RESUMO
Ascorbic acid (AA) may contribute to restoring hemostatic balance after mental stress (MS) in overweight/obese adults. We aimed to determine the effects of AA administration on hemostatic responses to MS in overweight/obese men. Fourteen overweight/obesity men (27 ± 7 years; BMI: 29.7 ± 2.6 kg m-2) performed the Stroop color-word stress task for 5 min after non-simultaneous infusion of placebo (PL, 0.9% NaCl) and AA (3 g). Blood was collected at baseline, during MS, and 60 min after MS to measure: activated partial thromboplastin time, prothrombin time, and fibrinogen concentration, by coagulometer; platelet-derived microvesicles (PMV, mv/µL), by flow cytometry; nitrite (µM), by chemiluminescence. In PL session, MS led to decreases in PTs (stress, p = 0.03; 60 min, p < 0.001), PT-INR (stress, p < 0.001; 60 min, p < 0.01), aPTTs (60 min, p = 0.03), aPTT ratio (60 min, p = 0.04) and fibrinogen (60 min, p = 0.04), while increased PT activity (60 min, p = 0.01) when compared to baseline. Furthermore, AA increased PTs (60 min, p < 0.001), PT-INR (60 min, p = 0.03) and decreased PT activity (60 min, p < 0.001) and fibrinogen (stress, p = 0.04) when compared to PL. Nitrite was increased in response to stress during AA session (p < 0.001 vs PL). There was no difference in PMV. Ascorbic acid prevented the impaired hemostatic profile and improved nitrite response to stress in the overweight and obese adults.
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Hemostáticos , Trombofilia , Humanos , Masculino , Adulto , Sobrepeso/complicações , Ácido Ascórbico/farmacologia , Ácido Ascórbico/uso terapêutico , Nitritos , Obesidade/complicações , Tempo de Tromboplastina Parcial , Tempo de Protrombina , Fibrinogênio/análiseRESUMO
Previous studies show that COVID-19 survivors have elevated muscle sympathetic nerve activity (MSNA), endothelial dysfunction, and aortic stiffening. However, the neurovascular responses to mental stress and exercise are still unexplored. We hypothesized that COVID-19 survivors, compared with age- and body mass index (BMI)-matched control subjects, exhibit abnormal neurovascular responses to mental stress and physical exercise. Fifteen severe COVID-19 survivors (aged: 49 ± 2 yr, BMI: 30 ± 1 kg/m2) and 15 well-matched control subjects (aged: 46 ± 3 yr, BMI: 29 ± 1 kg/m2) were studied. MSNA (microneurography), forearm blood flow (FBF), and forearm vascular conductance (FVC, venous occlusion plethysmography), mean arterial pressure (MAP, Finometer), and heart rate (HR, ECG) were measured during a 3-min mental stress (Stroop Color-Word Test) and during a 3-min isometric handgrip exercise (30% of maximal voluntary contraction). During mental stress, MSNA (frequency and incidence) responses were higher in COVID-19 survivors than in controls (P < 0.001), and FBF and FVC responses were attenuated (P < 0.05). MAP was similar between the groups (P > 0.05). In contrast, the MSNA (frequency and incidence) and FBF and FVC responses to handgrip exercise were similar between the groups (P > 0.05). MAP was lower in COVID-19 survivors (P < 0.05). COVID-19 survivors exhibit an exaggerated MSNA and blunted vasodilatory response to mental challenge compared with healthy adults. However, the neurovascular response to handgrip exercise is preserved in COVID-19 survivors. Overall, the abnormal neurovascular control in response to mental stress suggests that COVID-19 survivors may have an increased risk to cardiovascular events during mental challenge.
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COVID-19 , Força da Mão , Adulto , Humanos , Pessoa de Meia-Idade , Pressão Sanguínea/fisiologia , Hemodinâmica , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Sistema Nervoso Simpático , Antebraço/irrigação sanguínea , Músculo Esquelético/inervaçãoRESUMO
The main goal was to determine the impact of mental stress (MS) on blood flow regulation in overweight/obese men. Fourteen overweight/obese men (27 ± 7 years; 29.8 ± 2.6 kg/m2 ) participated in two randomized experimental sessions with oral administration of the AT1R blocker Olmesartan (40 mg; AT1RB) or placebo (PL). After 2 h, a 5-min acute MS session (Stroop Color Word Test) was administered. Blood flow was assessed at baseline and during the first 3 min of MS by vascular ultrasound in the brachial artery. Blood was collected before (baseline) and during mental stress (MS) for measurement of nitrite (chemiluminescence) and endothelin-1 (ELISA kit). The AT1R blocker was able to reverse the MS responses observed in the placebo session for retrograde flow (p < 0.01), retrograde SR (p < 0.01) and oscillatory shear index (p = 0.01). Regarding vasoactive substances, no differences were observed in ET-1 (p > 0.05) responses to MS between experimental sessions. However, for nitrite responses, the administration of the AT1R blocker was able to increase circulating levels of NO (p = 0.03) Blockade of AT1R appears to prevent the decrease in endothelial function by reducing low shear stress and maintaining the vasoactive substances balance after MS in overweight/obese men.
Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II , Obesidade , Sobrepeso , Fluxo Sanguíneo Regional , Estresse Psicológico , Humanos , Masculino , Artéria Braquial/fisiologia , Endotélio Vascular/fisiologia , Nitritos , Obesidade/complicações , Sobrepeso/complicações , Fluxo Sanguíneo Regional/fisiologia , Vasodilatação/fisiologia , Adulto Jovem , Adulto , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêuticoRESUMO
The main goal of this study was to determine whether oxidative imbalance mediated by AT1 receptor (AT1R) is responsible for deleterious endothelial responses to mental stress (MS) in overweight/obese class I men. Fifteen overweight/obese men (27±7 years old; 29.8±2.6 kg/m2) participated in three randomized experimental sessions with oral administration of the AT1R blocker olmesartan (40 mg; AT1R blockade) or ascorbic acid (AA; 3g) infusion or placebo [both intravenously (0.9% NaCl) and orally]. After two hours, endothelial function was determined by flow-mediated dilation (FMD) before (baseline), 30 min (30MS), and 60 min (60MS) after a five-minute acute MS session (Stroop Color Word Test). Blood was collected before (baseline), during MS, and 60 min after MS for redox homeostasis profiling: lipid peroxidation (TBARS; thiobarbituric acid reactive species), protein carbonylation, and catalase activity by colorimetry and superoxide dismutase (SOD) activity by an ELISA kit. At the placebo session, FMD significantly decreased 30MS (P=0.05). When compared to baseline, TBARS (P<0.02), protein carbonylation (P<0.01), catalase (P<0.01), and SOD (P<0.01) increased during the placebo session. During AT1R blockade, FMD increased 30 min after MS (P=0.01 vs baseline; P<0.01 vs placebo), while AA infusion increased FMD only 60 min after MS. No differences were observed during MS with the AT1R blockade and AA regarding TBARS, protein carbonylation, catalase, and SOD. AT1R-mediated redox imbalances played an important role in endothelial dysfunction to mental stress.
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INTRODUCTION: Primary headache disorders, such as migraine and tension-type headache (TTH), represent a significant public health concern. Besides, cognitive/mental stress was suggested to contribute to TTH and migraine physiopathology. Thus, this study aimed to evaluate the existence of a causal relationship between stress (mental/cognitive or daily stress) and headache or pain improvement in migraine and TTH patients. AREAS COVERED: We developed a systematic review of the literature, including studies that utilized mental/cognitive stress tasks or daily stress by lifestyle questionnaire in migraine and TTH patients. Necessarily, these studies should have healthy patients and a pain measure (quantitative sensory tests or headache/migraine detection). PubMed, EMBASE, and SCOPUS were searched, using terms about stress and primary headaches. EXPERT OPINION: Both mental/cognitive stress and daily stress (perceived) were related to an increase in pain perception and related to the development of headache or enhanced transient pain intensity in migraine and TTH patients. Different factors could enrich the comprehension of the influence of stress on pain/headache induction in migraine and TTH patients, including methodological standardization, consistency of assessing, and isolating the many headache triggers in randomized controlled trial studies.
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Transtornos de Enxaqueca , Cefaleia do Tipo Tensional , Cognição , Cefaleia , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , DorRESUMO
INTRODUÇÃO: A avaliação sistemática das experiências das mulheres durante o parto representa uma importante estratégia para viabilizar melhorias na atenção à saúde materna e neonatal. OBJETIVOS: Adaptar o Childbirth Experience Questionnaire (CEQ) para o contexto brasileiro e determinar as propriedades psicométricas da versão em português (do Brasil), denominada CEQ-2BR. MÉTODOS: Estudo transversal com 225 puérperas recrutadas através das redes sociais. Após o consentimento informado, as participantes preencheram um formulário eletrônico, que incluía a versão preliminar da CEQ-2BR. O tratamento dos dados foi realizado através dos pacotes estatísticos SPSS e AMOS 26. A confiabilidade do CEQ-2BR foi avaliada usando o coeficiente alfa de Cronbach. Para medidas paramétricas utilizou-se o Qui-quadrado de Pearson e o T de Student e, nas medidas não-paramétricas, U de Mann Whitney. A magnitude dos coeficientes de correlação foi classificada segundo os critérios de Cohen. RESULTADOS: O CEQ-2BR demonstrou boa consistência interna para "autocapacidade", "suporte profissional", "segurança percebida" e "participação", tendo sido verificado que a avaliação negativa da experiência de parto aumenta em 1,9% e 2,1%, a sintomatologia ansiosa e depressiva pós-parto, respectivamente. CONCLUSÃO: O CEQ-2BR é uma medida válida e confiável sobre experiência de parto na população brasileira, apresenta propriedades psicométricas satisfatórias, sendo recomendado inclusive para multíparas. Houve correlação entre níveis altos de ansiedade pré-natal com experiência negativa de parto. A experiência negativa de parto explica parte das sintomatologias de ansiedade e depressão pós-parto.
