Does cardiovascular reactivity to mental stress have prognostic value in postinfarction patients? A pilot study

The possible relationship between mental stress-induced cardiovascular reactivity and clinical prognosis was examined in a pilot study of 13 postinfarction patients. All patients had previously participated in the placebo condition of a secondary intervention trial. On completion of the trial, blood pressure, heart rate, and venous plasma catecholamines were evaluated at rest and in response to a modified Stroop test on two occasions. At follow-up 39 to 64 months later, five patients had suffered a new clinical event (reinfarction and/or stroke). These patients had shown significantly larger systolic and diastolic blood pressure responses to the Stroop test than had patients who remained event-free at follow-up. Catecholamine concentrations also differed between groups during mental stress, but on only one of the two test days. Groups did not differ on baseline measurements, cardiovascular response to exercise testing, fasting serum lipid and glucose concentrations, age, or duration of follow-up.