with…

Comparison

Mental stress vs Healthy volunteers and baseline measurements…

Design

Cross-sectional

Follow-up

3 minutes after mental stress

Authors

TNTasneem Z. NaqviCardiac Imaging HHHanh K Hyuhn

Discussion

Member takes

Implication

May indicate cerebrovascular endothelial dysfunction in hypertension; hypothesis-generating for prognostic and therapeutic studies.

Study Design

Type

Cross-Sectional (n=58)

Blinding

Single-blind

Multicenter

Structured PICO

Does mental stress induce different carotid artery vasodilation and blood flow responses in hypertensive patients compared to healthy volunteers?

Population

58 adults, including 30 healthy volunteers and 28 patients with essential hypertension, evaluated for carotid artery reactivity to mental stress.

Intervention

Mental stress (Stroop color word conflict, math or anger recall tests)

Comparator

Healthy volunteers (young and older) and baseline measurements before mental stress

Outcome

Carotid artery (CA) endothelium-dependent vasodilation and blood flow in response to mental stresssurrogate

Main Result

Absolute Event Rate: -2% vs 5%

p-value: p=<0.0001

Mental stress-induced carotid artery vasodilation and flow reserve are attenuated in hypertension, suggesting cerebral vascular endothelial dysfunction.

Limitations

Small sample size
Potential residual effects of antihypertensive medications despite 24-hour washout
Lack of continuous imaging of the carotid artery during mental stress due to speech interference
Lack of an operator-independent, automatic method to assess IMT and CA reactivity
Did not measure local NO release or effect of NO inhibitor
Did not measure lipid profile at the time of the study

Cite This Study

Naqvi et al. (2009) conducted a cross-sectional in Essential hypertension (n=58). Mental stress vs. Healthy normotensive subjects was evaluated on Percent change in carotid artery diameter in response to mental stress (p=<0.0001). Mental stress produced carotid artery vasodilation in healthy subjects (5% increase) but this response was absent in hypertensive subjects (-2% change), indicating impaired cerebrovascular endothelial function.

synapsesocial.com/papers/6aa74207bb64cafef81b3bfc https://doi.org/10.1186/1476-7120-7-32

Topics

Hypertension management

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July 3, 2009Cardiovascular UltrasoundOpen Access

Cerebrovascular mental stress reactivity is impaired in hypertension

View Full Paper

Ask AI

Bookmark

Key result

Mental stress fails to induce carotid vasodilation in hypertensives, indicating impaired cerebrovascular endothelial function.

P<0.0001
n=58

Why the study?

Does mental stress induce different carotid artery vasodilation and blood flow responses in hypertensive patients compared to healthy volunteers?

Population

58 subjects including 10 young healthy volunteers, 20 older healthy volunteers, and 28 patients with…

Comparison

Mental stress vs Healthy volunteers and baseline measurements…

Design

Cross-sectional

Follow-up

3 minutes after mental stress

Authors

TNTasneem Z. NaqviCardiac Imaging HHHanh K Hyuhn

Discussion

Member takes

Implication

May indicate cerebrovascular endothelial dysfunction in hypertension; hypothesis-generating for prognostic and therapeutic studies.

Study Design

Type

Cross-Sectional (n=58)

Blinding

Single-blind

Multicenter

Structured PICO

Does mental stress induce different carotid artery vasodilation and blood flow responses in hypertensive patients compared to healthy volunteers?

Population

58 adults, including 30 healthy volunteers and 28 patients with essential hypertension, evaluated for carotid artery reactivity to mental stress.

Intervention

Mental stress (Stroop color word conflict, math or anger recall tests)

Comparator

Healthy volunteers (young and older) and baseline measurements before mental stress

Outcome

Carotid artery (CA) endothelium-dependent vasodilation and blood flow in response to mental stresssurrogate

Main Result

Absolute Event Rate: -2% vs 5%

p-value: p=<0.0001

Mental stress-induced carotid artery vasodilation and flow reserve are attenuated in hypertension, suggesting cerebral vascular endothelial dysfunction.

Limitations

Small sample size
Potential residual effects of antihypertensive medications despite 24-hour washout
Lack of continuous imaging of the carotid artery during mental stress due to speech interference
Lack of an operator-independent, automatic method to assess IMT and CA reactivity
Did not measure local NO release or effect of NO inhibitor
Did not measure lipid profile at the time of the study

Cite This Study

synapsesocial.com/papers/6aa74207bb64cafef81b3bfc https://doi.org/10.1186/1476-7120-7-32

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Topics

Hypertension management

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