Abstract
The cardiovascular system typically adapts to acute mental stress by a response pattern called the “defense reaction” which serves to prepare the organism for fight or flight.1,2 The changes associated with the defense reaction provide short term survival benefit, but they may also provoke acute cardiovascular complications, as discussed in Chap. 9 on the triggering of plaque rupture, and Chap. 10 on stress cardiomyopathy.
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Folkow B. Physiological aspects of primary hypertension. Physiol Rev. 1982;62:347-504.
Herd JA. Cardiovascular responses to stress. Physiol Rev. 1991;71:305-330.
Henry JP, Stephens PM, Ely DL. Psychosocial hypertension and the defence and defeat reactions. J Hypertens. 1986;4:687-697.
Steptoe A, Vögele C. Methodology of mental stress testing in cardiovascular research. Circulation. 1991;83:II-14-II-24.
Hjemdahl P. Plasma catecholamines – analytical challenges and physiological limitations. Baillère’s Clin Endocrinol Metab. 1993;7:307-353.
Rowell LB. Reflex control of regional circulations in humans. J Auton Nerv Syst. 1984;11:101-114.
Shepherd JT, Mancia G. Reflex control of the human cardiovascular system. Rev Physiol Biochem Pharmacol. 1986;105:3-99.
Malpas SC. Sympathetic nervous system overactivity and its role in the development of cardiovascular disease. Physiol Rev. 2010;90:513-557.
Rozanski A, Blumenthal JA. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99:2192-2217.
Julius S. The blood pressure seeking properties of the central nervous system. J Hypertens. 1988;6:177-185.
DiBona GF, Esler M. Translational medicine: the antihypertensive effect of renal denervation. Am J Physiol. 2010;298:R245-R253.
Lundberg JM. Pharmacology of cotransmission in the autonomic nervous system: integrative aspects on amines, neuropeptides, adenosine triphosphate, amino acids and nitric oxide. Pharmacol Rev. 1996;48:113-178.
Pernow J, Kahan T, Hjemdahl P, Lundberg JM. Possible involvement of neuropeptide Y in sympathetic vascular control of canine skeletal muscle. Acta Physiol Scand. 1988;132:43-50.
Pernow J, Schwieler J, Kahan T, et al. Influence of sympathetic discharge pattern on norepinephrine and neuropeptide Y release. Am J Physiol. 1989;257:H866-H872.
Morris MJ, Cox HS, Lambert GW, et al. Region-specific neuropeptide Y overflows at rest and during sympathetic activation in humans. Hypertension. 1997;29:137.
Tidgren B, Theodorsson E, Hjemdahl P. Renal and systemic plasma immunoreactive neuropeptide Y and calcitonin gene-related peptide responses to mental stress and adrenaline in humans. Clin Physiol. 1991;11:9-19.
Tidgren B, Hjemdahl P, Theodorsson E, Nussberger J. Renal responses to dynamic exercise in man. J Appl Physiol. 1991;70:2279-2286.
Hjemdahl P. Physiology of the autonomic nervous system as related to cardiovascular function: implications for stress research. In: Byrne DG, Rosenman RH, eds. Anxiety and the Heart. New York: Hemisphere Publ Corp; 1991:95-158.
Esler M, Jennings G, Lambert G, et al. Overflow of catecholamine neurotransmitters to the circulation: source, fate and functions. Physiol Rev. 1990;70:963-985.
Wallin BG, Fagius J. Peripheral sympathetic neural activity in conscious humans. Annu Rev Physiol. 1988;50:565-576.
Joyner MJ, Charkoudian N, Walin BG. Sympathetic nervous system and blood pressure in humans – individualized patterns of regulation and their implications. Hypertension. 2010;56:10-16.
Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability; standards of measurement, physiological interpretation, and clinical use. Eur Heart J. 1996;17:354-381.
Lahiri MK, Kannankeril PJ, Goldberger JJ. Assessment of autonomic function in cardiovascular disease. J Am Coll Cardiol. 2008;51:1725-1733.
Kingwell BA, Thompson JM, Kaye DM, et al. Heart rate spectral analysis, cardiac norepinephrine spillover and muscle sympathetic nerve activity during human sympathetic nervous activation and failure. Circulation. 1994;90:234-240.
Hjemdahl P, Åkerstedt T, Pollare T, Gillberg M. Influence of beta-adrenoceptor blockade by metoprolol and propranolol on plasma concentrations and effects of noradrenaline and adrenaline during i.v. infusion. Acta Physiol Scand. 1983;515(Suppl):45-53.
Åkerstedt T, Gillberg M, Hjemdahl P, et al. Comparison of urinary and plasma catecholamine responses to mental stress. Acta Physiol Scand. 1983;117:19-26.
Kopp U, Bradley T, Hjemdahl P. Renal venous outflow and urinary excretion of norepinephrine, epinephrine and dopamine during graded renal nerve stimulation. Am J Physiol. 1983;244:E52-E60.
Hedman A, Hjemdahl P, Nordlander R, Åström H. Effects of mental and physical stress on central haemodynamics and cardiac sympathetic nerve activity during QT interval-sensing rate-responsive and fixed rate ventricular inhibited pacing. Eur Heart J. 1990;11:903-915.
Anderson EA, Wallin BG, Mark AL. Dissociation of sympathetic nerve activity in arm and leg muscle during mental stress. Hypertension. 1987;9(suppl 3):114-119.
Folkow B, Di Bona GF, Hjemdahl P, et al. Measurements of plasma norepinephrine concentrations in human primary hypertension – a word of caution on their applicability for assessing neurogenic contributions. Hypertension. 1983;5:399-403.
Friberg P, Meredith I, Jennings G, et al. Evidence of increased renal noradrenaline spillover rate during sodium restriction in man. Hypertension. 1990;16:121-130.
Lambert E, Dawood T, Schlaich M, et al. Single-unit sympathetic discharge pattern in pathological conditions associated with elevated cardiovascular risk. Clin Exp Pharmacol Physiol. 2008;35:503-507.
Esler M, Eikelis N, Schlaich M, et al. Chronic mental stress is a cause of essential hypertension: presence of biological markers of stress. Clin Exp Pharmacol Physiol. 2008;35:498-502.
Esler M, Eikelis N, Schlaich M, et al. Human sympathetic nerve biology: parallel influences of stress and epigenetics in essential hypertension and panic disorder. Ann NY Acad Sci. 2008;1148:338-348.
Joyner MJ, Dietz NM. Sympathetic vasodilatation in human muscle. Acta Physiol Scand. 2003;177:329-336.
Willerson JT, Golino P, Eidt J, et al. Specific platelet mediators and unstable coronary artery lesions: experimental evidence and potential clinical implications. Circulation. 1989;80:198-205.
Charakida M, Masi S, Lüscher TF, et al. Assessment of atherosclerosis: the role of flow mediated dilatation. Eur Heart J. 2010;31:2854-2861.
Deanfield J, Donald A, Ferri C, et al. Endothelial function and dysfunction. Methodological issues for assessments in the different vascular beds: a statement by the Working Group on endothelin and endothelial factors of the European Society of hypertension. J Hypertens. 2005;23:7-17.
Deanfield JE, Halcox JP, Rabelink JP. Endothelial function and dysfunction: testing and clinical relevance. Circulation. 2007;115:1285-1295.
Vanhoutte PM, Tang EHC. Endothelial contractions: when a good guy turns bad! J Physiol. 2008;586:5295-5304.
Folkow B. Physiological aspects of the “defence” and “defeat” reactions. Acta Physiol Scand. 1997;640(suppl):34-37.
Brod J. Haemodynamic basis of acute pressor reactions and hypertension. Br Heart J. 1963;25:227-245.
Freyschuss U, Hjemdahl P, Juhlin-Dannfelt A, Linde B. Cardiovascular and sympathoadrenal responses to mental stress: influence of β-blockade. Am J Physiol. 1988;255:H443-H451.
Brod J, Cachovan M, Bahlman J, et al. Haemodynamic response to an emotional stress (mental arithmetic) with special reference to the venous side. Aust N Z J Med. 1976;6(suppl2):19-25.
Yeung AC, Vekshtein VI, Krantz DS, et al. The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress. N Engl J Med. 1991;325:1551-1556.
Ludmer PL, Selwyn AP, Shook TL, et al. Paradoxical vasoconstriction induced by acetylcholine in atherosclerotic coronary arteries. N Engl J Med. 1986;315:1046-1051.
Monahan KD. Effect of aging on baroreflex function in humans. Am J Physiol. 2007;293:R3-R12.
De Meersman RE, Stein PK. Vagal modulation and aging. Biol Psychol. 2007;74:165-173.
Kaye DM, Esler MD. Autonomic control of the aging heart. Neuromol Med. 2008;10:179-186.
Esler MD, Kaye DM, Thompson JM, et al. Effects of aging on epinephrine secretion, and on regional release of epinephrine from the human heart. J Clin Endocrinol Metab. 1995;80:435-442.
Lindqvist M, Melcher A, Hjemdahl P. Hemodynamic and sympatho-adrenal responses to mental stress during nitric oxide synthesis blockade. Am J Physiol. 2004;287:H2309-H2315.
Linde B, Hjemdahl P, Freyschuss U, Juhlin-Dannfelt A. Adipose tissue and skeletal muscle blood flow during mental stress. Am J Physiol. 1989;256:E12-E18.
Hjemdahl P, Fagius J, Freyschuss U, et al. Muscle sympathetic nerve activity and norepinephrine release during mental challenge in humans. Am J Physiol. 1989;257:E654-E664.
Lindqvist M, Kahan T, Melcher A, et al. Forearm vasodilator mechanisms during mental stress – possible roles of epinephrine and ANP. Am J Physiol. 1996;270:E393-E399.
Rusch NJ, Shepherd JT, Webb RC, Vanhoutte PM. Different behaviour of the resistance vessels of the human calf and forearm during contralateral isometric exercise, mental stress, and abnormal respiratory movements. Circ Res. 1981;48:I-118-I-130.
Dietz NM, Rivera JM, Eggener SE, et al. Nitric oxide contributes to the rise in forearm blood flow during mental stress in humans. J Physiol. 1994;480:361-368.
Ghiadoni L, Donald AE, Cropley M, et al. Mental stress induces transient endothelial dysfunction in humans. Circulation. 2000;102:2473-2478.
Tidgren B, Hjemdahl P. Renal responses to mental stress and epinephrine in man. Am J Physiol. 1989;257:F682-F689.
Hollenberg NK, Williams GH, Adams DF. Essential hypertension: abnormal renal vascular and endocrine responses to a mild psychological stimulus. Hypertension. 1981;2:11-17.
Tidgren B, Hjemdahl P. Reflex activation of renal nerves in humans – effects on noradrenaline, dopamine and renin overflow to renal venous plasma. Acta Physiol Scand. 1988;134:23-34.
Freyschuss U, Hjemdahl P, Juhlin-Dannfelt A, Linde B. Cardiovascular and metabolic responses to low dose adrenaline infusion: an invasive study in humans. Clin Sci (Lond). 1986;70:199-206.
Mancia G, Bousquet P, Elghozi JL, et al. The sympathetic nervous system and the metabolic syndrome. J Hypertens. 2007;25:909-920.
Mancia G, Grassi G, Giannattasio C, Seravalle G. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension. 1999;34(part 2):724-728.
Palatini P, Julius S. Heart rate and cardiovascular risk. J Hypertens. 1997;15:3-17.
Lown B, Verrier RL. Neural activity and ventricular fibrillation. N Engl J Med. 1976;294:1165-1170.
Verrier RL, Lown B. Behavioral stress and cardiac arrhythmias. Annu Rev Physiol. 1984;46:155-176.
Strike PC, Steptoe A. Systematic review of mental stress-induced myocardial ischemia. Eur Heart J. 2003;24:690-703.
Rehnqvist N, Hjemdahl P, Billing E, et al. Effects of metoprolol versus verapamil in patients with stable angina pectoris - the Angina Prognosis Study In Stockholm (APSIS). Eur Heart J. 1996;17:76-81.
Forslund L, Björkander I, Ericson M, et al. Prognostic implications of autonomic function in patients with stable angina pectoris – analyses of catecholamines and heart rate variability in the APSIS study. Heart. 2002;87:415-422.
Björkander I, Forslund L, Kahan T, et al. Differential index – a simple time domain heart rate variability method with prognostic implications in stable angina pectoris. Cardiology. 2008;111:126-33.
Chida Y, Steptoe A. Greater cardiovascular responses to mental stress are associated with poor subsequent cardiovascular risk status. Hypertension. 2010;55:1026-1032.
Flaa A, Eide IK, Kjeldsen SE, Rostrup M. Sympathoadrenal stress reactivity is a predictor of future blood pressure. An 18-year follow-up study. Hypertension. 2008;52:336-341.
Kajantie E, Phillips DIW. The effects of sex and hormonal status on the physiological response to acute psychosocial stress. Psychoneuroendocrinology. 2006;31:151-178.
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Hjemdahl, P., Esler, M. (2011). Cardiovascular and Autonomic Responses to Stress. In: Hjemdahl, P., Steptoe, A., Rosengren, A. (eds) Stress and Cardiovascular Disease. Springer, London. https://doi.org/10.1007/978-1-84882-419-5_3
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