The effect of natural habituation on coagulation responses to acute mental stress and recovery in men

Roland von Känel; Daniel Preckel; Lilian Zgraggen; Katharina Mischler; Brigitte M. Kudielka; André Haeberli; Joachim E. Fischer

doi:10.1160/TH04-04-0223

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2004; 92(06): 1327-1335
DOI: 10.1160/TH04-04-0223

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

The effect of natural habituation on coagulation responses to acute mental stress and recovery in men

Authors

Roland von Känel

¹Department of General Internal Medicine, University Hospital Berne, Switzerland

²Institute for Behavioral Sciences, Federal Institute of Technology, Zurich, Switzerland
Daniel Preckel

²Institute for Behavioral Sciences, Federal Institute of Technology, Zurich, Switzerland
Lilian Zgraggen

²Institute for Behavioral Sciences, Federal Institute of Technology, Zurich, Switzerland
Katharina Mischler

²Institute for Behavioral Sciences, Federal Institute of Technology, Zurich, Switzerland
Brigitte M. Kudielka

²Institute for Behavioral Sciences, Federal Institute of Technology, Zurich, Switzerland
André Haeberli

³Thrombosis Research Laboratory, University Hospital Berne, Switzerland
Joachim E. Fischer

²Institute for Behavioral Sciences, Federal Institute of Technology, Zurich, Switzerland

Abstract

Summary

Blood coagulation activation might be one mechanism linking acute mental stress with coronary events. We investigated the natural habituation of coagulation responses and recovery to short-term mental stress.Three times with one-week intervals, 24 men (mean age 47 ± 7 years) underwent the same 13-min stressor (preparation, job interview, mental arithmetic). During each visit venous blood was obtained four times (baseline, immediately post-stress, 45 min of recovery, 105 min of recovery). Eight blood coagulation parameters were measured at weeks one and three. Acute stress provoked increases in von Willebrand factor antigen, fibrinogen, clotting factor FVII activity (FVII:C), FVIII:C, FXII:C (p’s ≤0.019), and D-dimer (N.S.). All coagulation parameters experienced full recovery except FVIII:C (p = 0.022). Stress did not significantly affect activated partial thromboplastin time and prothrombin time. At all time points FVIII:C and FXII:C levels were significantly higher at week one compared to week three (p’s ≤0.041). Before catheter insertion, systolic blood pressure (p = 0.001) and heart rate (p = 0.026) were relatively higher at week one. Unlike the magnitude of systolic blood pressure response to stress (p = 0.007) and of cortisol recovery from stress (p = 0.002), the magnitude of all coagulation responses to stress and the recovery from stress were similar in week one and week three. Sympathetic activation with anticipatory stress best explained increased baseline activity in FVIII and FXII at week one. An incapacity of the coagulation system to adapt to stress repeats is perhaps a consequence of evolution, but might also contribute to increased coronary risk in some individuals, particularly in those with cardiovascular diseases.

Keywords

Blood coagulation - cardiovascular disease - psychological stress - recovery - habituation

Full Text

References

References
1 Bairey CN, Krantz DS, Rozanski A. Mental stress as an acute trigger of ischemic left ventricular dysfunction and blood pressure elevation in coronary artery disease. Am J Cardiol 1990; 66: G28-31.
2 Mittleman MA, Maclure M, Sherwood JB. et al. Triggering of acute myocardial infarction onset by episodes of anger. Determinants of Myocardial Infarction Onset Study Investigators. Circulation 1995; 92: 1720-5.
3 Wootton DM, Ku DN. Fluid mechanics of vascular systems, diseases, and thrombosis. Annu Rev Biomed Eng 1999; 01: 299-329.
4 Preckel D, von Kanel R. Regulation of hemostasis by the sympathetic nervous system: Any contribution to coronary artery disease?. Heart Drug 2004; 04: 123-30.
5 Ruberg FL, Loscalzo J. Prothrombotic determinants of coronary atherothrombosis. Vasc Med 2002; 07: 289-99.
6 Virmani R, Kolodgie FD, Burke AP. et al. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2000; 20: 1262-75.
7 Suzuki S, Sakamoto S, Koide M. et al. Hanshin-Awaji earthquake as a trigger for acute myocardial infarction. Am Heart J 1997; 134: 974-7.
8 Meisel SR, Kutz I, Dayan KI. et al. Effect of Iraqi missile war on incidence of acute myocardial infarction and sudden death in Israeli civilians. Lancet 1991; 338: 660-1.
9 Kario K, McEwen BS, Pickering TG. Disasters and the heart: a review of the effects of earthquake-induced stress on cardiovascular disease. Hypertens Res 2003; 26: 355-67.
10 Jern C, Eriksson E, Tengborn L. et al. Changes of plasma coagulation and fibrinolysis in response to mental stress. Thromb Haemost 1989; 62: 767-71.
11 Davis MC. Oral contraceptive use and hemodynamic, lipid, and fibrinogen responses to smoking and stress in women. Health Psychol 1999; 18: 122-30.
12 Steptoe A, Kunz-Ebrecht S, Owen N. et al. Influence of socioeconomic status and job control on plasma fibrinogen responses to acute mental stress. Psychosom Med 2003; 65: 137-44.
13 Steptoe A, Kunz-Ebrecht S, Rumley A. et al. Prolonged elevations in haemostatic and rheological responses following psychological stress in low socioeconomic status men and women. Thromb Haemost 2003; 89: 83-90.
14 Musumeci V, Baroni S, Cardillo C. et al. Cardiovascular reactivity, plasma markers of endothelial and platelet activity and plasma renin activity after mental stress in normals and hypertensives. J Hypertens Suppl 1987; 05: S1-4.
15 Jern C, Manhem K, Eriksson E. et al. Hemostatic response to mental stress during the menstrual cycle. Thromb Haemost 1991; 66: 614-8.
16 Palermo A, Bertalero P, Pizza N. et al. Decreased fibrinolytic response to adrenergic stimulation in hypertensive patients. J Hypertens Suppl 1989; 07: S162-3.
17 von Kanel R, Dimsdale JE, Ziegler MG. et al. Effect of acute psychological stress on the hypercoagulable state in subjects (spousal caregivers of patients with Alzheimer’s disease) with coronary or cerebrovascular disease and/or systemic hypertension. Am J Cardiol 2001; 87: 1405-8.
18 von Kanel R, Mills PJ, Ziegler MG. et al. Effect of beta2-adrenergic receptor functioning and increased norepinephrine on the hypercoagulable state with mental stress. Am Heart J 2002; 144: 68-72.
19 von Kanel R, Mills PJ, Fainman C. et al. Effects of psychological stress and psychiatric disorders on blood coagulation and fibrinolysis: a biobehavioral pathway to coronary artery disease?. Psychosom Med 2001; 63: 531-44.
20 McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med 1998; 338: 171-9.
21 von Kanel R, Dimsdale JE, Adler KA. et al. Effects of depressive symptoms and anxiety on hemostatic responses to acute mental stress and recovery in the elderly. Psychiatry Res 2004; 126: 253-64.
22 Virmani R, Burke AP, Farb A. Sudden cardiac death. Cardiovasc Pathol 2001; 10: 275-82.
23 Larsen LF, Andersen HR, Hansen AB. et al. Variation in risk indicators of cardiovascular disease during the menstrual cycle: an investigation of within-subject variations in glutathione peroxidase, haemostatic variables, lipids and lipoproteins in healthy young women. Scand J Clin Lab Invest 1996; 56: 241-9.
24 Kirschbaum C, Pirke KM, Hellhammer DH. The ‘Trier Social Stress Test’ - a tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology 1993; 28: 76-81.
25 Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychol Bull 2004; 130: 355-91.
26 Schommer NC, Hellhammer DH, Kirschbaum C. Dissociation between reactivity of the hypothalamus-pituitary-adrenal axis and the sympathetic-adrenal-medullary system to repeated psychosocial stress. Psychosom Med 2003; 65: 450-60.
27 Gonzalez-Bono E, Moya-Albiol L, Salvador A. et al. Anticipatory autonomic response to a public speaking task in women: the role of trait anxiety. Biol Psychol 2002; 60: 37-49.
28 Clauss A. Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol 1957; 17: 237-46.
29 Reber G, Bounameaux H, Perrier A. et al. Performances of a new, automated latex assay for the exclusion of venous thromboembolism. Blood Coagul Fibrinolysis 2001; 12: 217-20.
30 Sukhu K, Martin PG, Cross L. et al. Evaluation of the von Willebrand factor antigen (vWF-Ag) assay using an immuno-turbidimetric method (STA Liatest vWF) automated on the MDA 180 coagulometer. Clin Lab Haematol 2000; 22: 29-32.
31 Wilson PW, D’Agostino RB, Levy D. et al. Prediction of coronary heart disease using risk factor categories. Circulation 1998; 97: 1837-47.
32 Freyburger G, Trillaud H, Labrouche S. et al. D-dimer strategy in thrombosis exclusion - a gold standard study in 100 patients suspected of deep venous thrombosis or pulmonary embolism: 8 DD methods compared. Thromb Haemost 1998; 79: 32-7.
33 Bozic M, Blinc A, Stegnar M. D-dimer, other markers of haemostasis activation and soluble adhesion molecules in patients with different clinical probabilities of deep vein thrombosis. Thromb Res 2002; 108: 107-14.
34 Macht DI. Influence of some drugs and of emotions on blood coagulation. JAMA 1952; 148: 265-70.
35 Ogston D, McDonald GA, Fullerton HW. The influence of anxiety in tests of blood coagulability and fibrinolytic activity. Lancet 1962; 02: 521-3.
36 Johnston DW, Gold A, Kentish J. et al. Effect of stress management on blood pressure in mild primary hypertension. Br Med J 1993; 306: 963-6.
37 von Kanel R, Dimsdale JE. Effects of sympathetic activation by adrenergic infusions on hemostasis in vivo. Eur J Haematol 2000; 65: 357-69.
38 Poredos P. Endothelial dysfunction and cardiovascular disease. Pathophysiol Haemost Thromb 2002; 32: 274-7.
39 Tomoda F, Takata M, Kagitani S. et al. Different platelet aggregability during mentalstress in two stages of essential hypertension. Am J Hypertens 1999; 12: 1063-70.
40 Palermo A, Bertalero P, Pizza N. et al. Decreased fibrinolytic response to adrenergic stimulation in hypertensive patients. J Hypertens Suppl 1989; 07: S162-3.
41 Grignani G, Pacchiarini L, Zucchella M. et al. Effect of mental stress on platelet function in normal subjects and in patients with coronary artery disease. Haemostasis 1992; 22: 138-46.
42 Canevari A, Tacconi F, Zucchella M. et al. Antithrombin III biological activity and emotional stress in patients with coronary artery disease. Haematologica 1992; 77: 180-2.