title: Awareness and control of the cardiovascular response to stress among men with and without an acute myocardial infarction.
abstract: OBJECTIVE
  To compare males who had sustained an acute myocardial infarction with healthy controls in awareness and control of their cardiovascular responses to laboratory stressors as well as their ability to relax.
  
  
  METHODS
  Patients and volunteer controls were recruited to participate in a case control comparative study using a structured protocol.
  
  
  METHODS
  Patients were recruited from the Ottawa General Hospital. Controls came from the Ottawa-Carleton region. All participants were studied in the authors' laboratory at the hospital.
  
  
  METHODS
  Thirty-two men who had sustained an acute myocardial infarction within two years and 39 healthy male controls are reported. Forty-one patients refused participation and 47 were excluded.
  
  
  METHODS
  All participants completed a self-administered questionnaire and underwent a structured 1 h laboratory session that included exposure to psychological and physical (cold pressor) stress alternating with attempts to relax. During the laboratory session, cardiovascular reactivity was monitored noninvasively.
  
  
  RESULTS
  Compared with controls, patients presented with higher levels of cardiovascular reactivity on exposure to stress, primarily in their vasoconstrictive response. More cases demonstrated an increase in systemic vascular resistance while attempting to relax; they reported feeling relaxed immediately following exposure to stress.
  
  
  CONCLUSIONS
  The discordance between the subjective feeling of relaxation and the actual physiological response indicates, in postinfarction male patients, an impaired ability to monitor and regulate the stress response.
authors.affiliation: Department of Psychology, Ottawa General Hospital, Ontario.
authors.forename: R P
authors.initials: RP
authors.lastname: Nolan
authors.forename: A T
authors.initials: AT
authors.lastname: Wielgosz
authors.forename: E S
authors.initials: ES
authors.lastname: Biro
authors.forename: M B
authors.initials: MB
authors.lastname: Wielgosz
mesh_terms: D000328:Adult; D000368:Aged; D001364:Awareness; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000523:psychology; D012063:Relaxation; D013315:Stress, Psychological / Q000503:physiopathology*