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Hemodynamics and Arterial Properties in Response to Mental Stress in Individuals with Mild Hypertension

From College of Nursing, University of Florida, Gainesville, Florida 32610-0187.

Address reprint requests to: Pei-Shan Tsai, PhD, College of Nursing, Taipei Medical University, 250 Wu Hsing St., Taipei, Taiwan 110. Email: ptsai{at}tmu.edu.tw

Received for publication July 1, 2002; revision received October 23, 2002.

OBJECTIVE: The role of tonic sympathetic stimulation on the properties of large arteries is largely unknown. The purpose of this study was to determine the effect of mental stress on hemodynamics and arterial properties in mild hypertensives.

METHOD: Twenty-three subjects with mild hypertension and 19 age-matched normotensives were compared to examine changes in hemodynamics and central arterial wave reflection before, during, and after mental stress.

RESULTS: The results demonstrate an acute effect of mental stress on blood pressure, heart rate, and arterial compliance. The static component (MBP) and the pulsatile (PP) component of arterial pressure increased significantly during mental stress and returned to baseline within a few minutes. Mild hypertensives did not have an increased response to mental stress. For both groups, an increase in HR and a consequent rise in CO were responsible for the increase in BP in response to mental stress. Compared with baseline, both groups demonstrated a decrease in arterial compliance during stress. Mental stress did not induce a significant change in total peripheral vascular resistance nor did it affect central arterial wave reflection in both groups. Individuals with mild hypertension demonstrated higher PP (p < .001), lower arterial compliance (p < .01), and higher AI (p < .05) than those with normal BP.

CONCLUSIONS: Hemodynamic and arterial responses to mental stress in individuals with normal BP and mild hypertension were similar. Several parameters, however, were different in basal state. These differences (ie, higher PP, lower compliance, and higher AI in the mild hypertensive group) could be due to the chronic effect of sympathetic stimulation on central arteries.

Key Words: augmentation index, • arterial properties, • mild hypertension, • hemodynamics, • sympathetic nervous system

Abbreviations: AI = augmentation index;; BP = blood pressure;; CO = cardiac output;; DBP = diastolic blood pressure;; HR = heart rate;; MBP = mean blood pressure;; PP = pulse pressure;; SBP = systolic blood pressure;; SCWT = Stroop Color and Word Test;; SV = stroke volume;; TPR = total peripheral resistance.

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