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Divergent Effects of Laughter and Mental Stress on Arterial Stiffness and Central Hemodynamics

From the Peripheral Vessels Unit, 1st Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece.

Address correspondence and reprint requests to Charalambos Vlachopoulos, 17, Kerassoundos Street, 11528 Athens, Greece. E-mail: cvlachop{at}otenet.gr

Objective: To investigate the effect of laughter and mental stress on arterial stiffness and central hemodynamics. Arterial stiffness and wave reflections are independent predictors of cardiovascular risk. Chronic psychological stress is an independent risk factor for cardiovascular events, whereas acute stress deteriorates vascular function.

Methods: Eighteen healthy individuals were studied on three occasions, according to a randomized, single-blind, crossover, sham procedure-controlled design. The effects of viewing a 30-minute segment of two films inducing laughter or stress were assessed. Carotid-femoral pulse wave velocity was used as an index of arterial stiffness; augmentation index was used as a measure of wave reflections.

Results: Laughter decreased pulse wave velocity (by 0.30 m/sec, p = .01), and augmentation index (by 2.72%, p = .05). Conversely, stress increased pulse wave velocity (by 0.29 m/sec, p = .05) and augmentation index (by 5.1%, p = .005). Laughter decreased cortisol levels by 1.67 µg/dl (p = .02), soluble P-selectin by 26 ng/ml (p = .02) and marginally von Willebrand factor (by 2.4%, p = .07) and increased total oxidative status (by 61 µmol/L, p < .001). Stress decreased interleukin-6 (by 0.11 pg/ml, p = .04) and increased total oxidative status (by 44 µmol/L, p = .007). Soluble CD40 ligand and fibrinogen remained unchanged.

Conclusions: Positive (laughter) and negative (stress) behavioral interventions have divergent acute effects on arterial stiffness and wave reflections. These findings have important clinical implications extending the spectrum of lifestyle modifications that can ameliorate arterial function.

Key Words: arterial stiffness • laughter • mental stress • pulse wave velocity • wave reflections

Abbreviations: FMD = flow-mediated dilatation; SD = standard deviation; PWV = pulse wave velocity; AIx = augmentation index; sP-selectin = soluble P-selectin; IL-6 = interleukin-6; sCD40L = soluble CD40 ligand; vWF = von Willebrand factor; TOS = total oxidative status; ANOVA = analysis of variance; ANCOVA = analysis of covariance; MAP = mean arterial pressure.

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