INTRODUCTION: The systematic evaluation of women's experiences during childbirth represents an important strategy for implementing improvements in maternal and newborn health care. OBJECTIVE: To adapt the Childbirth Experience Questionnaire (CEQ) for the Brazilian context and to determine the psychometric properties of the Portuguese version (from Brazil), called CEQ-2BR. METHODS: Cross-sectional study with 226 postpartum women recruited from social media. After informed consent, participants completed an electronic form, which included the preliminary Portuguese version of the CEQ-2BR questionnaire. Data processing was performed using statistical packages SPSS and AMOS 26. The CEQ-2BR reliability was evaluated using the Cronbach's alpha coefficient. For parametric measurements Pearson's and Student T's chi-square were used, and Mann Whitney U was used for non-parametric measurements. The magnitude of the correlation coefficients was classified according to Cohen's criteria. RESULTS: The CEQ2BR internal consistence was assured for "Own capacity", "Professional support", "Perceived safety" and "Participation". A negative assessment of the childbirth experience was found to increase postpartum anxious and depressive symptoms by 1.9% and 2.1%, respectively. CONCLUSION: The CEQ-2BR is a valid and reliable measure of childbirth experience in the Brazilian population, has satisfactory psychometric properties and can be recommended even for multiparous women. There was a significant correlation between high levels of prenatal anxiety and negative childbirth experience. The negative experience of childbirth explains part of the symptoms of postpartum anxiety and depression.
INTRODUCCIÓN: La evaluación sistemática de las experiencias de las mujeres durante el parto representa una estrategia importante para implementar mejoras en la atención de la salud materna y neonatal. OBJETIVO: Adaptar el Childbirth Experience Questionnaire (CEQ) para el contexto brasileño y determinar las propiedades psicométricas de la versión portuguesa (de Brasil), denominada CEQ-2BR. MÉTODOS: Estudio transversal con 226 puérperas captadas de redes sociales. Después del consentimiento informado, las participantes completaron un formulario electrónico, que incluía la versión preliminar en portugués del cuestionario CEQ-2BR. El procesamiento de datos se realizó mediante los paquetes estadísticos SPSS y AMOS 26. La confiabilidad del CEQ-2BR se evaluó mediante el coeficiente alfa de Cronbach. Para las mediciones paramétricas se utilizó el chi-cuadrado de Pearson y Student T, y la U de Mann Whitney para las mediciones no paramétricas. La magnitud de los coeficientes de correlación se clasificó según el criterio de Cohen. RESULTADOS: El CEQ-2BR tiene buena consistencia interna para "Auto capacidad", "Apoyo profesional", "Seguridad percibida" y "Participación. Se encontró que una evaluación negativa de la experiencia del parto aumenta los síntomas de ansiedad y depresión posparto en un 1,9 % y un 2,1 %, respectivamente. CONCLUSIÓN: El CEQ-2BR es una medida válida y confiable de la experiencia del parto en la población brasileña, tiene propiedades psicométricas satisfactorias y puede recomendarse incluso para mujeres multíparas. Hubo una correlación significativa entre los altos niveles de ansiedad prenatal y la experiencia de parto negativa. La experiencia negativa del parto explica parte de los síntomas de ansiedad y depresión posparto.
