Depressive symptoms, anxiety and social stress are associated with diminished cardiovascular reactivity in a psychological treatment-naive population

Stressor-evoked heart rate, perceived physiological arousal, and anxiety symptoms in young adults

BACKGROUND

Acute psychological stress is associated with increases in heart rate (HR) and state anxiety. Stressor-evoked perceived HR changes relate more strongly to state anxiety than actual HR reactivity. However, research has yet to examine these associations in the context of general anxiety symptoms.

METHODS

Participants (N = 160) completed a resting baseline period followed by a standardized acute psychological stress task; HR was recorded throughout. After the stress task, participants rated their perceived stressor-evoked physiological arousal and anxiety intensity. Participants also completed a general anxiety symptoms measure ~17 days later.

RESULTS

The a priori hypothesized model demonstrated a good fit to the data, χ2 (59) = 93.15, p = .003; CFI = 0.94; TLI = 0.91; SRMR = 0.05; RMSEA = 0.06 (90 % CI = 0.04-0.08). After controlling for covariates, perceived physiological arousal was positively related to both cognitive and somatic anxiety. In turn, only somatic anxiety was positively associated with general anxiety symptoms. Perceived physiological arousal was related to general anxiety symptoms through state somatic anxiety. HR reactivity was not statistically significantly associated with either cognitive or somatic anxiety.

LIMITATIONS

The study was correlational, which limits the ability to determine causation.

CONCLUSIONS

Perceived HR, rather than actual HR, is more closely associated with anxiety intensity during acute psychological stress. Stressor-evoked perceived HR and general anxiety symptoms are related indirectly through stressor-evoked somatic anxiety intensity. The findings have implications for elucidating the mechanisms of the stress-anxiety relationship.

Psychological factors and blood pressure responses to acute stress in women with takotsubo syndrome: an exploratory study

AIMS

This secondary analysis aimed to (i) describe psychological resources and distress in women with takotsubo syndrome (TS) and (ii) explore whether such factors affect blood pressure (BP) responses to acute mental stress.

METHODS AND RESULTS

Participants were 47 women consecutively enrolled in an ongoing study examining the prognostic significance of stress reactivity in TS. Psychological resources (resilience and adaptive coping) and distress [depression, anxiety, post-traumatic stress disorder (PTSD), and perceived stress] were self-reported using validated questionnaires <12 weeks after TS. Using a standardized protocol, systolic BP (SBP) and diastolic BP (DBP) (mmHg) were measured every 5 min during baseline (10 min), mental stress (10 min), and recovery (20 min). Associations of psychological resources and distress (high vs. low composite scores), respectively, with BP during mental stress and recovery (change from baseline), were examined using one-way analyses of covariance (covariates: age and anti-hypertensive medications). Given the study's exploratory nature, results are shown as effect sizes. On average, women (Mage = 64.3 years) had high perceived stress, anxiety, and PTSD symptoms and low resilience. Women with high (vs. low) psychological distress displayed less complete SBP (d = 0.57) and DBP (d = 0.33) recovery to baseline. Women with low (vs. high) psychological resources demonstrated lower SBP responses during mental stress (d = -0.26) alongside a more complete SBP recovery (d = 0.30).

CONCLUSION

Female survivors of TS with high psychological distress exhibited impaired BP recovery following acute mental stress. While the prognostic significance of impaired BP recovery from mental stress remains to be determined in longitudinal studies, this finding could help identify TS survivors at risk for recurrence.

Loneliness mediates the association between trait social anxiety and cardiovascular reactivity to acute psychological stress

The primary aims of the current study are (1) to examine the association between trait social anxiety and cardiovascular reactivity to acute psychological stress, and (2) to identify if loneliness significantly mediates the association between trait social anxiety and cardiovascular reactivity. A sample of 658 participants completed a cardiovascular reactivity protocol consisting of a resting baseline and stressor phase (mental arithmetic and Stroop), with systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored throughout. Participants also completed self-reported measures assessing social anxiety and loneliness. Social anxiety was associated with increased self-reported stress. However, no significant associations between social anxiety and measures of cardiovascular reactivity were observed in regression analyses. Loneliness was significantly associated with lower SBP and DBP reactivity. Additionally, loneliness significantly mediated the association between trait social anxiety and both SBP reactivity and DBP reactivity. Here, trait social anxiety predicted greater levels of loneliness, which in turn was associated with diminished cardiovascular reactivity. No significant associations emerged for HR reactivity. These blunted blood pressure responses to acute stress may indicate a potential mechanism leading to adverse prospective health outcomes.

