Interactions among higher trait anxiety, sympathetic activity, and endothelial function in the elderly

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• 作者：Kosuke Narita ; Tetsuhito Murata ; Toshihiko Hamada ; Tetsuya Takahashi ; Masao Omori ; Narufumi Suganuma ; Haruyoshi Yoshida ; Yuji Wada
• 关键词：Trait anxiety ; Endothelial function ; Sympathetic modulation ; Elderly subjects ; Cardiovascular disease ; Heart rate variability
• 刊名：Journal of Psychiatric Research
• 出版年：2007
• 出版时间：August 2007
• 年：2007
• 卷：41
• 期：5
• 页码：418-427
• 全文大小：298 K

文摘

Negative psychological characteristics have been recognized as independent risk factors of cardiovascular disease (CVD). The purpose of this study was to evaluate the influence of depression and anxiety on cardiac autonomic function and endothelial function in healthy elderly subjects. Forty-six healthy elderly volunteers (mean age 60.8 years) were enrolled in this study. Cardiac autonomic function was assessed by spectral analysis of heart rate variability (HRV) with the head-up tilt test. Brachial artery endothelium-dependent flow-mediated dilation (FMD) was measured using high-resolution ultrasound. A significant positive correlation was observed between the State and Trait Anxiety Inventory (STAI)-trait score as a parameter of anxiety and HRV sympathetic modulation in the supine position (baseline), and a significant negative correlation between this score and the head-up-induced HRV sympathetic response from the baseline. The STAI-trait score also showed a significant negative correlation with the percent change of FMD ( % FMD). Analysis using structural equation modeling showed that higher trait anxiety reduced % FMD via abnormalities of sympathetic activity. On the other hand, psychometric parameters of depression were not associated with any HRV component or % FMD. These results suggest that there are specific interactions among higher trait anxiety, abnormalities of sympathetic activity, and endothelial dysfunction. This finding may be useful in clarifying the pathophysiological mechanism by which anxiety is associated with increased risks for atherosclerosis and CVD.