Coronary artery diseaseEffects of Acute Mental Stress and Exercise on Inflammatory Markers in Patients With Coronary Artery Disease and Healthy Controls
Section snippets
Methods
Patients with documented CAD were tested 2 to 4 weeks after successful elective percutaneous coronary intervention (n = 36, 59 ± 8 years of age, 12 women). Patients with successful percutaneous intervention were studied to rule out potential influences of stress-induced ischemia, which could increase proinflammatory markers. Failed revascularization was defined as residual stenosis >50% or <20% luminal gain, major complication during revascularization (emergency bypass surgery, myocardial
Results
Patient characteristics are listed in Table 1. Statistical analyses were adjusted for age and body mass index because groups differed on these measurements. As shown in Figure 1, baseline systolic and diastolic blood pressure levels were higher in patients with CAD than in controls (p values <0.05). Mental challenge and exercise resulted in significant increases in blood pressure and heart rate in the 2 groups (p values <0.001). Exercise-induced hemodynamic responses did not differ
Discussion
This study demonstrates that acute mental arousal and exercise elicit increases in inflammatory markers in patients with CAD. In addition, these changes are greater in patients with CAD than in controls and occur in the absence of myocardial ischemia. Recurring increases in inflammatory markers in response exogenous challenges such as mental distress may contribute to the gradual progression of CAD.
The present results are consistent with previous observations of increased inflammatory
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This work was funded by Grant HL66149 from the National Institutes of Health, Bethesda, Maryland.