Beta-endorphin response to exercise and mental stress in patients with ischemic heart disease.
We compared symptomatic, hemodynamic and opioid responses of heart disease patients to exercise testing and a stressful public speaking task. Plasma beta-endorphins were measured at rest and immediately post stress. Nineteen of 50 patients had angina during exercise; 31 had asymptomatic ischemia. No patient had angina during the speech, but two had ECG changes and 39% had radionuclide changes indicating ischemia. Patients with asymptomatic ischemia on exercise had a significantly greater beta-endorphin response than those with angina. Public speaking elicited a significantly larger beta-endorphin increase relative to change in double product (an index of stress) than did exercise.


CONCLUSIONS
(1) Patients with silent vs painful ischemia experience a greater beta-endorphin response to exercise. (2) beta-endorphin response to a speech stressor is greater than to exercise when controlled for an index of stress. (3) Increased beta-endorphin response to a speech stressor may partially explain the predominance of silent ischemia during psychological stress.
Miller
P F
PF
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill.
Light
K C
KC
Bragdon
E E
EE
Ballenger
M N
MN
Herbst
M C
MC
Maixner
W
W
Hinderliter
A L
AL
Atkinson
S S
SS
Koch
G G
GG
Sheps
D S
DS
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000097:blood / Q000523:psychology; D001143:Arousal / Q000502:physiology*; D003327:Coronary Disease / Q000097:blood / Q000523:psychology; D005080:Exercise Test; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000523:psychology; D017202:Myocardial Ischemia / Q000097:blood* / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications*; D001615:beta-Endorphin / Q000097:blood*
D001615:beta-Endorphin