New study says people take mental stress to heart

DALLAS, March 26 Mental stress can trigger a lack of blood flow to the heart and increase the risk of death in people with coronary artery disease, researchers report in todays rapid access Circulation: Journal of the American Heart Association.

Patients who had ischemia in response to mental stress had a three-fold increase in the risk of death compared to people without mental stress, says David S. Sheps, M.D., lead author and associate chief of the division of cardiovascular medicine, University of Florida Health Sciences Center, Gainesville. This adds to a growing body of evidence that links mental stress and bad outcomes in individuals with coronary artery disease.

Previous studies have shown that reduced blood flow during mental stress tests is linked to significantly higher rates of adverse cardiac events. These studies werent designed to detect differences in death rates, however.

Researchers used an imaging test called radionuclide angiography to detect wall motion abnormalities in the hearts pumping during ischemia, which occurs when there is not enough blood flow in the coronary arteries. Radionuclide angiography involves injecting a dye to label red blood cells. This lets researchers view the working heart.

Wall motion abnormalities are specific markers of ischemia, Sheps says. Radionuclide imaging provides us a motion picture of the heart beating. Normally there is a nice symmetrical motion of the heart. With ischemia, certain portions will contract less vigorously or bulge out.

Mental stress increases oxygen demand because blood pressure and heart rate are elevated, he says. Vascular resistance and coronary artery constriction during mental stress also decrease the blood supply. Psychological factors such as anger or depression didnt increase the patients incidence of death in this study. They have been shown to be risk factors in other studies.

The 196 patients in this study Psychophysiological Investigat

Contact: Carole Bullock
American Heart Association

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