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How mental stress affects endothelial function

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  • Published:
Pflügers Archiv - European Journal of Physiology Aims and scope Submit manuscript

Abstract

Mental stress is an important factor contributing to recognized mechanisms underlying cardiovascular events. Among these, stress-related endothelial dysfunction is an early risk factor that predicts future development of severe cardiovascular disorders. Acute mental stress by a variety of tests impairs endothelial function in humans, although the opposite results have been reported by some investigators. Chronic stress always deteriorates endothelial function in humans and experimental animals. Stress hormones, such as glucocorticoids and pro-inflammatory cytokines, and endothelin-1 liberated in response to mental stress participate in endothelial dysfunction possibly via downregulation of endothelial nitric oxide synthase (eNOS) expression, eNOS inactivation, decreased nitric oxide (NO) actions, and increased NO degradation, together with vasoconstriction counteracting against NO-induced vasodilatation. Catecholamines do not directly affect endothelial function but impair its function when blood pressure elevation by the amines is sustained. Endogenous opioids favorably affect endothelial function, which counteract deteriorating effects of other stress hormones and mediators. Inhibition of cortisol and endothelin-1 production, prevention of pro-inflammatory mediator accumulation, hypnotics, mirthful laughter, humor orientation, and lifestyle modification would contribute to the prevention and treatment for stress-related endothelial dysfunction and future serious cardiovascular disease.

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Abbreviations

ACh:

Acetylcholine

ACTH:

Adrenocorticotropic hormone

BH4 :

Tetrahydrobiopterin

BK:

Bradykinin

Cyclic GMP:

Cyclic guanosine monophosphate

CRH:

Corticotropine-releasing hormone

eNOS:

Endothelial nitric oxide synthase

ET:

Endothelin

GTN:

Nitroglycerin

HUVEC:

Human umbilical vein endothelial cell

IL:

Interleukin

l-NA:

N G-nitro-l-arginine

l-NAME:

l-NA methylester

l-NMMA:

N G-monomethyl-l-arginine

MCh:

Methacholine

NO:

Nitric oxide

NOS:

Nitric oxide synthase

NOx:

Nitrate/nitrite

PI3K:

Phosphatidylinositol 3-kinase

ROS:

Reactive oxygen species

SNP:

Sodium nitroprusside

SOD:

Superoxide dismutase

TNF:

Tumor necrosis factor

VEGF:

Vascular endothelial growth factor

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Acknowledgements

We would like to thank Ms. M. Bando for her assistance in the computer graphics of Figs. 1 and 2.

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The author has no conflict of interest in any matter related to this work.

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Toda, N., Nakanishi-Toda, M. How mental stress affects endothelial function. Pflugers Arch - Eur J Physiol 462, 779–794 (2011). https://doi.org/10.1007/s00424-011-1022-6

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