Assuntos
Período Pós-Parto , Saúde Mental , PartoRESUMO
Introducción: en el artículo se analizan los hábitos de estudio, el estrés académico y la relación entre ellas en estudiantes de una universidad estatal en Lima (Perú). Materiales y métodos: se empleó un estudio transaccional, descriptivo y correlacional a una muestra de tipo probabilístico que estuvo conformada por 316 discentes. Los datos se recolectaron en junio de 2019, utilizando dos instrumentos de investigación: el Inventario de Estrés Académico de Barraza y el Inventario de Hábitos de Estudio de Vicuña. Se usó el coeficiente de correlación de Spearmanpara determinar si existía relación entre hábitos de estudio y estrés académico. Resultados: el 77 % de los estudiantes presenta un nivel de estrés de moderado a profundo; en cuanto a los hábitos de estudio, el 13 % tiene hábitos de estudio de nivel muy negativo a negativo; esto significa que los estudiantes demuestran que sus estrategias y técnicas habituales para la obtención de información y la forma en que realizan sus tareas no les permiten obtener un resultado óptimo, mientras que el 57.6 % tiene hábitos de tendencia negativa. Asimismo, se encontró que los hábitos de estudio y el estrés académico están relacionados de manera directa (p < 0.05). Conclusiones: los hábitos de estudio están relacionados positivamente con los estresores académicos y reacciones o síntomas, sin embargo, no están asociados con estrategias de afrontamiento
Introduction: This study analyzes the study habits, academic stress, and the relationship between them in students at a state university in Lima. Materials and methods: For this purpose, we conducted a transac-tional, descriptive, and correlational study. The sample consisted of 316 students. Through two research instrumentsthe questionnaires used were: Barraza Academic Stress Inventory and the Vicuna Study Habits Inventorythe data were collected in June 2019. For the statistical analysis, the Spearman cor-relation coefficient was used to determine the existence of a relationship between the study habits and academic stress. Results: 77% of the students presented with a moderate to deep level of stress. Regarding the study habits, total of 13% have study habits from a very negative to a negative level, this means that students show that their usual strategies and techniques for obtaining information and the way they carry out their tasks do not allow them to obtain an optimal result, while 57.6% have negative tendency habits. Conclusions: Likewise, it was found that study habits and academic stress are directly related (p< 0.05). Thus, we concluded that study habits are positively related to academic-stress-inducing factors and reactions or symptoms. However, they are not related to the coping strategies
Introdução: no presente trabalho foram analisados os hábitos de estudo, o estresse acadêmico e a rela-ção entre eles em alunos de uma universidade estadual de Lima. Materiais e métodos: utilizou-se um estudo transacional, descritivo e correlacional com amostra probabilística composta por 316 alunos. Os dados foram coletados em junho 2019, por meio de dois instrumentos de pesquisa: o inventário de estresse acadêmico de Barraza e o inventário de hábitos de estudo de Vicuña. Para a análise estatística, o coeficiente de correlação de Spearman foi utilizado para determinar se havia relação entre hábitos de estudo e estresse acadêmico. Resultados: os resultados mostram que 77% dos alunos apresentam um nível de estresse de moderado a profundo; quanto aos hábitos de estudo, 13% têm hábitos de estudo de um nível muito negativo a negativo, isto significa que os alunos demonstram que as suas estratégias e técnicas habituais de obtenção de informação e a forma como realizam as suas tarefas não lhes permitem obter um resultado óptimo, enquanto 57.6% têm hábitos com tendência negativa. Da mesma forma, hábitos de estudo e estresse acadêmico mostraram-se diretamente relacionados (p < 0.05). Conclusões: os hábitos de estudo estão positivamente relacionados a estressores acadêmicos e reações ou sintomas; no entanto, eles não estão relacionados às estratégias de enfrentamento
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Humanos , Estresse Psicológico , Peru , Sinais e Sintomas , Estudantes , Inquéritos e Questionários , Hábitos , AprendizagemRESUMO
Hypertension is often associated with metabolic changes. The sustained increase in sympathetic activity is related to increased blood pressure and metabolic changes. Environmental stimuli may be related to increased sympathetic activity, blood pressure, and metabolic changes, especially in genetically predisposed individuals. The aim of this study was to evaluate the response of fatty acids to physical and mental stress in healthy volunteers and the hemodynamic, hormonal, and metabolic implications of these stimuli. Fifteen healthy individuals with a mean age of 31 ± 7 years, of both sexes, were evaluated. They were assessed at baseline and after combined physical and mental stress (isometric exercise test, Stroop color test). Blood samples were collected at baseline and after stimulation for glucose, insulin, fatty acid, and catecholamine levels. Blood pressure, heart rate, cardiac output, systemic vascular resistance, and distensibility of the large and small arteries were analyzed. The data obtained at baseline and after stimuli were from the same individual, being the control itself. Compared to baseline, after physical and mental stress there was a statistically significant increase (p < .05) in free fatty acids, norepinephrine, diastolic blood pressure, peripheral vascular resistance, and distensibility of the large and small arteries. In conclusion, the combination of physical and mental stress raised fatty acids, norepinephrine, diastolic blood pressure, and peripheral vascular resistance in healthy individuals.
