A Greater Reduction in High-Frequency Heart Rate Variability to a Psychological Stressor is Associated With Subclinical Coronary and Aortic Calcification in Postmenopausal Women

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Psychosomatic Medicine (Impact Factor: 3.47). 08/2005; 67(4):553-60. DOI: 10.1097/01.psy.0000170335.92770.7a
Source: PubMed


Reduced cardiac parasympathetic activity, as indicated by a reduced level of clinic or ambulatory high-frequency heart rate variability (HF-HRV), is associated with an increased risk for atherosclerosis and coronary artery disease. We tested whether the reduction in HF-HRV to a psychological stressor relative to a baseline level is also associated with subclinical coronary or aortic atherosclerosis, as assessed by calcification in these vascular regions.
Spectral estimates of 0.15 to 0.40 Hz HF-HRV were obtained from 94 postmenopausal women (61-69 years) who engaged in a 3-minute speech-preparation stressor after a 6-minute resting baseline. A median of 282 days later, electron beam tomography (EBT) was used to measure the extent of coronary and aortic calcification.
In univariate analyses, a greater reduction in HF-HRV from baseline to speech preparation was associated with having more extensive calcification in the coronary arteries (rho = -0.29, p = .03) and in the aorta (rho = -0.22, p = .06). In multivariate analyses that controlled for age, education level, smoking status, hormone therapy use, fasting glucose, high-density lipoproteins, baseline HF-HRV, and the stressor-induced change in respiration rate, a greater stressor-induced reduction in HF-HRV was associated with more calcification in the coronary arteries (B = -1.21, p < .05), and it was marginally associated with more calcification in the aorta (B = -0.92, p = .09).
In postmenopausal women, a greater reduction in cardiac parasympathetic activity to a psychological stressor from baseline may be an independent correlate of subclinical atherosclerosis, particularly in the coronary arteries.

Download full-text


Available from: Kristen Salomon, Jan 03, 2014
  • Source
    • "Other studies also suggest that changes in adrenergic neurotransmission would provide insight into sex differences in autonomic regulation of the heart. For example, heart rate variability decreases in women at menopause [50, 51]. In post-menopausal women with normal ventricular ejection fraction and those with systolic dysfunction (heart failure with reduced ejection fraction), cardiac-specific sympathetic activation and cardiac norepinephrine spillover was greater than in age-matched men [52]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: All-cause mortality from cardiovascular disease is declining in the USA. However, there remains a significant difference in risk factors for disease and in mortality between men and women. For example, prevalence and outcomes for heart failure with preserved ejection fraction differ between men and women. The reasons for these differences are multifactorial, but reflect, in part, an incomplete understanding of sex differences in the etiology of cardiovascular diseases and a failure to account for sex differences in pre-clinical studies including those designed to develop new diagnostic and treatment modalities. This review focuses on the underlying physiology of these sex differences and provides evidence that inclusion of female animals in pre-clinical studies of heart failure and in development of imaging modalities to assess cardiac function might provide new information from which one could develop sex-specific diagnostic criteria and approaches to treatment.
    Journal of Cardiovascular Translational Research 11/2013; 7(2). DOI:10.1007/s12265-013-9514-8 · 3.02 Impact Factor
    • "sturbances . The parasympathetic sys - tem restores the body energy reserve , with effects on target organs ( e . g . , intestinal motility , secretion , digestion and absorption , and reproductive functions ) that are mostly stim - ulatory with the exception of the cardiovascular system ( Chen , Orr , Yang , & Kuo , 2006 ; Egizio et al . , 2008 ; Gianaros et al . , 2005 ; Henje Blom , Olsson , Serlachius , Ericson , & Ingvar , 2010 ; Katoh et al . , 2002 ; Roumelioti et al . , 2010 ; Schroeder et al . , 2005 ; Vaschillo et al . , 2008 ) . The autonomic nervous system operates in the context of two major information - transfer systems , endocrine and immune , that mediate bidirectional communication bet"
    [Show abstract] [Hide abstract]
    ABSTRACT: Measures of heart rate variability (HRV) are major indices of the sympathovagal balance in cardiovascular research. These measures are thought to reflect complex patterns of brain activation as well and HRV is now emerging as a descriptor thought to provide information on the nervous system organization of homeostatic responses in accordance with the situational requirements. Current models of integration equate HRV to the affective states as parallel outputs of the central autonomic network, with HRV reflecting its organization of affective, physiological, “cognitive,” and behavioral elements into a homeostatic response. Clinical application is in the study of patients with psychiatric disorders, traumatic brain injury, impaired emotion-specific processing, personality, and communication disorders. HRV responses to highly emotional sensory inputs have been identified in subjects in vegetative state and in healthy or brain injured subjects processing complex sensory stimuli. In this respect, HRV measurements can provide additional information on the brain functional setup in the severely brain damaged and would provide researchers with a suitable approach in the absence of conscious behavior or whenever complex experimental conditions and data collection are impracticable, as it is the case, for example, in intensive care units. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Journal of Psychophysiology 01/2012; 26(4):178. DOI:10.1027/0269-8803/a000080 · 1.59 Impact Factor
  • Source
    • "The economic importance of studying the relation between fairness perceptions and HRV results from the fact that the latter is an early indicator of functional and structural impairments of the cardiovascular system, which increases the probability of future manifest coronary heart disease (Steptoe and Marmot 2002, Dekker et al. (2000), Gianaros et al. (2005)). In other words, establishing a causal link between unfair pay and HRV would suggest that on top of behavioral consequences, perceptions of unfair pay can have important negative health consequences, in particular on stress-related cardiovascular health. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper investigates physiological responses to perceptions of unfair pay. In a simple principal agent experiment agents produce revenue by working on a tedious task. Principals decide how this revenue is allocated between themselves and their agents. In this environment unfairness can arise if an agent's reward expectation is not met. Throughout the experiment we record agents' heart rate variability. Our findings provide evidence of a link between perceived unfairness and heart rate variability. The latter is an indicator of stress-related impaired cardiac autonomic control, which has been shown to predict coronary heart diseases in the long run. Establishing a causal link between unfair pay and heart rate variability therefore uncovers a mechanism of how perceptions of unfairness can adversely affect cardiovascular health. We further test potential adverse health effects of unfair pay using data from a large representative data set. Complementary to our experimental findings we find a strong and highly significant association between health outcomes, in particular cardiovascular health, and fairness of pay.
    SSRN Electronic Journal 05/2011; DOI:10.2139/ssrn.1868888
Show more