Nebel L E, Howell R H, Krantz D S, Falconer J J, Gottdiener J S, Gabbay F H
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA.
Psychophysiology. 1996 May;33(3):273-81. doi: 10.1111/j.1469-8986.1996.tb00424.x.
Two studies assessed the circadian variation of cardiovascular responses to stress in healthy and coronary artery disease (CAD) populations. In within-subjects designs, stressors were administered to healthy male subjects and male CAD patients both in the morning and afternoon, and subjects were classified as either morning or evening types using the Morningness-Eveningness Questionnaire (Horne & Ostberg, 1976, International Journal of Chronobiology, 4, 97-110). No consistent circadian variation in blood pressure or heart rate responses was observed in the aggregate sample of either healthy subjects or CAD patients. However, there were significant interactions between circadian type and time of day. In both populations, morning subjects exhibited higher cardiovascular levels during the morning session, and evening subjects exhibited higher levels during the afternoon session. Analyses of cardiovascular reactivity revealed less consistent evidence for this interaction. Self-reports of stress revealed interactions between time of day and morningness/eveningness only in the CAD sample. In CAD patients, preliminary analysis of myocardial wall function, an index of myocardial ischemia, did not reveal a significant interaction between morningness/eveningness and time of day, perhaps due to small sample size. The presence of differing circadian patterns in stress response based on individual differences in morningness/eveningness is discussed in terms of its methodological implications for psychophysiological research and in terms of the role of stress as an acute trigger of CAD.
两项研究评估了健康人群和冠状动脉疾病（CAD）人群中，心血管对应激反应的昼夜变化。在受试者内设计中，分别在上午和下午对健康男性受试者和男性CAD患者施加应激源，并使用晨型-夜型问卷（霍恩和奥斯特伯格，1976年，《国际时间生物学杂志》，第4卷，97 - 110页）将受试者分为晨型或夜型。在健康受试者或CAD患者的总体样本中，未观察到血压或心率反应存在一致的昼夜变化。然而，昼夜类型和一天中的时间之间存在显著的交互作用。在这两个人群中，晨型受试者在上午时段表现出较高的心血管水平，而夜型受试者在下午时段表现出较高的水平。对心血管反应性的分析显示，这种交互作用的证据不太一致。应激的自我报告仅在CAD样本中显示出一天中的时间与晨型/夜型之间的交互作用。在CAD患者中，对心肌壁功能（心肌缺血的一个指标）的初步分析未显示出晨型/夜型与一天中的时间之间存在显著的交互作用，这可能是由于样本量较小。基于晨型/夜型的个体差异，应激反应中不同昼夜模式的存在，从其对心理生理学研究的方法学意义以及应激作为CAD急性触发因素的作用方面进行了讨论。