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Hipertensão , Norepinefrina , Adulto , Pressão Sanguínea , Ácidos Graxos , Feminino , Frequência Cardíaca , Hemodinâmica , Humanos , Masculino , Projetos Piloto , Estresse Psicológico , Adulto JovemRESUMO
Introducción: El estrés mental agudo, así como los estados de ansiedad inducidos para influenciar la reactividad psicofisiológica en jóvenes sanos, aportan cambios en los patrones nerviosos que pueden ser medidos mediante la variabilidad de la frecuencia cardiaca. Objetivo: Determinar las diferencias en los parámetros lineales del balance autonómico cardiovascular en individuos jóvenes en estado basal y durante la prueba de cálculo aritmético. Métodos: Se realizó un estudio cuasi-experimental, sin grupo control de tipo antes y después, en el Laboratorio de Ciencias Básicas Biomédicas de la Universidad de Ciencias Médicas de Santiago de Cuba. Población y muestra de 10 sujetos. Se registró el trazado electrocardiográfico (5 min) durante el reposo y luego durante la prueba de cálculo aritmético. Resultados: Existieron diferencias significativas entre ambos estados en las variables frecuencia cardiaca (p = 0,005); mínima (p = 0,007); máxima (p = 0,005); intervalo RR (p = 0,005); stress index (p = 0,028); índice simpático (p = 0,005); bajas frecuencias (p = 0,005); relación LF/HF (p = 0,005); RMSSD (p = 0,007); NN50 (p = 0,008); pNN50 (p = 0,005); índice parasimpático (p = 0,005) y altas frecuencias (p = 0,005). El estrés mental provocó una disminución parasimpática y un predominio simpático uniforme en todos los sujetos participantes en el estudio. Conclusiones: Durante el estrés mental inducido por la prueba de cálculo aritmético la dinámica lineal de la respuesta autonómica cardiovascular experimenta un aumento en la actividad simpática y una disminución del tono parasimpático, traduciendo una respuesta adaptativa en la regulación de la función cardiovascular por el sistema nervioso autónomo(AU)
Introduction: Acute mental stress and states of anxiety induced to influence psychophysiological reactivity in healthy young people, result in changes in nervous patterns which may be measured in terms of heart rate variability. Objective: Determine the differences in linear parameters for autonomic cardiovascular balance in young individuals at baseline and during the arithmetic computation test. Methods: A non-observational quasi-experimental before-after study without a control group was conducted at the Basic Biomedical Sciences Laboratory of the University of Medical Sciences of Santiago de Cuba. The study population and sample was 10 subjects. The electrocardiographic tracing (5 min) was recorded at rest and then during the arithmetic computation test. Results: Significant differences were found between the two states as to the variables heart rate (p = 0.005), minimum (p = 0.007), maximum (p = 0.005), RR interval (p = 0.005), stress index (p = 0.028), sympathetic index (p = 0.005), low frequencies (p = 0.005), LF/HF ratio (p = 0.005), RMSSD (p = 0.007), NN50 (p = 0.008), pNN50 (p = 0.005), parasympathetic index (p = 0.005) and high frequencies (p = 0.005). Mental stress caused a parasympathetic reduction and uniform sympathetic predominance in all the subjects participating in the study. Conclusions: During the mental stress induced by the arithmetic computation test, the linear dynamic of the autonomic cardiovascular response experiences an increase in sympathetic activity and a reduction in parasympathetic tone, displaying an adaptive response in cardiovascular function regulation by the autonomous nervous system(AU)
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Humanos , Masculino , Feminino , Estresse Psicológico/etiologia , Escala de Ansiedade Frente a Teste/normas , Frequência Cardíaca/fisiologia , Ensaios Clínicos Controlados não Aleatórios como AssuntoRESUMO
STUDY OBJECTIVES: To compare vascular function of sedentary (SED) versus physically active (ACTIVE) patients with obstructive sleep apnea (OSA) during rest and mental stress. METHODS: Patients with untreated OSA without other comorbidities were classified into SED and ACTIVE groups according to the International Physical Activity Questionnaire. Blood pressure (BP), heart rate (HR), forearm blood flow (FBF) (plethysmography), and forearm vascular conductance (FVC = FBF / mean BP × 100) were continuously measured at rest (4 minutes) followed by 3 minutes of mental stress (Stroop Color Word Test). RESULTS: We studied 40 patients with OSA (men = 24, age = 50 ± 1 years, body mass index = 29.3 ± 0.5 kg/m2, apnea-hypopnea index = 39.3 ± 4 events/h). Leisure time physical activity domain in SED (n = 19) and ACTIVE (n = 21) was 20 ± 8 and 239 ± 32 min/wk, (P < .05). Baseline profile and perception of stress were similar in both groups. Baseline FBF (3.5 ± 0.2 mL/min/100 mL versus 2.4 ± 0.14 mL/min/100 mL) and FVC (3.5 ± 0.2 U versus 2.3 ± 0.1 U) were significantly lower in the SED group than in the ACTIVE group, respectively (P < .05). HR and BP increased similarly during mental stress test in both groups. Changes during mental stress in FBF (0.65 ± 0.12 versus 1.04 ± 0.12) and FVC (0.58 ± 0.11 versus 0.99 ± 0.11) were significantly lower in the SED group than in the ACTIVE group, respectively (P < .05). There was a significant correlation between leisure time physical activity and FBF (r = .57, P < .05) and FVC (r = .48, P < .05) during mental stress. CONCLUSIONS: The vascular response among patients with OSA is influenced by the level of physical activity. A high level of physical activity may partially protect against the cardiovascular dysfunction associated with OSA.