Depression and cardiovascular reactions to acute psychological stress: Is anhedonia the driver?

Blunted cardiovascular reactions in response to acute psychological stress are predictive of future health risk. A large body of research has identified depression as an influential factor associated with blunted cardiovascular reactivity. Separately, there has been a resurgence in focus on anhedonia as a key feature of depression, responsible for poor treatment responses to non-improvement in cardiac event-free survival. In a re-analysis of a previously published study that found depression to be associated with blunted systolic blood pressure (SBP) and heart rate responses (HR), we used cross-sectional network models to examine if anhedonia symptoms were key drivers of this observation. Healthy young adults (N = 180) completed measures of depression symptoms (Hospital Anxiety and Depression Scale (HADS)) and had their blood pressure and heart rate monitored throughout a standardized stress testing protocol. Using network analysis, a Walktrap algorithm identified two clusters of depressive symptoms: anhedonia and non-anhedonia. These anhedonia symptoms of depression, but not the non-anhedonia symptoms, were associated with blunted SBP and HR reactivity, such that those scoring higher on HADS-D items capturing anhedonia displayed more blunted cardiovascular response profiles. Moreover, these findings were robust to adjustment for several covariates. This study adds greater clarity on the depression-cardiovascular reactivity to stress association, by demonstrating that anhedonia is a key driver of this observation.

The Brain-Heart Axis: An Umbrella Review on Impact of Psychiatric Disease on Incidence, Management, and Outlook of Cardiovascular Disease

Psychiatric conditions, such as depression, anxiety, bipolar disorder, and schizophrenia, are increasingly recognized as significant risk factors for cardiovascular disease (CVD). This review systematically analyzes evidence from various databases to provide a comprehensive understanding of the impact of psychiatric illnesses on the incidence, management, and prognosis of CVD. Key findings suggest a bidirectional relationship between psychiatric disorders and CVD, indicating that mental health conditions can predispose individuals to CVD, while CVD can exacerbate or trigger psychiatric symptoms. The review explores the underlying mechanisms of these associations, including behavioral factors, stress responses, and medication side effects. It also examines the challenges in managing CVD patients with comorbid psychiatric conditions, emphasizing the importance for integrated care approaches. This review underscores the necessity of considering mental health as an integral component of cardiovascular care and calls for further research to develop tailored management strategies for these complex conditions, ultimately aiming to improve patient outcomes and quality of life. This comprehensive analysis provides valuable insights for future investigations and guides clinicians in optimizing care for patients with both psychiatric and cardiovascular conditions.

Research status of pathogenesis of anxiety or depression after percutaneous coronary intervention and Traditional Chinese Medicine intervention

ETHNIC PHARMACOLOGICAL RELEVANCE

Anxiety or depression after percutaneous coronary intervention (PCI) is a common clinical disease. Currently, conventional pharmacotherapy primarily involves the administration of anxiolytic or antidepressant medications in conjunction with anticoagulants, antiplatelet agents, and other cardiovascular drugs. However, challenges such as drug dependence, adverse reactions and related concerns persist in the treatment of this disease. Numerous pertinent studies have demonstrated that Traditional Chinese Medicine (TCM) exhibits significant therapeutic efficacy and distinctive advantages in managing post-PCI anxiety or depression.

AIM OF THIS REVIEW

This review attempted to summarize the characteristics of TCM for treating anxiety or depression after PCI, including single Chinese herbs, Chinese medicine monomers, compound TCM prescriptions, TCM patented drugs, and other TCM-related treatment methods, focusing on the analysis of the relevant mechanism of TCM treatment of this disease.

METHODS

By searching the literature on treating anxiety or depression after PCI with TCM in PubMed, Web of Science, CNKI, and other relevant databases, this review focuses on the latest research progress of TCM treatment of this disease.

RESULTS

In the treatment of anxiety or depression after PCI, TCM exerts significant pharmacological effects such as anti-inflammatory, antioxidant, anti-anxiety or anti-depression, cardiovascular and cerebrovascular protection, and neuroprotection, mainly by regulating the levels of related inflammatory factors, oxidative stress markers, neurotransmitter levels, and related signaling pathways. TCM has a good clinical effect in treating anxiety or depression after PCI with individualized treatment.

CONCLUSIONS

TCM has terrific potential and good prospects in the treatment of anxiety or depression after PCI. The main direction of future exploration is the study of the mechanism related to Chinese medicine monomers and the large sample clinical study related to compound TCM prescriptions.

Effects of mindfulness-based interventions on cardiovascular risk factors: An umbrella review of systematic reviews and meta-analyses

OBJECTIVE

Reviews have shown that mindfulness-based interventions (MBIs) were effective in improving cardiovascular risk factors (CVRFs), but the results were contradictory. This umbrella review aimed to summarize and grade the existing reviews on CVRFs associated with MBIs.

METHODS

The protocol of this umbrella review had been registered in PROSPERO (CRD42022356812). PubMed, Web of science, Embase, The Cochrane Library, Scopus, Medline, PsycINFO and CINAHL were searched from database inception to 20 July 2022. The quality of evidence was assessed through GRADE.

RESULTS

Twenty-seven reviews with 14,923 participants were included. Overall, 45% of reviews had low heterogeneity (I2 < 25%). For the quality of evidence, 31% were rated very low, 42% were rated low, 17% were rated moderate and 10% were rated high. MBIs significantly improved systolic blood pressure [SMD -5.53 mmHg (95% CI -7.81, -3.25)], diastolic blood pressure [SMD -2.13 mmHg (95% CI -2.97, -1.30)], smoking [Cohen's d 0.42 (95% CI 0.20, 0.64)], glycosylated hemoglobin [MD 0.01 (95% CI -0.43, -0.07)], binge eating behavior [SMD -6.49 (95% CI -10.80, -2.18)], depression [SMD -0.72 (95% CI -1.23, -0.21)] and stress [SMD -0.67 (95% CI -1.00, -0.34)].

CONCLUSIONS

In conclusion, this umbrella review provided evidence for the role of MBIs in the improvement of CVRFs.

Psychological, physiological, and biochemical correlations after negative emotional videos in college students with and without premenstrual syndrome

Introduction

Women with premenstrual syndrome (PMS) suffer heavily from emotional problems, the pathogenesis of which is believed to be related to the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system (ANS) and central nervous system (CNS). We took into account all 3 aspects to observed the psychological, physiological and biochemical correlations under anger and sadness in college students with and without PMS.

Methods

33 students with PMS and 24 healthy students participated in the emotion induction experiment, and were required to fill out self-report scales. Their salivary cortisol (SCort), skin conductivity level (SCL), heart rate variability (HRV), blood pressure (BP) and electroencephalogram (EEG) data were collected at the resting stage and 10-15 minutes after each video.

Results

Compared to healthy controls, students with PMS showed lower SCort level and higher VLF at rest, and no statistic difference in activities of ANS and HPA axis after emotional videos, but different results in EEG in all conditions. The decreases in SBP during angry video, SCort after angry and neutral videos, and increases in θ band power during sad video were moderately correlated with increases in PMS score. No intergroup differences were found in self-report emotions.

Discussion

Students with PMS had lower activity of HPA axis and possibly higher activity of PNS at rest, and different response patterns in CNS in all conditions. Several EEG frequencies, especially θ band, in specific encephalic regions during emotional videos, as well as declined HPA activities in dealing with angry and neutral stressors, in which γ activity in frontal lobe may play a role, showed moderate correlations with more severe PMS.