Burnout Is Associated with Reduced Parasympathetic Activity and Reduced HPA Axis Responsiveness, Predominantly in
Wieke de Vente1, Jan G C van Amsterdam2, Miranda Olff3
1Department of Clinical Psychology, University of Amsterdam, Weesperplein 4, 1018 XA Amsterdam, Netherlands ; Research Institute Child Development and Education, University of Amsterdam, P.O. Box 15776, 1001 NG Amsterdam, Netherlands.
Insights
Burnout increases cardiovascular disease (CVD) risk due to stress-related nervous system and hormonal imbalances. These physiological dysregulations, particularly in males, highlight burnout as a significant CVD risk factor.
Area of Science:
- Physiology
- Endocrinology
- Cardiovascular Health
Background:
- Growing evidence links burnout to increased cardiovascular disease (CVD) risk.
- Stress-induced dysregulation of the sympathetic, parasympathetic, and hypothalamic-pituitary-adrenal (HPA) axes is a potential mechanism.
- Understanding these physiological changes is crucial for CVD prevention.
Purpose of the Study:
- To investigate the hypothesis that burnout-related autonomic and HPA axis dysregulation contributes to CVD risk.
- To compare physiological responses to a psychosocial stressor between individuals with burnout and healthy controls.
Main Methods:
- 55 patients with burnout and 40 healthy participants underwent a psychosocial stressor (mental arithmetic, public speech).
- Measured physiological variables included blood pressure, heart rate, cardiac output, vascular resistance, cortisol, and alpha-amylase.
- Compared basal levels, reactivity, and recovery between burnout patients and controls, analyzing sex differences.
Main Results:
- Male burnout patients had higher baseline systolic blood pressure and lower basal cortisol/alpha-amylase reactivity than healthy males.
- Female burnout patients showed a trend towards lower basal cortisol.
- Both male and female burnout patients exhibited reduced heart rate variability and elevated cardiac output.
Conclusions:
- Burnout is associated with dysregulation of the sympathetic, parasympathetic, and HPA axes.
- This dysregulation, more pronounced in males, supports burnout as a CVD risk factor.
- Findings underscore the physiological pathways linking burnout to cardiovascular disease.
Abstract:
There is mounting evidence that burnout is a risk factor for cardiovascular disease (CVD). Stress-related dysregulation of the sympathetic and parasympathetic system and the hypothalamic pituitary adrenal (HPA) axis may explain the enhanced risk for CVD. To test this hypothesis, 55 patients (34 males and 21 females) with burnout on sickness absence and 40 healthy participants (16 males and 24 females) were exposed to a psychosocial stressor consisting of mental arithmetic and public speech. Physiological variables (i.e., blood pressure, heart rate, cardiac output, vascular resistance, cortisol, and alpha-amylase) were measured. Basal levels, reactivity, and recovery were compared between groups. In male patients, baseline systolic blood pressure was higher, whereas basal alpha-amylase and cortisol reactivity were lower than in healthy males. In female patients, a tendency for lower basal cortisol was found as compared to healthy females. Furthermore, reduced basal heart rate variability and a trend for elevated basal cardiac output were observed in both male and female patients. Burnout is characterised by dysregulation of the sympathetic and parasympathetic system and the HPA axis, which was more pronounced in males than in females. This study further supports burnout as being a risk factor for CVD through dysregulation of the sympathetic and parasympathetic system and the HPA axis.
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