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Pressão Sanguínea/fisiologia , Exercício Físico/fisiologia , Frequência Cardíaca/fisiologia , Comportamento Sedentário , Apneia Obstrutiva do Sono/fisiopatologia , Estresse Psicológico/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia , Fluxo Sanguíneo Regional/fisiologia , Apneia Obstrutiva do Sono/complicações , Estresse Psicológico/complicações , Teste de StroopRESUMO
BACKGROUND: Individuals who exhibit large-magnitude blood pressure (BP) reactions to acute psychological stressors are at risk for hypertension and premature death by cardiovascular disease. This study tested whether a multivariate pattern of stressor-evoked brain activity could reliably predict individual differences in BP reactivity, providing novel evidence for a candidate neurophysiological source of stress-related cardiovascular risk. METHODS AND RESULTS: Community-dwelling adults (N=310; 30-51 years; 153 women) underwent functional magnetic resonance imaging with concurrent BP monitoring while completing a standardized battery of stressor tasks. Across individuals, the battery evoked an increase systolic and diastolic BP relative to a nonstressor baseline period (M ∆systolic BP/∆diastolic BP=4.3/1.9 mm Hg [95% confidence interval=3.7-5.0/1.4-2.3 mm Hg]). Using cross-validation and machine learning approaches, including dimensionality reduction and linear shrinkage models, a multivariate pattern of stressor-evoked functional magnetic resonance imaging activity was identified in a training subsample (N=206). This multivariate pattern reliably predicted both systolic BP (r=0.32; P<0.005) and diastolic BP (r=0.25; P<0.01) reactivity in an independent subsample used for testing and replication (N=104). Brain areas encompassed by the pattern that were strongly predictive included those implicated in psychological stressor processing and cardiovascular responding through autonomic pathways, including the medial prefrontal cortex, anterior cingulate cortex, and insula. CONCLUSIONS: A novel multivariate pattern of stressor-evoked brain activity may comprise a phenotype that partly accounts for individual differences in BP reactivity, a stress-related cardiovascular risk factor.
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Pressão Sanguínea , Encéfalo/fisiopatologia , Sistema Cardiovascular/fisiopatologia , Estresse Psicológico/fisiopatologia , Adulto , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico/métodos , Análise Discriminante , Feminino , Humanos , Modelos Lineares , Aprendizado de Máquina , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Testes Neuropsicológicos , Fenótipo , Análise de Componente Principal , Fatores de Risco , Estresse Psicológico/diagnóstico por imagem , Estresse Psicológico/psicologiaRESUMO
Objective: Anxiety and depression have been linked to blunted blood pressure (BP) and heart rate (HR) reactions to mental stress tests; however, most studies have not included indices of underlying hemodynamics nor multiple stress tasks. This study sought to examine the relationships of anxiety and depression with hemodynamic responses to acute active and passive coping tasks. Methods: A total of 104 participants completed the Hospital Anxiety and Depression Scales and mental arithmetic, speech, and cold pressor tasks while BP, HR, total peripheral resistance, and cardiac output (CO) were assessed. Results: After adjustment for traditional risk factors and baseline cardiovascular activity, depression scores were negatively associated with systolic BP, HR, and CO responses to the mental arithmetic task, while anxiety scores were inversely related to the systolic BP response to mental arithmetic. Conclusion: High anxiety or depression scores appear to be associated with blunted cardiac reactions to mental arithmetic (an active coping task), but not to the cold pressor test or speech tasks. Future research should further examine potential mechanisms and longitudinal pathways relating depression and anxiety to cardiovascular reactivity. Clinical trial registration number: TCTR20160208004
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Ansiedade/fisiopatologia , Estresse Psicológico/fisiopatologia , Adaptação Psicológica/fisiologia , Sistema Cardiovascular/fisiopatologia , Depressão/fisiopatologia , Ansiedade/psicologia , Dor/fisiopatologia , Dor/psicologia , Escalas de Graduação Psiquiátrica , Valores de Referência , Análise e Desempenho de Tarefas , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/psicologia , Fatores de Risco , Depressão/psicologia , Hemodinâmica/fisiologiaRESUMO
STUDY OBJECTIVES: To investigate muscle sympathetic nerve activity (MSNA) response and executive performance during mental stress in obstructive sleep apnea (OSA). METHODS: Individuals with no other comorbidities (age = 52 ± 1 y, body mass index = 29 ± 0.4, kg/m2) were divided into two groups: (1) control (n = 15) and (2) untreated OSA (n = 20) defined by polysomnography. Mini-Mental State of Examination (MMSE) and Inteligence quocient (IQ) were assessed. Heart rate (HR), blood pressure (BP), and MSNA (microneurography) were measured at baseline and during 3 min of the Stroop Color Word Test (SCWT). Sustained attention and inhibitory control were assessed by the number of correct answers and errors during SCWT. RESULTS: Control and OSA groups (apnea-hypopnea index, AHI = 8 ± 1 and 47 ± 1 events/h, respectively) were similar in age, MMSE, and IQ. Baseline HR and BP were similar and increased similarly during SCWT in control and OSA groups. In contrast, baseline MSNA was higher in OSA compared to controls. Moreover, MSNA significantly increased in the third minute of SCWT in OSA, but remained unchanged in controls (P < 0.05). The number of correct answers was lower and the number of errors was significantly higher during the second and third minutes of SCWT in the OSA group (P < 0.05). There was a significant correlation (P < 0.01) between the number of errors in the third minute of SCWT with AHI (r = 0.59), arousal index (r = 0.55), and minimum O2 saturation (r = -0.57). CONCLUSIONS: As compared to controls, MSNA is increased in patients with OSA at rest, and further significant MSNA increments and worse executive performance are seen during mental stress. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov, registration number: NCT002289625.
