Interactions among higher trait anxiety, sympathetic activity, and endothelial function in the elderly

Area of Science:

• Cardiology
• Psychology
• Gerontology

Background:

• Negative psychological traits are recognized risk factors for cardiovascular disease (CVD).
• Understanding the impact of anxiety and depression on cardiovascular health in the elderly is crucial.

Purpose of the Study:

• To evaluate the influence of depression and anxiety on cardiac autonomic function.
• To assess the impact of depression and anxiety on endothelial function in healthy elderly subjects.

Main Methods:

• Assessed cardiac autonomic function using spectral analysis of heart rate variability (HRV) via head-up tilt test.
• Measured brachial artery endothelium-dependent flow-mediated dilation (FMD) using high-resolution ultrasound.
• Utilized the State and Trait Anxiety Inventory (STAI) and psychometric depression parameters.

Main Results:

• Higher STAI-trait anxiety scores correlated positively with baseline HRV sympathetic modulation.
• Higher STAI-trait anxiety scores correlated negatively with head-up tilt-induced HRV sympathetic response and percent change in FMD (%FMD).
• Structural equation modeling indicated higher trait anxiety reduces %FMD through sympathetic activity abnormalities; depression showed no association.

Conclusions:

• Specific interactions exist between higher trait anxiety, sympathetic activity abnormalities, and endothelial dysfunction.
• These findings may elucidate the pathophysiological mechanisms linking anxiety to increased atherosclerosis and CVD risk.