ArticleInternational journal of cardiology2018
Mental stress peripheral vascular reactivity is elevated in women with coronary vascular dysfunction: Results from the NHLBI-sponsored Cardiac Autonomic Nervous System (CANS) study.
Article in International journal of cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 30 citations in OpenAlex.
- Anxiety and peripheral artery disease.Clinical science (London, England : 1979) · 2026Review
- Bidirectional brain-heart communication in coronary heart disease: from coronary plaques to central autonomic networks.Frontiers in neuroscience · 2026Review
- Mental stress as a trigger of cardiovascular events: A narrative review.European journal of clinical investigation · 2026Review
- Redox Regulation of Microvascular Physiology and Pathophysiology: Insights into Therapeutic Strategies and Limitations.Antioxidants & redox signaling · 2025Review
- Changing clinical perspectives on sex and healthcare disparities in ischaemic heart disease.The Lancet regional health. Europe · 2025Review
- Paroxysmal Supraventricular Tachycardia and Troponin Elevation: Insights into Mechanisms, Risk Factors, and Outcomes.Journal of clinical medicine · 2025Article
- Parasympathetic response in women with coronary vascular dysfunction during mental stress compared to those with non-cardiac chest pain and reference controls.International journal of cardiology. Heart & vasculature · 2025Article
- Psychosocial stress and cardiovascular disease.American journal of preventive cardiology · 2025Review
- The Role of Psychosocial Stress on Cardiovascular Disease in Women: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2024Review
- Quantitation of diffuse myocardial ischemia with mental stress and its association with cardiovascular events in individuals with recent myocardial infarction.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Clinical and psychological characteristics of patients with ischemia and non-obstructive coronary arteries (INOCA) and obstructive coronary artery disease.American heart journal plus : cardiology research and practice · 2023Article
- Latest from the WISE: Contributions to the Understanding of Ischemia and Heart Failure among Women with No Obstructive Coronary Arteries.Reviews in cardiovascular medicine · 2023Review
- The sex-dependent response to psychosocial stress and ischaemic heart disease.Frontiers in cardiovascular medicine · 2023Review
- Ischemia and no obstructive coronary arteries (INOCA): A narrative review.Atherosclerosis · 2022Review
- Mental Stress and Its Effects on Vascular Health.Mayo Clinic proceedings · 2022Review
- Anxiety Disorders Are Associated With Coronary Endothelial Dysfunction in Women With Chest Pain and Nonobstructive Coronary Artery Disease.Journal of the American Heart Association · 2021Article
- Brain-heart connections in stress and cardiovascular disease: Implications for the cardiac patient.Atherosclerosis · 2021Review
- The Role of Mental Stress in Ischaemia with No Obstructive Coronary Artery Disease and Coronary Vasomotor Disorders.European cardiology · 2021Review
- Gender-Related Differences in Chest Pain Syndromes in the Frontiers in CV Medicine Special Issue: Sex & Gender in CV Medicine.Frontiers in cardiovascular medicine · 2021Review
- Peripheral endothelial dysfunction is a novel risk factor for systolic dysfunction and heart failure progression.International journal of cardiology. Heart & vasculature · 2020Article
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundWomen with chest pain, ischemia, and no obstructive coronary artery disease often have coronary vascular dysfunction (CVaD). Peripheral vascular reactivity to mental stress may contribute mechanistic understanding of stress-induced ischemia in women with CVaD.
methods62 women (41 CVaD and 21 controls) underwent mental stress testing (MST) with anger recall, mental arithmetic, and forehead cold pressor (COP) challenge. Emotional arousal was measured (Likert scale). Reactive hyperemia index (RHI) was calculated before and after MST by peripheral arterial tonometry (PAT). Stress PAT ratio (SPR) of pulse amplitude during stress to rest was obtained to measure vasoconstriction. Wilcoxson rank sum test was used for analysis.
resultsMean age of CVaD and control groups was 58±9 and 55±10years (p=0.73). Baseline RHI correlated with coronary endothelial function (r=0.36, p=0.03) and inversely with RHI change post-MST (r=-0.51, p<0.001). During MST, 10% of controls reported chest pain vs. 41% of CVaD subjects (p=0.01). RHI did not change significantly after MST in either group. CVaD subjects had lower SPR vs. controls during mental arithmetic (0.54 [0.15, 1.46] vs. 0.67 [0.36, 1.8], p=0.039), not evident in the other tasks. Vasoconstriction inversely correlated with anxiety (r=-3.4, p=0.03), frustration (r=-0.37, p=0.02), and feeling challenged (r=-0.37, p=0.02) in CVaD but not controls.
conclusionsMental stress peripheral vascular reactivity is elevated in women with CVaD compared to controls. Elevated vascular reactivity may be one contributor to stress-induced chest pain in CVaD. Interventions that modulate vasoconstrictive responses may be of benefit and should be tested in clinical trials in women with CVaD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.