Stress, sleep disorders and vitamin D deficiency: associations with endothelial dysfunction, circadian blood pressure profile and early myocardial impairment in individuals with high occupational stress

Aim . To evaluate associations of psychoemotional stress, sleep quality, and vitamin D status with endothelial dysfunction, circadian blood pressure profile and early left ventricular myocardial impairment in individuals exposed to high occupational stress stratified by the presence of cardiovascular pathology. Material and methods . This cross-sectional study included 180 men aged 18 to 42 years: individuals with subclinical cardiovascular changes (n=40), and apparently healthy controls (n=50). Perceived stress and sleep quality were assessed; serum 25(OH)D and endothelin-1 were measured. Ambulatory blood pressure monitoring, standard echocardiography and two-dimensional speckle-tracking echocardiography were performed. Results. Group 1 demonstrated greater stress, poorer sleep, lower 25(OH)D, higher endothelin-1 and less negative global longitudinal strain than controls (p<0,05). A non-dipper profile was found in 49 (54,4%) participants in group 1, 7 (17,5%) in group 2, and none in controls (p<0,001). Serum 25(OH)D was inversely correlated with endothelin-1 levels (r=-0,64; p<0,001), and perceived stress (r=-0,41; p<0,01). Vitamin D deficiency was associated with endothelial dysfunction (odds ratio =3,7; 95% confidence interval: 2,0-6,8; p<0,001). Conclusion . Psychoemotional stress and sleep disturbances are associated with an adverse circadian blood pressure profile, vitamin D deficiency, endothelial dysfunction and early myocardial impairment. Vitamin D deficiency is associated with endothelial dysfunction, but the findings do not establish an independent causal effect.