A greater reduction in high-frequency heart rate variability to a psychological stressor is associated with subclinical coronary and aortic calcification in postmenopausal women.
OBJECTIVE
Reduced cardiac parasympathetic activity, as indicated by a reduced level of clinic or ambulatory high-frequency heart rate variability (HF-HRV), is associated with an increased risk for atherosclerosis and coronary artery disease. We tested whether the reduction in HF-HRV to a psychological stressor relative to a baseline level is also associated with subclinical coronary or aortic atherosclerosis, as assessed by calcification in these vascular regions.


METHODS
Spectral estimates of 0.15 to 0.40 Hz HF-HRV were obtained from 94 postmenopausal women (61-69 years) who engaged in a 3-minute speech-preparation stressor after a 6-minute resting baseline. A median of 282 days later, electron beam tomography (EBT) was used to measure the extent of coronary and aortic calcification.


RESULTS
In univariate analyses, a greater reduction in HF-HRV from baseline to speech preparation was associated with having more extensive calcification in the coronary arteries (rho = -0.29, p = .03) and in the aorta (rho = -0.22, p = .06). In multivariate analyses that controlled for age, education level, smoking status, hormone therapy use, fasting glucose, high-density lipoproteins, baseline HF-HRV, and the stressor-induced change in respiration rate, a greater stressor-induced reduction in HF-HRV was associated with more calcification in the coronary arteries (B = -1.21, p < .05), and it was marginally associated with more calcification in the aorta (B = -0.92, p = .09).


CONCLUSIONS
In postmenopausal women, a greater reduction in cardiac parasympathetic activity to a psychological stressor from baseline may be an independent correlate of subclinical atherosclerosis, particularly in the coronary arteries.
Gianaros
Peter J
PJ
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. gianarospj@upmc.edu
Salomon
Kristen
K
Zhou
Fan
F
Owens
Jane F
JF
Edmundowicz
Daniel
D
Kuller
Lewis H
LH
Matthews
Karen A
KA
D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012307:Risk Factors; D013060:Speech / Q000502:physiology; D013315:Stress, Psychological / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed