title: The role of stress hormones in the relationship between resting blood pressure and coagulation activity.
abstract: BACKGROUND
  Systemic hypertension confers a hypercoagulable state. We hypothesized that resting mean blood pressure (MBP) interacts with stress hormones in predicting coagulation activity at rest and with acute mental stress.
  
  
  METHODS
  We measured plasma clotting factor VII activity (FVII:C), FVIII:C, fibrinogen, D-dimer, epinephrine and norepinephrine, and saliva cortisol in 42 otherwise healthy normotensive and hypertensive medication-free men (mean age 43 +/- 14 years) at rest, immediately after stress, and twice during 60 min of recovery from stress.
  
  
  RESULTS
  At rest, the MBP-by-epinephrine interaction predicted FVII:C (beta = -0.33, P < 0.04) and D-dimer (beta = 0.26, P < 0.05), and the MBP-by-cortisol interaction predicted D-dimer (beta = 0.43, P = 0.001), all independent of age and body mass index (BMI). Resting norepinephrine predicted fibrinogen (beta = 0.42, P < 0.01) and D-dimer (beta = 0.37, P < 0.03), both independent of MBP. MBP predicted FVIII:C change from rest to immediately post-stress independent of epinephrine (beta = -0.37, P < 0.03) and norepinephrine (beta = -0.38, P < 0.02). Cortisol change predicted FVIII:C change (beta = -0.30, P < 0.05) independent of age, BMI and MBP. Integrated norepinephrine change from rest to recovery (area under the curve, AUC) predicted D-dimer AUC (beta = 0.34, P = 0.04) independent of MBP. The MBP-by-epinephrine AUC interaction predicted FVII:C AUC (beta = 0.28) and fibrinogen AUC (beta = -0.30), and the MBP-by-norepinephrine AUC interaction predicted FVIII:C AUC (beta = -0.28), all with borderline significance (Ps < 0.09) and independent of age and BMI.
  
  
  CONCLUSIONS
  MBP significantly altered the association between stress hormones and coagulation activity at rest and, with borderline significance, across the entire stress and recovery interval. Independent of MBP, catecholamines were associated with procoagulant effects and cortisol reactivity dampened the acute procoagulant stress response.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Zurich, Switzerland.
authors.forename: Petra H
authors.initials: PH
authors.lastname: Wirtz
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
authors.forename: Luljeta
authors.initials: L
authors.lastname: Emini
authors.forename: Katharina
authors.initials: K
authors.lastname: Rüdisüli
authors.forename: Sara
authors.initials: S
authors.lastname: Groessbauer
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
mesh_terms: D000328:Adult; D001777:Blood Coagulation / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D004837:Epinephrine / Q000097:blood; D006728:Hormones / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D009638:Norepinephrine / Q000097:blood; D013312:Stress, Physiological / Q000097:blood*
chemical_list: D006728:Hormones; D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine