Psychological stress and the progression of carotid artery disease
Psychological stress and the progression of carotid artery disease
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DOI：
10.1097/00004872-199715010-00004
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发表时间：
1997-01-01
影响因子：
4.9
通讯作者：
Jennings, JR
中科院分区：
文献类型：
--
作者：
Barnett, PA;Spence, JD;Jennings, JR
背景 我们研究了心血管反应性（心血管系统对心理压力的反应）与颈动脉粥样硬化的严重程度和进展之间的关系。方法使用双功能超声检查，我们测量了 2 年内颅外颈动脉中所有可检测斑块面积的变化。通过测量令人沮丧的认知任务（斯特鲁普色词干扰任务）期间血流动力学的变化来评估心血管反应性。通过对患有多种类型动脉粥样硬化疾病的 351 名受试者进行访谈、体检和血液检测来测量已确定的动脉粥样硬化危险因素。 结果 273 名 (78%) 受试者的颈动脉中存在动脉粥样硬化斑块。在向前逐步多元回归分析中，发现年龄较大 (β = 0.46)、高血压病史 (β = 0.20)、使用降脂药物（β = 0.18）、较长的吸烟史（β = 0.13）、较大的胆固醇与高密度脂蛋白比率（β = 0.13）、任务期间心率变化较小（β = -0.12）和较高的静息收缩压（SEP；β = 0.11）与较大的斑块面积显着相关（R(2) = 0.35）。在随访 2 年的 136 名未经治疗受试者中，在控制年龄和初始斑块面积后，任务期间收缩压变化较大（β = 0.28）、总胆固醇与高密度脂蛋白比值较高（β = 0.23）、静息预射期较短（β = -0.19）和较低体重指数（β = -0.17）是动脉粥样硬化变化的显着预测因子。逐步多元回归分析（R（2）= 0.24），结论这些结果支持精神应激条件下的血流动力学反应可能影响动脉粥样硬化进展的假设。
Background We examined the relation between cardiovascular reactivity (the response of the cardiovascular system to psychological stress) and the severity and progression of carotid atherosclerosis.Methods Using duplex ultrasonography, we measured the change in the area of all detectable plaques in the extracranial carotid arteries during 2 years. Cardiovascular reactivity was assessed by measuring changes in hemodynamics during a frustrating cognitive task (the Stroop Color Word Interference Task). Established risk factors for atherosclerosis were measured by interviewing patients, a physical examination, and blood assays for 351 subjects with a wide range of types of atherosclerotic disease.Results Atherosclerotic plaques were present in the carotid arteries of 273 (78%) subjects, In a forward stepwise multiple regression analysis, it was found that greater age (beta = 0.46), a history of hypertension (beta = 0.20), use of lipid level-lowering agents (beta = 0.18), a longer history of smoking (beta = 0.13), a larger cholesterol :high-density lipoprotein ratio (beta = 0.13), a smaller change in heart rate during the task (beta = -0.12), and a higher resting systolic blood pressure (SEP; beta = 0.11) were associated significantly with a greater plaque area (R(2) = 0.35). In 136 untreated subjects who were followed up for 2 years, a greater change SBP during the task (beta = 0.28), a higher total cholesterol : high-density lipoprotein ratio (beta = 0.23), a shorter resting preejection period (beta = -0.19), and a lower body mass index (beta = -0.17) were significant predictors of the change in atherosclerosis, after controlling for age and initial plaque area in a stepwise multiple regression analysis (R(2) = 0.24),Conclusions These results support the hypothesis that hemodynamic responses under conditions of mental stress may influence the progression of atherosclerosis.