Stress-Linked Heart Disease Predicted by Brain Activity

High blood pressure and heart rate in response to stress may increase the risk of premature death from heart disease.

The brain may have a unique activity pattern triggered by stress that predicts bodily reactions, including those that increase the risk of cardiovascular disease, such as high blood pressure, according to a study published by the Journal of the American Heart Association.

The brain imaging study of cardiovascular stress physiology suggests a novel explanation of why stress may increase the risk of heart disease in certain patients.

“Psychological stress can influence physical health and risk for heart disease, and there may be biological and brain-based explanations for this influence,” said senior study author Peter Gianaros, PhD.

To explore how the brain and body may be linked to stress and overall health, the authors conducted mental stress tests. The investigators used an MRI to examine blood pressure and heart rates.

While responding to time-pressured computer challenges, the participants received negative feedback, which made the experience stressful.

Included in the study were 157 men and 153 women aged 30 to 51 years who were part of the Pittsburgh Imaging Project, a study of how the brain related to heart disease risk.

The authors found that the stress tests increased blood pressure and heart rate in a majority of patients compared with baseline measurement, which was expected.

Using a machine-learning approach, the authors found that a certain brain activity pattern was able to predict the blood pressure and heart rate reactions to the tests, according to the study.

The areas in the brain found to predict stress-induced cardiovascular reactions were involved with determining whether the environment was threatening. The brain areas also controlled the heart and blood vessels through the autonomic nervous system, according to the authors.

The authors hypothesize that patients who have exaggerated responses to stressors—including heightened blood pressure and heart rate—may be at a higher risk of developing hypertension and experiencing premature death related to cardiovascular disease, according to the study.

Since the participants were middle-aged and healthy, the authors caution that the findings may not translate to those with heart disease. The authors were unable to make any conclusions about causality, according to the study.

“This kind of work is proof-of-concept, but it does suggest that, in the future, brain imaging might be a useful tool to identify people who are at risk for heart disease or who might be more or less suited for different kinds of interventions, specifically those that might be aimed at reducing levels of stress,” Dr Gianaros said. “It’s the people who show the largest stress-related cardiovascular responses who are at the greatest risk for poor cardiovascular health and understanding the brain mechanisms for this may help to reduce their risk.”