Article

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

ABSTRACT

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

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.
    Full-text · Article · Nov 2013 · Journal of Cardiovascular Translational Research
  • 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.
    Full-text · Article · May 2011 · SSRN Electronic Journal
  • Source
    • "SBP, DBP, HR), across both tasks women displayed greater reductions in HR variability. This stress response has been found to be associated with greater CVD risk among older women (Gianaros et al., 2005). Hence, in future efforts to understand sex differences in marriage and health, parasympathetic responses to marital interactions seem worthy of additional research. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Marital strain confers risk of cardiovascular disease (CVD), perhaps though cardiovascular reactivity (CVR) to stressful marital interactions. CVR to marital stressors may differ between middle-age and older adults, and types of marital interactions that evoke CVR may also differ across these age groups, as relationship contexts and stressors differ with age. The authors examined cardiovascular responses to a marital conflict discussion and collaborative problem solving in 300 middle-aged and older married couples. Marital conflict evoked greater increases in blood pressure, cardiac output, and cardiac sympathetic activation than did collaboration. Older couples displayed smaller heart rate responses to conflict than did middle-aged couples but larger blood pressure responses to collaboration—especially in older men. These effects were maintained during a posttask recovery period. Women did not display greater CVR than men on any measure or in either interaction context, though they did display greater parasympathetic withdrawal. CVR to marital conflict could contribute to the association of marital strain with CVD for middle-aged and older men and women, but other age-related marital contexts (e.g., collaboration among older couples) may also contribute to this mechanism. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Full-text · Article · May 2009 · Psychology and Aging
Show more