Beta-endorphin response to exercise and mental stress in patients with ischemic heart disease

We compared symptomatic, hemodynamic and opioid responses of heart disease patients to exercise testing and a stressful public speaking task. Plasma beta-endorphins were measured at rest and immediately post stress. Nineteen of 50 patients had angina during exercise; 31 had asymptomatic ischemia. No...

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Bibliographic Details
Published in:Journal of psychosomatic research 1993-07, Vol.37 (5), p.455-465
Main Authors: Miller, Paula F., Light, Kathleen C., Bragdon, Edith E., Ballenger, Martha N., Herbst, Margaret C., Maixner, William, Hinderliter, Alan L., Atkinson, Susan S., Koch, Gary G., Sheps, David S.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Angina Pectoris - blood
Angina Pectoris - psychology
Arousal - physiology
beta-Endorphin - blood
Biological and medical sciences
Coronary Disease - blood
Coronary Disease - psychology
Exercise Test
Female
Fundamental and applied biological sciences. Psychology
Hemodynamics - physiology
Humans
Illness and personality
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - psychology
Myocardial Ischemia - blood
Myocardial Ischemia - psychology
Psychology and medicine
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Stress, Psychological - complications
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Summary:We compared symptomatic, hemodynamic and opioid responses of heart disease patients to exercise testing and a stressful public speaking task. Plasma beta-endorphins were measured at rest and immediately post stress. Nineteen of 50 patients had angina during exercise; 31 had asymptomatic ischemia. No patient had angina during the speech, but two had ECG changes and 39% had radionuclide changes indicating ischemia. Patients with asymptomatic ischemia on exercise had a significantly greater beta-endorphin response than those with angina. Public speaking elicited a significantly larger beta-endorphin increase relative to change in double product (an index of stress) than did exercise. (1) Patients with silent vs painful ischemia experience a greater beta-endorphin response to exercise. (2) beta-endorphin response to a speech stressor is greater than to exercise when controlled for an index of stress. (3) Increased beta-endorphin response to a speech stressor may partially explain the predominance of silent ischemia during psychological stress.
ISSN:0022-3999
1879-1360
DOI:10.1016/0022-3999(93)90002-W