Acute Psychological Stress and Pulse Wave Velocity: Meta-Analysis and Recommendations for Future Research

Repeated exposures to acute psychological stress may be associated with cardiovascular disease (CVD) risk, but the mechanisms underlying this relationship are not fully understood. The objective of this meta-analysis was to determine the effect of acute psychological stress on central pulse wave velocity (PWV) compared to pre-stress (baseline) levels in adults free of overt CVD. Electronic databases (PubMed, SPORTDiscus, and Google Scholar) were queried from inception to July 2024. Reference lists of eligible studies and previous relevant reviews were also screened. Studies were included if: (i) a noninvasive measure of PWV was used that included a central (aortic) arterial segment; (ii) participants were adults (≥ 18 years) free of overt CVD; and (iii) the acute stressor was purely psychological in nature. Appraisal and Synthesis Methods: Effect sizes were calculated as standardized mean differences (SMD) and pooled using a random-effects model. The magnitude of effect was adjudicated as trivial (< 0.2), small (0.2), moderate (0.5), or large (0.8). A total of 11,689 studies were identified, from which 7 studies (11 effects, N = 162 participants) were eligible for inclusion. Moderate Acute psychological stress induced a moderate (SMD: 0.51, p < 0.0001; 95% CI: 0.34, 0.68) increase (detrimental) in central PWV, and there was insubstantial heterogeneity between studies (Cochran's Q (10) = 2.62 (p = 0.99)). The small overall number of studies as well as key differences in study methodologies limit the ability to elucidate the magnitude and consistency of stress-induced increases in PWV. Nonetheless, the present findings suggest that acute psychological stress induces significant increases in central PWV among adults free of overt CVD. The acute PWV response to psychological stress likely contributes to elevated CVD risk over time.