Cardiovascular reactivity to mental stress in the Stockholm Female Coronary Risk Study

Objective: This study evaluated the ability of mental stress testing to dis criminate between women with and without CHD, and among women with differen t disease manifestations, taking into account history of hypertension and b eta -blocker use. Methods: Analyses were based on data from a community-bas ed case-control study of women aged 65 years or younger. The study group co nsisted of 292 women who were hospitalized for an acute event of CHD, eithe r AMI or unstable AP in Stockholm between 1991 and 1994. Controls were matc hed to cases by age and catchment area. Cardiovascular reactivity and emoti onal response to an anagram task solved under time pressure were measured 3 to 6 months after hospitalization. Results: Patients reacted with smaller increases in heart rate (4 bpm) than their controls (7 bpm). Results for th e rate-pressure product were similar. Cardiovascular reactions did not dist inguish patients with AP from those with AML History of hypertension (prese nt in 50% of patients and 11% of controls) was related to enhanced diastoli c blood pressure reactivity. Patients on beta -blockers (66%) had lower hea rt-rate levels throughout testing, but did not differ in their cardiovascul ar stress reactions when compared with the remaining participants. Conclusi ons: Women with heart disease have somewhat lower heart-rate responses to s tress than healthy age-matched controls. History of hypertension is related to enhanced diastolic blood pressure reactivity to mental stress in both p atients and controls.