Effect on heart rate and blood pressure after mental stress in coronary artery disease patients and normal individuals
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Abstract:
Introduction: Cardiovascular diseases are the leading cause of death in almost every region of the world. One of the major risk factors for coronary artery disease is stress. The study was carried out to find the effect of mental stress on heart rate and blood pressure in coronary artery disease patients and in their age-matched normal counterparts.
Materials and methods: Blood pressure and heart rate were recorded before and immediately after standardized mental stress (mental calculation for a minute) after necessary instruction among the volunteers (n=100, 50 coronary artery disease patients and 50 control, age 40-80 years) and then analyzed.
Results: The mean HR was 75.40/min and the mean SBP was 121.84 mmHg of patient before stress which increased to 80.26/min (HR) and 135.12 mmHg (SBP) after stress. Similarly, the mean HR was 76.72/min and SBP was 116.24 mmHg before stress which increased to 80.5/min (HR) and 121.56 mmHg (SBP) after stress in normal individual. The result of the study showed mental stress induced rise in heart rate and blood pressure in both the groups. Nevertheless, mental stress induced increase in systolic blood pressure in patients exhibited higher than that of their aged-matched normal counterparts (p<0.05).
Conclusions: The incidence of coronary artery disease is increasing day by day in the modern society. The measurement of heart rate and blood pressure (casual and mental stress induced) may help the clinicians to predict/screen coronary artery disease, especially the silent ones, and can prevent sudden angina pain.Keywords:
Mental stress
Circadian patterns of heart rate, systolic and diastolic blood pressure, and rate-pressure product were compared in elders with heart disease (N = 22, mean age 86 years) and a comparison group (N = 18, mean age 80 years) who did not have a cardiac diagnosis. For 4 consecutive days, automated measures of heart rate, diastolic and systolic blood pressure, and rate-pressure product were taken every 2 hours while subjects were awake. Activity-rest patterns were recorded by an observer, and demographic and medication profiles were obtained. Data were subjected to cosinor analysis, and the groups were compared on rhythmic parameters. Although the cardiac subjects were older, in poorer health, less active, and more prone to daytime napping, they exhibited more rhythms in rate-pressure product than did the comparison subjects. The cardiac group also had more synchronized oscillation of overt heart rate and systolic blood pressure rhythms. These results can be attributed to standardized times of cardiac medication administration. Attention to patterns of heart rate and systolic blood pressure in elders may suggest more appropriate times of day for conducting individual cardiac assessments.
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The goal of this study was to evaluate the changes in blood pressure (BP) and heart rate variability (HRV) parameters due to a mental load. The findings indicate that mental arithmetic stress causes prompt increases in BP, heart rate and induced decreases in HRV. A shift toward an increase in sympathetic tone and changes in Poincare plot measures were observed during mental stress. The present study demonstrates that mental stress leads to an increase in predictability, regularity of the RR intervals and decreased value of complexity measures, that reflects a change towards more stable and periodic behavior of the heart rate under stress. Linear Discriminant Analysis shows that CCM and SampEn achieving the best results in detecting stress condition, and the latter indicates that chaos being inherent to the physiological control of heart rate.
Mental stress
Predictability
Poincaré plot
Mental arithmetic
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Aim: To determine whether orally delivered instructions can modify the intensity and direction of blood pressure and heart rate fluctuation. Methods: The blood pressure of 120 subjects, 60 hypertensive and 60 normotensive, was measured before and after oral instructions. The normotensive subjects were selected from a sample of university students and the hypertensive patients were selected at a routine medical screening. Each sample of 60 subjects was randomly divided into four groups of 15. Each subject was left seated alone in a room for 5min. The researcher then measured the subjects' blood pressure and heart rate. Following this, each group of normotensives and hypertensives was told that their blood pressure would diminish, or that it would not change or that it would increase. The control group was given no instructions. After 5 min the blood pressure and heart were measured again. Results: In the normotensive and hypertensive groups who were told that their blood pressure would increase, systolic blood pressure increased by 4.3 and 2.5mmHg, respectively. In the groups who were told that their blood pressure would decrease, systolic pressure fell by 7.8 and 7.4 mmHg, respectively. Those who were told that no change would occur showed a systolic pressure decrease of 3.5 and 1.8 mmHg, respectively. In the control groups systolic blood pressure decreased by 5.6 and 4.2 mmHg, respectively. Conclusions: These results show that oral instructions are a source of variation in the assessment of blood pressure and emphasize the need for 24-h blood pressure monitoring to eliminate this type of variation.
