Article Text

  1. A. Cho,
  2. R. Barndt
  1. Los Angeles, CA.


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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