Our pilot studies (PS), using systolic time intervals (STI), prove that chronic work stress increases neurovascular tone (NVT) in type A men (TAM). STI decrease with a rise in stress (STI=PEP/ LVET X100%) and are an index of adrenergic systemic vascular resistance (ASVR). BP varies with SVR and cardiac output (CO). In PS maximum % coronary collagen stenosis (%CS) was predicted by STI alone (R=0.96) at low SBP≤120, and by STI with SBP≥120 (R=0.98, by multiple regression), both at P≤0.001. In prospective studies (PROS) TAM were randomized into group (G) 1 and 2 (before chronic stress) and compared with low stress TA control G (GC1, STI≥38). G3 were TAM randomly selected with 10 yrs chronic work stress (STI≤30) vs. GC3. Each G received 3 gm sodium diet daily (qd). G2 and 3 received Rx2: elavil 10-100 mg qd, atenolol 13-100 mg qd, and diltiazem CD 240-250 mg qd, to keep STI≥38 and SBP≤126 at C levels after start time (T1). Rx2 was given to G2 for 6 yrs and G3 for 10 yrs. All groups were matched TAM, age 55±5 yrs with no significant (Sig* at P≤0.01) risk factors (RF). RF levels were: SBP 110±10, LDL≤130, triglycerides ≤150, HgA1C≤6.1, and non smokers. Serial measurements were made at T1 and T2 (end) of: BP, pulse pressure (PP), aortic stiffness (AS=PP/change in aortic diameter by PP), aortic collagen (AC) and %CS by ultrasonic measurements as previously reported by our clinic. All groups started with PP, AS, AC and %CS at C levels (GC1). All data was placed into a blind matrix for analysis later. G1 was subdivided into 1A (SBP≤101) and 1B (SBP≥100). Results: PROS G means shown. (Table)
Where: *=Sig difference from GC1 at P≤0.01& **=Sig change from T1 at P≤0.01, both by T test. Sig** increases in %CS are seen in G1A & B. G1A CS is predicted by STI alone (R=0.95, P≤0.001). %CS was predicted by PS multiple regression (in G1B, G3, C1, C3) using STI & SBP (mR=0.97, P≤0.01), explaining 94% of the regression variability & excluding other RF. Rx2 prevented Sig** %CS change in G2 & caused Sig** regression in G3. Stress causes Sig* CS by increased ASVR alone or in combination with SBP.
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