Response to Mental Stress, Arterial Stiffness, Central Pressures, and Cardiovascular Risk
Vlachopoulos et al1 argue that research on mental stress, physiological responses, and future cardiovascular disease would benefit from a broadening of outcomes to measures such as arterial stiffness and central hemodynamics. We fully agree that these newly established hemodynamic indices are relevant to stress and cardiovascular disease, as well as being valuable predictors of future risk.2 Research indicates that arterial stiffness is directly influenced by acute mental stress. Additionally, Ellins et al3 demonstrated recently that inflammatory responses to stress (increases in plasma fibrinogen and tumor necrosis factor-α) were positively associated with vascular stiffness measured 3 years later, independent of covariates. Other intermediate cardiovascular risk markers, such as impaired endothelial function4 and coronary artery calcification,5 are also associated with mental stress. These measures are likely to provide more insight into the role of emotional stress in cardiovascular risk than the more commonly assessed variables, such as blood pressure level.
Vlachopoulos C, Xaplanteris P, Stefanadis C. Mental stress, arterial stiffness, central pressures and cardiovascular risk. Hypertension. 2010; 56: e28.
Ghiadoni L, Donald A, Cropley M, Mullen MJ, Oakley G, Taylor M, O'Connor G, Betteridge J, Klein N, Steptoe A, Deanfield JE. Mental stress induces transient endothelial dysfunction in humans. Circulation. 2000; 102: 2473–2478.
Hamer M, O'Donnell K, Lahiri A, Steptoe A. Salivary cortisol responses to mental stress are associated with coronary artery calcification in healthy men and women. Eur Heart J. 2010; 31: 424–429.