Awareness and control of the cardiovascular response to stress among men with and without an acute myocardial infarction
Nolan, R.P.; Wielgosz, A.T.; Biro, E.S.; Wielgosz, M.B.
Canadian Journal of Cardiology 10(7): 733-738
1994
ISSN/ISBN: 0828-282X PMID: 7922829 Document Number: 427026
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. DESIGN: Patients and volunteer controls were recruited to participate in a case control comparative study using a structured protocol. SETTING: 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. PATIENTS: 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. INTERVENTIONS: 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. MAIN 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 system vascular resistance while attempting to relax; they reported feeling relaxed immediately following exposure to stress. CONCLUSION: 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.