Hidden Stress Underlies Heart Attacks
(Orlando, FL, Reuters Health, 11/11/03)

Diane Becker of Johns Hopkins University in Baltimore, and team, report that people who react to mental stress with increased blood pressure are likelier to suffer a heart attack or severe coronary event, than those whose pressure is stable. The researchers studied 295 siblings under 60 years old, who had shown signs of artery disease on an angiogram. The investigators continuously monitored the subjects' pulse and blood pressure readings while the subjects took a test designed to frustrate them. The test-takers were required to identify colors displayed on a screen in a manner calculated to confuse them. The word "red," for instance, might appear in blue surrounded by other distracting colors. The computer responded, "wrong" to incorrect answers and speeded up to increase the frustration factor; when subjects answered correctly. After the test, the participants rated the degree of stress they had felt.

The scientists found that, even when people feel calm and their pulse is steady, if their blood pressure tends to spike during mental stress, they are 6 times likelier to suffer a severe coronary event during the next 6 years. These people with "hyper-reactive blood pressure to mental stress" may remain unaware of the stress, of the blood pressure spikes and of the cardiovascular damage, until advanced disease symptoms manifest. These findings suggest that biological stress may be distinct from conscious stress. The scientists speculate that the hormone catecholamine may directly trigger the blood pressure increase.