This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cardillo, C. Articles by Panza, J. A. Search for Related Content PubMed PubMed Citation Articles by Cardillo, C. Articles by Panza, J. A.

CLINICAL STUDIES

Impairment of the nitric oxide–mediated vasodilator response to mental stress in hypertensive but not in hypercholesterolemic patients

^a Cardiology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA

Manuscript received June 16, 1998; accepted July 2, 1998.

Address for correspondence: Dr. Julio A. Panza, Cardiology Branch, NHLBI, NIH, Building 10, Room 7B-15, 10 Center Drive, Bethesda, Maryland 20892-1650
panzaj{at}gwgate.nhlbi.nih.gov

Objectives. This study investigated whether mental stress–induced vasodilation mediated by endothelium-derived nitric oxide (NO) is defective in conditions with endothelial dysfunction, such as hypertension and hypercholesterolemia.

Background. Vascular release of NO modulates the vasodilator response to mental stress in healthy subjects. Previous studies have shown that hypertensive and hypercholesterolemic patients have impaired endothelium-dependent vasodilation to pharmacologic agents due to decreased NO activity. However, whether this abnormality also operates in response to physiologic stimuli such as mental stress has not been defined.

Methods. Forearm blood flow responses (plethysmography) to mental stress were compared in 12 normal subjects, 12 hypertensive patients and 10 hypercholesterolemic patients before and during NO synthesis inhibition with N^G-monomethyl-L-arginine (4 µmol/min). Vascular responses to acetylcholine (7.5, 15 and 30 µg/min), an endothelium-dependent vasodilator, and sodium nitroprusside (0.8, 1.6 and 3.2 µg/min), an exogenous NO donor, were also assessed in each group.

Results. During saline the vasodilator response to mental stress was significantly blunted in hypertensive (37 ± 11%; p = 0.01) but not in hypercholesterolemic (85 ± 21%; p = 0.78) patients compared with controls (93 ± 15%). N^G-Monomethyl-L-arginine administration significantly blunted mental stress–induced vasodilation in healthy subjects (p = 0.004 vs. saline) and hypercholesterolemic patients (p = 0.03 vs. saline), but not in hypertensive patients (p = 0.69 vs. saline). The vasodilator effect of the highest dose of acetylcholine was similarly blunted in hypertensive (215 ± 44%; p = 0.02) and hypercholesterolemic (172 ± 71%; p = 0.02) patients compared with controls (364 ± 34), whereas the vasorelaxing response to sodium nitroprusside was similar in the three groups.

Conclusions. Hypertensive but not hypercholesterolemic patients have impaired NO-dependent vasodilation during mental stress. These findings may be accounted for by different mechanisms underlying endothelial dysfunction in these two conditions and might explain an increased susceptibility of hypertensive patients to vascular damage over repeated exposure to stressful situations.

This article has been cited by other articles:

				B Wolff, H J Grabe, H Volzke, J Ludemann, C Kessler, J B Dahm, H J Freyberger, U John, and S B Felix Relation between psychological strain and carotid atherosclerosis in a general population Heart, April 1, 2005; 91(4): 460 - 464. [Abstract] [Full Text] [PDF]

				R. A. Mangiafico, L. S. Malatino, T. Attina, R. Messina, and C. E. Fiore Exaggerated Endothelin Release in Response to Acute Mental Stress in Patients with Intermittent Claudication Angiology, July 1, 2002; 53(4): 383 - 390. [Abstract] [PDF]

				O. A. Paniagua, M. B. Bryant, and J. A. Panza Role of Endothelial Nitric Oxide in Shear Stress-Induced Vasodilation of Human Microvasculature : Diminished Activity in Hypertensive and Hypercholesterolemic Patients Circulation, April 3, 2001; 103(13): 1752 - 1758. [Abstract] [Full Text] [PDF]

				C. Cardillo, C. M. Kilcoyne, R. O. Cannon III, and J. A. Panza Increased activity of endogenous endothelin in patients with hypercholesterolemia J. Am. Coll. Cardiol., November 1, 2000; 36(5): 1483 - 1488. [Abstract] [Full Text] [PDF]

				H. Schoder, D. H. Silverman, R. Campisi, J. W. Sayre, M. E. Phelps, H. R. Schelbert, and J. Czernin Regulation of myocardial blood flow response to mental stress in healthy individuals Am J Physiol Heart Circ Physiol, February 1, 2000; 278(2): H360 - H366. [Abstract] [Full Text] [PDF]