Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Dec 26, 2020; 12(12): 626-633
Published online Dec 26, 2020. doi: 10.4330/wjc.v12.i12.626
Psychological stress and long-term blood pressure variability of military young males: The cardiorespiratory fitness and hospitalization events in armed forces study
Yen-Po Lin, Chia-Hao Fan, Kun-Zhe Tsai, Ko-Hwan Lin, Chih-Lu Han, Gen-Min Lin
Yen-Po Lin, Department of Critical Care Medicine, Yonghe Cardinal Tien Hospital, Yonghe 234, Taiwan
Chia-Hao Fan, Department of Nursing, Hualien Armed Forces General Hospital, Hualien 97144, Taiwan
Kun-Zhe Tsai, Department of Dentistry, Hualien Armed Forces General Hospital, Hualien 971, Taiwan
Ko-Hwan Lin, Department of Psychiatry, Hualien Armed Forces General Hospital, Hualien 97144, Taiwan
Chih-Lu Han, Department of Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
Gen-Min Lin, Department of Medicine, Hualien Armed Forces General Hospital, Hualien 970, Taiwan
Author contributions: Lin GM contributed to conception and design of the study, and acquired and interpreted the data; Tsai KZ analyzed the data; Fan CH, Lin YP, and Han CL collected and reviewed the data; Lin YP wrote the article; Han CL made critical revisions related to important intellectual content of the article; all authors provided approval of the final version of the article to be published.
Supported by the Hualien Armed Forces General Hospital Grant, No. HAFGH-D-109007.
Institutional review board statement: This prospective study was reviewed and approved by the Institutional Review Board of the Mennonite Christian Hospital (No. 16-05-008) in Hualien, Taiwan.
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
Data sharing statement: As the study materials were obtained from the military in Taiwan, the data were confidential and not allowed to be opened in public. If there are any needs for clarification, the readers can contact Colonel Dr. Gen-Min Lin, the corresponding author, for sharing the data.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gen-Min Lin, MD, MPhil, PhD, Assistant Professor, Chief Doctor, Department of Medicine, Hualien Armed Forces General Hospital, No. 100 Jinfeng Street, Hualien 970, Taiwan. farmer507@yahoo.com.tw
Received: July 3, 2020
Peer-review started: July 3, 2020
First decision: October 6, 2020
Revised: October 10, 2020
Accepted: November 4, 2020
Article in press: November 4, 2020
Published online: December 26, 2020
Processing time: 167 Days and 1.3 Hours
ARTICLE HIGHLIGHTS
Research background

An experiment in mice demonstrated that acute stress might result in increased short-term heart rate variability and blood pressure variability (BPV); however, chronic stress would not alter short-term BPV.

Research motivation

Whether chronic mental stress is associated with long-term BPV remains unclear in human beings.

Research objectives

To examine the association of psychological stress with long-term BPV in young male adults.

Research methods

The association between chronic psychological stress and long-term BPV was examined in 1112 healthy military males, averaged 32.2 years in Taiwan. Psychological stress was quantitatively evaluated using the Brief Symptom Rating Scale (BSRS-5), from the least symptom of 0 to the most severe of 20, and the five components of anxiety, insomnia, depression, interpersonal sensitivity, and hostility (the severity score in each component from 0 to 4). Long-term BPV was assessed by standard deviation (SD) for systolic and diastolic blood pressure (SBP and DBP), and average real variability (ARV), defined as the average absolute difference between successive measurements of SBP or DBP, across four visits in the study period from 2012 to 2018 (2012-14, 2014-15, 2015-16, and 2016-18).

Research results

The results of multivariable linear regressions showed that there were no correlations of the BSRS-5 score with SDSBP, SDDBP, ARVSBP, and ARVDBP after adjusting for all the covariates [β(SE): -0.022 (0.024), -0.023 (0.026), -0.001 (0.018), and 0.001 (0.020), respectively; P > 0.05 for all]. In addition, there were also no correlations between each component of the BSRS score and the long-term BPV indexes.

Research conclusions

Our findings suggest that chronic psychological stress might not be associated with long-term BPV in military young males.

Research perspectives

Future studies should focus on the association between chronic mental stress and long-term BPV which is assessed by a smaller interval of blood pressure measurement (i.e., from years to months).