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Vasomotor
Mental stress
Coronary atherosclerosis
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Abstract Little is known about transient effects of foods and nutrients on reactivity to mental stress. In a randomized crossover study of healthy adults ( n = 20), we measured heart rate variability (respiratory sinus arrhythmia), blood pressure, and other hemodynamic variables after three test meals varying in type and amount of fat. Measurements were collected at rest and during speech and cold pressor tasks. There were significant postmeal changes in resting diastolic blood pressure (−4%), cardiac output (+18%), total peripheral resistance (−17%), and interleukin‐6 (−27%). Heart rate variability and hemodynamic reactivity to stress was not affected by meal content. We recommend that future studies control for time since last meal and continue to examine effects of meal content on heart rate variability.
Vagal Tone
Mental stress
Crossover study
Reactivity
Cold pressor test
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We sought to determine if an exercise programme of moderate aerobic intensity would decrease the heart-rate response to mental stress in teenagers with normal hearts. Mental stress testing (50 arithmetic problems) was performed in student volunteers before and after a 5-week period of rigorous aerobic exercise training of 2.5 h for 5 days/week. In the baseline state, the mental stress test increased the heart rate by an average of 20 ± 12 bpm to its observed peak at 30 s of testing (p < 0.001). Exercise training had a significant effect on the maximum heart rate (106 ± 19 vs. 89 ± 13 bpm, p < 0.001) and on the maximum increase in heart rate with mental stress (20 ± 12 pre vs. 9 ± 15 bpm post training, p < 0.001). Mental stress results in a marked heart response consistent with a marked neurohormonal effect. This response is effectively blunted by a 5-week moderately intensive exercise programme. These results should encourage endorsement of a regular exercise programme as an important lifestyle modification for improving maladaptive responses to stress.
Mental stress
Aerobic Exercise
Mental arithmetic
Increased heart rate
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Objective: To test the hypothesis that heavy smoking is associated with a persistent increase in blood pressure Design: In 10 normotensive smokers asked to smoke one cigarette every 15 min for 1 h, blood pressure and heart rate were continuously monitored during the smoking period and during the preceding non-smoking hour. In six other normotensive smokers asked to smoke two cigarettes per hour throughout the whole day, blood pressure and heart rate were monitored non-invasively in ambulatory conditions for 8h (0900—700 h). Blood pressure monitoring was repeated during a non-smoking day Methods: Beat-to-beat blood pressure and heart rate were monitored at rest by means of the Finapres device. Blood pressure signal was sampled at 165 Hz by a computer to calculate hourly data. Ambulatory blood pressure and heart rate were measured once every 10 min Results: In resting conditions, the first cigarette caused an immediate and marked increase in blood pressure and heart rate, and the peak blood pressure and heart rate achieved were similar for the remaining three cigarettes. In each instance, the hemodynamic effects were so prolonged that throughout the smoking hour, blood pressure and heart rate were persistently higher than during the non-smoking hour. The standard deviations of systolic and diastolic blood pressure and heart rate were also higher during the smoking hour, indicating an increase in blood pressure and heart rate variability. In the six ambulant smokers, daytime blood pressure and heart rate were also persistently higher during smoking than during non-smoking Conclusions: Heavy smoking is associated with a persistent rise in blood pressure and also with an increase in blood pressure variability. These effects (which may escape clinic blood pressure measurements performed during non-smoking) may account for some of the smoking-related cardiovascular risk
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Vasomotor
Mental stress
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Though immediate pain is reported by nearly all patients undergoing needle-EMG,little is known about its cardiovascular risk from changes in blood-pressure orheart-rate. This study was thus conducted to investigate if, and to whichdegree, blood-pressure and heart-rate are influenced by needle-EMG. In 50patients, 24 women, 26 men, aged 26–78 years, conventional needle-EMGs from 54muscles were recorded. Pain was assessed on a verbal analogue pain-scale (1–10)and blood-pressure and heart-rate were measured before, during and after EMG.Mean pain-ratings before, during and after EMG were 0.8, 4.1 and 1.0,respectively. Mean systolic/diastolic blood-pressure was 144/87mmHg before,145/86mmHg during and 144/87mmHg after EMG. Mean heart-rate before, during andafter EMG was 77, 77 and 78 beats/min, respectively. Systolic/diastolicblood-pressure increased above 145/85mmHg in only 2/6 patients during EMG. Theweak affection of blood-pressure and heart-rate by pain from needle-EMG wasfound in patients with and without hypertension. Mean blood-pressure, heart-rateand pain-ratings before, during and after EMG were independent of age, sex andmuscle. The correlation between pain-ratings and blood-pressure and heart-ratewas not significant. This study shows that needle-EMG moderately hurts but doesnot increase blood-pressure or heart-rate, irrespective of known arterialhypertension. Based upon these findings, the cardiovascular risk of needle-EMGfrom changes in blood-pressure or heart-rate is regarded negligibly low.
Mean blood pressure
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