STRESS-INDUCED PULSE PRESSURE CHANGE PREDICTS WOMENS CAROTID ATHEROSCLEROSIS

Background and Purpose-Individuals who exhibit large increases in bloo d pressure and heart rate during mental stress may be at risk for acce lerated atherosclerosis. This report evaluates the association between stress-induced hemodynamic responses and carotid atherosclerosis in 2 54 healthy postmenopausal women.Methods-The magnitude of change in blo od pressure and heart rate from rest to public speaking and mirror ima ge tracing, two stressful tasks, was measured. Average intima-media th ickness (IMT) and focal plaque in the common carotid artery, bulb, and internal carotid artery were measured with the use of duplex ultrason ography on average 2.3 years later. Results-The average WIT was 0.77 m m, with a range of 0.60 to 1.37; 52.5% had at least one plaque. Correl ational analysis showed that greater IMT was associated with greater p ulse pressure change during mental stress (r=0.17, P<0.01). Statistica l adjustments for possible confounders (age, hormone replacement thera py use, resting pulse pressure, smoking status, and triglyceride level s) did not alter the results. The plaque index was associated with gre ater pulse pressure change during the mirror image tracing task (odds ratio=1.47, P=0.01) for women with a plaque score of greater than or e qual to 2 versus 1 or 0, adjusted for possible confounders. Conclusion s-Mental stress-induced pulse pressure changes may influence the devel opment of early atherosclerosis in the carotid artery of women. Wideni ng of pulse pressure during stress, as well as at rest, may be a marke r of compromised compliance in the vessel wall.