The online version of this article (doi:10.1186/1476-7120-7-32) contains supplementary material, which is available to authorized users.
An erratum to this article is available at http://dx.doi.org/10.1186/1476-7120-7-40.
The authors declare that they have no competing interests.
TZN conceived and designed the study, performed all ultrasound examinations of carotid arteries and transcranial Doppler, modified the mental stress protocols to suite study needs, assisted with data measurement, collection, interpretation and final analysis and drafted the manuscript to its final version. HKH made substantial contributions running the mental stress protocols, data entry and analysis and helped to draft the manuscript. Both authors have given final approval of the version to be published and take responsibility for the content of the manuscript. Both authors read and approved the final manuscript.
Brachial artery reactivity in response to shear stress is altered in subjects with hypertension. Since endothelial dysfunction is generalized, we hypothesized that carotid artery (CA) reactivity would also be altered in hypertension.
To compare (CA endothelium-dependent vasodilation in response to mental stress in normal and hypertensive subjects.
We evaluated CA reactivity to mental stress in 10 young healthy human volunteers (aged 23 ± 4 years), 20 older healthy volunteers (aged 49 ± 11 years) and in 28 patients with essential hypertension (aged 51 ± 13 years). In 10 healthy volunteers and 12 hypertensive subjects, middle cerebral artery (MCA) PW transcranial Doppler was performed before and 3 minutes after mental stress.
Mental stress by Stroop color word conflict, math or anger recall tests caused CA vasodilation in young healthy subjects (0.61 ± 0.06 to 0.65 ± 0.07 cm, p < 0.05) and in older healthy subjects (0.63 ± 0.06 to 0.66 ± 0.07 cm, p < 0.05), whereas no CA vasodilation occurred in hypertensive subjects (0.69 ± 0.06 to 0.68 ± 0.07 cm; p, NS). CA blood flow in response to mental stress increased in young healthy subjects (419 ± 134 to 541 ± 209 ml, p < 0.01 vs. baseline) and in older healthy subjects (351 ± 114 to 454 ± 136 ml, p < 0.01 vs. baseline) whereas no change in blood flow (444 ± 143 vs. 458 ± 195 ml; p, 0.59) occurred in hypertensive subjects. There was no difference in the CA response to nitroglycerin in healthy and hypertensive subjects. Mental stress caused a significant increase in baseline to peak MCA systolic (84 ± 22 to 95 ± 22 cm/s, p < 0.05), diastolic (42 ± 12 to 49 ± 14 cm/s, p < 0.05) as well as mean (30 ± 13 to 39 ± 13 cm/s, p < 0.05) PW Doppler velocities in normal subjects, whereas no change in systolic (70 ± 18 to 73 ± 22 cm/s, p < 0.05), diastolic (34 ± 14 to 37 ± 14 cm/s, p = ns) or mean velocities (25 ± 9 to 26 ± 9 cm/s, p = ns) occurred in hypertensive subjects, despite a similar increase in heart rate and blood pressure in response to mental stress in both groups.
Mental stress produces CA vasodilation and is accompanied by an increase in CA and MCA blood flow in healthy subjects. This mental stress induced CA vasodilation and flow reserve is attenuated in subjects with hypertension and may reflect cerebral vascular endothelial dysfunction. Assessment of mental stress induced CA reactivity by ultrasound is a novel method for assessing the impact of hypertension on cerebrovascular endothelial function and blood flow reserve.
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Harris CW, Edwards JL, Baruch A, Riley WA, Pusser BE, Rejeski WJ, Herrington DM: Effects of mental stress on brachial artery flow-mediated vasodilation in healthy normal individuals. Am Heart J 2000, 139: 405-411. PubMed
Faraci FM: Role of endothelium-derived relaxing factor in cerebral circulation: large arteries vs. microcirculation. Am J Physiol. 1991, 261(4 Pt 2):H1038-H1042. PubMed
Wafford JL, Kahl FR, Joward GR, McKinney WM, Toole JF, Crouse JR: Relation of extent of extracranial carotid artery atherosclerosis as measure by b-mode ultrasound to the extent of coronary atherosclerosis. Arthrioscler Thromb 1991, 11: 1786-1794. CrossRef
Folsom AR, Eckfeldt JH, Weitzman S, Ma J, Chambless LE, Barnes RW, Cram KB, Hutchinson RG: For the atherosclerosis risk in communities (aric) study investigators: Relation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size and physical activity. Stroke 1994, 25: 66-73. CrossRefPubMed
Harders AG, Laborde G, Droste DW, Rastogi E: Brain activity and blood flow velocity changes: a transcranial Doppler study. Int J of Neuroscience 1989, 47: 91-102. 10.3109/00207458908987421 CrossRef
Smilde TJ, Wollersheim H, Van Langen H, Stalenhoef AF: Reproducibility of ultrasonographic measurements of different carotid and femoral artery segments in healthy subjects and in pateints with increased intima-media thickness. Clin Sci (Lond) 1997, 93: 317-324. CrossRef
Stroop J: Studies of interference in serial verbal reactions. J Exp Psychol 1935, 18: 643-662. 10.1037/h0054651 CrossRef
Uehata A, Lieberman EH, Gerhard MD, Anderson TJ, Ganz P, Polak JF, Creager MA, Yeung AC: Noninvasive assessment of endothelium-dependent flow-mediated dilation of the brachial artery. Vascular Medicine 1997, 2: 87-92. PubMed
Celemajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, Lloyd JK, Deanfield JEa: Noninvasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992, 340: 1111-1115. 10.1016/0140-6736(92)93147-F CrossRef
Dubois-Rande JL, Dupouy P, Aptecar E, Bhatia A, Teiger E, Hittinger L, Berdeaux A, Castaigne A, Geschwind H: Comparison of the effects of exercise and cold pressor test on the vasomotion responses of normal and atherosclerotic coronary arteries and their relation to the flow-mediated mechanism. Am J Cardiol 1995, 76: 467-473. 10.1016/S0002-9149(99)80132-5 CrossRefPubMed
Jennings JR, Muldoon MF, Ryan CM, Mintun MA, Meltzer CC, Townsend DW, Sutton-Tyrrell K, Shapiro AP, Manuck SB: Cerebral blood flow in hypertensive patients: an initial report of reduced and compensatory blood flow responses during performance of two cognitive tasks. Hypertension 1998, 31: 1216-1222. CrossRefPubMed
Maseri A, L'Abbate A, Baroldi G, Chierchia S, Marzilli M, Ballestra AM, Severi S Parodi O, Biagini A, Distante A, Pesola A: Coronary vasospasm as a possible cause of myocardial infarction. A conclusion derived from a study of preinfarction angina. N Engl J Med. 1978, 299(23):1271-1277. CrossRefPubMed
- Cerebrovascular mental stress reactivity is impaired in hypertension
Tasneem Z Naqvi
Hanh K Hyuhn
- BioMed Central
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