Ghiadoni L, Donald A E, Cropley M, Mullen M J, Oakley G, Taylor M, O'Connor G, Betteridge J, Klein N, Steptoe A, Deanfield J E
Vascular Physiology Unit, Great Ormond Street Hospital for Children NHS Trust, London WC1 3JH, UK.
Circulation. 2000 Nov 14;102(20):2473-8. doi: 10.1161/01.cir.102.20.2473.
Mental stress has been linked to increased morbidity and mortality in coronary artery disease and to atherosclerosis progression. Experimental studies have suggested that damage to the endothelium may be an important mechanism.
Endothelial function was studied in 10 healthy men (aged 50. 4+/-9.6 years) and in 8 non-insulin-dependent diabetic men (aged 52. 0+/-7.2 years). Brachial artery flow-mediated dilation (FMD, endothelium dependent) and response to 50 microg of sublingual glyceryl trinitrate (GTN, endothelium independent) were measured noninvasively by use of high-resolution ultrasound before and after (30, 90, and 240 minutes) a standardized mental stress test. The same protocol without mental stress was repeated on a separate occasion in the healthy men. In healthy subjects, FMD (5.0+/-2.1%) was significantly (P:<0.01) reduced at 30 and 90 minutes after mental stress (2.8+/-2.3% and 2.3+/-2.4%, respectively) and returned toward normal after 4 hours (4.1+/-2.0%). Mental stress had no effect on the response to GTN. In the repeated studies without mental stress, FMD did not change. The diabetic subjects had lower FMD than did the control subjects (3.0+/-1.5% versus 5.0+/-2.1%, respectively; P:=0.02) but showed no changes in FMD (2.7+/-1.1% after 30 minutes, 2.8+/-1.9% after 90 minutes, and 3.1+/-2.3% after 240 minutes) or GTN responses after mental stress.
These findings suggest that brief episodes of mental stress, similar to those encountered in everyday life, may cause transient (up to 4 hours) endothelial dysfunction in healthy young individuals. This might represent a mechanistic link between mental stress and atherogenesis.
精神压力与冠状动脉疾病的发病率和死亡率增加以及动脉粥样硬化进展有关。实验研究表明，内皮损伤可能是一个重要机制。
对10名健康男性（年龄50.4±9.6岁）和8名非胰岛素依赖型糖尿病男性（年龄52.0±7.2岁）的内皮功能进行了研究。在标准化精神压力测试前后（30、90和240分钟），使用高分辨率超声无创测量肱动脉血流介导的舒张功能（FMD，内皮依赖性）和对50微克舌下硝酸甘油（GTN，内皮非依赖性）的反应。在健康男性中，在另一个时间重复进行无精神压力的相同方案。在健康受试者中，精神压力后30分钟和90分钟时FMD（5.0±2.1%）显著降低（分别为2.8±2.3%和2.3±2.4%，P<0.01），4小时后恢复正常（4.1±2.0%）。精神压力对GTN反应无影响。在无精神压力的重复研究中，FMD无变化。糖尿病受试者的FMD低于对照组（分别为3.0±1.5%和5.0±2.1%；P=0.02），但精神压力后FMD（30分钟后2.7±1.1%，90分钟后2.8±1.9%，240分钟后3.1±2.3%）或GTN反应无变化。
这些发现表明，与日常生活中遇到的类似的短暂精神压力事件可能导致健康年轻个体出现短暂（长达4小时）的内皮功能障碍。这可能代表了精神压力与动脉粥样硬化发生之间的机制联系。