Assuntos
Função Executiva , Músculos/inervação , Apneia Obstrutiva do Sono/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Adulto , Idoso , Nível de Alerta , Atenção , Pressão Sanguínea , Estudos de Casos e Controles , Feminino , Frequência Cardíaca , Humanos , Inibição Psicológica , Masculino , Pessoa de Meia-Idade , Polissonografia , Descanso , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/fisiopatologia , Teste de StroopRESUMO
En este estudio se examinó si el estrés mental crónico se asocia con el rendimiento académico en adolescentes coreanos. La muestra estuvo constituida por los 74.186 adolescentes de entre el 7 y el 12 ° grado (12-18 años) que participaron en la 8va encuesta en internet sobre Comportamiento de Riesgo en Jóvenes en 2012. Se utilizó el análisis de regresión logística multivariante para aclarar cómo el estrés crónico mental se relacionaba con el rendimiento académico después del ajuste por edad, índice de masa corporal, posición económica de la familia, el nivel de educación de los padres, la frecuencia de fumar, la frecuencia de ingesta de alcohol, y la frecuencia de la actividad física vigorosa y moderada y ejercicios de fuerza musculares. Para los varones, las personas con estrés mental crónico muy alto tenían menos probabilidades de lograr un rendimiento académico promedio o superior (odds ratio [OR] = 0.738, 95% intervalo de confianza [IC]: 0.629 a 0.867, p <0,001) que aquellos con muy estrés mental baja. Para las niñas, las que tenían estrés mental muy alto tenían menos probabilidades (OR = 0.668; IC del 95%: 0.521 - 0.857, p = 0.002), mientras que aquellas con estrés mental bajo tenían más probabilidades (OR IC = 1.324, 95%: 1.029 -1.704; p = 0.029) para tener un rendimiento promedio académico o superior, en comparación con las niñas con estrés muy bajo. Los grados (pruebas, exámenes de ingreso) fueron la principal causa de estrés mental crónico tanto en varones (51.7%) y niñas (54.,8%). Los varones y las niñas de la República de Corea de estrés mental crónico muy alto mostraron una disminución del rendimiento académico.
We examined whether chronic mental stress is associated with academic performance in Korean adolescents. Our sample consisted of the 74,186 adolescents between the 7th and 12th grades (aged 12-18 years) who participated in the 8th Korean Youth Risk Behavior Web-based Survey in 2012. We used multivariate logistic regression analysis to clarify how chronic mental stress was related to academic performance after adjustment for age, body mass index, family economic status, parents' education level, smoking frequency, alcohol intake frequency, and frequency of vigorous and moderate physical activity and muscular strength exercises. For boys, those with very high chronic mental stress were less likely to achieve average academic performance or higher (odds ratio [OR] = 0.738, 95% confidence interval [CI]: 0.629-0.867, p < 0.001) than were those with very low mental stress. For girls, those with very high mental stress were less likely (OR = 0.668, 95% CI: 0.521-0.857, p = 0.002), while those with low mental stress were more likely (OR = 1.324, 95% CI: 1.029-1.704; p = 0.029) to have average academic performance or hig-her, compared with girls with very low stress. Grades (tests, entrance examinations) were the primary cause of chronic mental stress in both boys (51.7%) and girls (54.8%). Republic of Korean boys and girls with very high chronic mental stress showed decreased academic performance.
