EMBARGOED FOR RELEASE Jan. 10, 2000
CONTACT: Meredith Meyer (313) 876-2882
High Levels of Stress Linked to Ischemic Heart Disease
DETROIT -- A treadmill stress test is frequently used to diagnose heart disease. Now, researchers have mounting evidence that another kind of stress test --a mental stress test -- may also be of value in identifying and managing patients at risk for a heart attack.
Stress was shown to provoke ischemia, or lack of blood flow to the heart that can lead to a heart attack, in a study led by Mark Ketterer, Ph.D., of Henry Ford Hospital's Department of Behavioral Health. The study -- the largest of its kind to measure the heart's physiological response to mental stress -- is published in the January issue of the Journal of Health Psychology.
"We've known for some time that stress plays a significant role in heart disease," Dr. Ketterer said. "This study demonstrates that personality traits such as anger or irritability can predict people who might have ischemia induced by mental stress. This can help us identify patients who might be at risk for heart disease. Many times if these patients can manage their anger, they can lower their risk for heart attack and death."
In the study, 184 patients with a history of heart disease or heart attack (160 males, 24 females) underwent treadmill stress tests to determine their baseline level of ischemia and on a separate visit were administered mental stress tests.
The five-minute mental stress tests consisted of a computerized "color-word task" (in which they were challenged to select color words that appeared in the wrong color) and a simulated "speech task" (in which the patient role-played a scripted confrontation with another person). At one-minute intervals during the test, blood was drawn to gauge hormonal levels and heart rate and blood pressure were automatically recorded. The heart was also imaged to determine the amount of blood pumped by the heart muscle and the motions of the heart wall.
Dr. Ketterer said it is significant that men and women in the study had distinctly different responses to stress. Women were found to be more likely to admit they were angry. He said these women might have an advantage in preventing future heart attacks.
The tests also revealed:
* anger provoked an ischemic response more than half the time (58 percent);
* patients with ischemia displayed more anger and irritability than patients who did not have ischemia;
* patients elicited a more intense physiological response to the speech task than the color-word task. This is consistent with previous observations that heart attacks seem to occur more frequently during a stressful interpersonal confrontation; and,
* patients who were found to be 'reward dependent' -- meaning they were eager to please others, were sympathetic and sensitive to social situations -- were more likely to display ischemia in stressful interpersonal situations than patients who were detached, insensitive and independent.
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