Assuntos
Estresse Psicológico , AdolescenteRESUMO
Mental stress induces transient endothelial dysfunction, which is an important finding for subjects at cardiometabolic risk. Thus, we tested whether aerobic exercise prevents this dysfunction among subjects with metabolic syndrome (MetS) and whether an increase in shear rate during exercise plays a role in this phenomenon. Subjects with MetS participated in two protocols. In protocol 1 (n = 16), endothelial function was assessed using brachial artery flow-mediated dilation (FMD). Subjects then underwent a mental stress test followed by either 40 min of leg cycling or rest across two randomized sessions. FMD was assessed again at 30 and 60 min after exercise or rest, with a second mental stress test in between. Mental stress reduced FMD at 30 and 60 min after the rest session (baseline: 7.7 ± 0.4%, 30 min: 5.4 ± 0.5%, and 60 min: 3.9 ± 0.5%, P < 0.05 vs. baseline), whereas exercise prevented this reduction (baseline: 7.5 ± 0.4%, 30 min: 7.2 ± 0.7%, and 60 min: 8.7 ± 0.8%, P > 0.05 vs. baseline). Protocol 2 (n = 5) was similar to protocol 1 except that the first period of mental stress was followed by either exercise in which the brachial artery shear rate was attenuated via forearm cuff inflation or exercise without a cuff. Noncuffed exercise prevented the reduction in FMD (baseline: 7.5 ± 0.7%, 30 min: 7.0 ± 0.7%, and 60 min: 8.7 ± 0.8%, P > 0.05 vs. baseline), whereas cuffed exercise failed to prevent this reduction (baseline: 7.5 ± 0.6%, 30 min: 5.4 ± 0.8%, and 60 min: 4.1 ± 0.9%, P < 0.05 vs. baseline). In conclusion, exercise prevented mental stress-induced endothelial dysfunction among subjects with MetS, and an increase in shear rate during exercise mediated this effect.
Assuntos
Artéria Braquial/fisiopatologia , Endotélio Vascular/fisiopatologia , Exercício Físico , Síndrome Metabólica/fisiopatologia , Estresse Psicológico/fisiopatologia , Vasodilatação , Adulto , Ciclismo , Pressão Sanguínea , Brasil , Teste de Esforço , Feminino , Frequência Cardíaca , Humanos , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/psicologia , Estresse Mecânico , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Fatores de TempoRESUMO
The objective of the present study was to compare cardiovascular and autonomic responses to a mental stress test and to a maximal isometric exercise test between offspring of normotensive (ON, n = 10) and hypertensive parents (OH, n = 10). Subjects underwent a 3-min Stroop Color Word Test and a maximal isometric exercise test performed in an isokinetic dynamometer with continuous RR interval monitoring. At rest, arterial pressure and heart rate were similar between groups, but there was a significant reduction in total RR interval variance (ON: 5933 ± 493 vs. OH: 2967 ± 390 ms(2)) and an increase in low-high frequency components ratio of heart rate variability (ON: 2.3 ± 0.4 vs. OH: 4.6 ± 0.8) in OH group. In the first minute of the mental stress test and after both tests, the OH group presented increased heart rate as compared with the ON group. After both tests, only the ON group presented an increase in sympathetic component, thus reaching resting values similar to those of the OH group. Our data demonstrated increased resting cardiac sympathetic modulation in offspring of hypertensive parents at similar levels to that observed in offspring of normotensive parents after a mental stress test or a maximal isometric exercise test. Additionally, the exacerbated heart rate responses to these physiological tests in OH subjects may be associated with resting autonomic dysfunction, thus reinforcing these evaluations as important tools for detecting early dysfunctions in this genetically predisposed population.
Assuntos
Filhos Adultos , Sistema Nervoso Autônomo/fisiopatologia , Sistema Cardiovascular/inervação , Hipertensão/genética , Hipertensão/fisiopatologia , Contração Isométrica , Músculo Esquelético/fisiopatologia , Adaptação Fisiológica , Análise de Variância , Pressão Arterial , Estudos de Casos e Controles , Predisposição Genética para Doença , Frequência Cardíaca , Hereditariedade , Humanos , Masculino , Linhagem , Fenótipo , Estresse Psicológico/fisiopatologia , Adulto JovemRESUMO
Considerando o crescente interesse científico no fenômeno burnout, apresentamos uma amostra da diversidade teórica que forma o campo de pesquisa neste tema a partir de algumas questões atuais de discussão sobre o seu conceito. Discutimos aparentes limitações da abordagem empírica à compreensão da natureza conceitual do burnout, apontando uma possível contribuição da clínica (dentro do campo da Psiquiatria) a este debate.
Considering the growing scientific interest in burnout phenomenon, we present a sample of the theoretic diversity that constitutes the research in this area presenting some of the debates currently being held on its concept. We discuss apparent limitations of the empirical approach on the comprehension of burnout conceptual nature, indicating a possible contribution from the clinical practice (within the of psychiatry) to this debate.