Pressure pain sensitivity: a new method of stress measurement in patients with ischemic heart disease.

BACKGROUND: Chronic stress is prevalent in patients with ischemic heart disease (IHD) and worsens the long-term prognosis. Chronic stress is vaguely defined, but is associated with depressive symptoms, reduced psychological wellbeing, and reduced quality of life (QOL). Stress seems to induce hyperalgesia.The aim of the present study was to evaluate hyperalgesia by pressure pain sensitivity (PPS) in patients with IHD, and compare PPS to questionnaires measuring depressive symptoms, reduced psychological wellbeing, and QOL as markers of stress. Design. A cross-sectional study of 361 subjects with IHD. METHODS: PPS was measured on the sternum, and compared to the questionnaires: Clinical stress symptoms score (CSS), Major Depression Inventory (MDI), WHO-5 Wellbeing Index, and SF-36 QOL score. RESULTS: PPS correlated to CSS (r = 0.20, p < 0.001), MDI (r = 0.14, p = 0.02), SF-36 mental component summary score (MCS) (r = - 0.10, p = 0.049), SF-36 physical component summary score (PCS) (r = - 0.17, p = 0.001), and self-perceived stress level (r = 0.15, p = 0.006). CSS correlated similarly (r = 0.5-0.7, all p < 0.001). Comparing subjects within the lowest vs. highest tertiles of PPS and CSS, the mean MDI score was 4 vs. 15, WHO-5 was 77 vs. 53, SF-36 PCS was 53 vs. 43, and SF-36 MCS was 58 vs. 46; all p < 0.001. CONCLUSIONS: PPS reflected to a modest degree markers of chronic stress in IHD. PPS and CSS together might be useful as easy-to use tools for evaluating these markers in IHD patients.

Soccer improves fitness and attenuates cardiovascular risk factors in hypertensive men.

INTRODUCTION: The present study investigated the fitness and health effects of medium-term soccer training for untrained hypertensive middle-age men. METHODS: Thirty-three untrained males (31-54 yr) with mild-to-moderate hypertension were randomized 2:1 to a soccer training group (STG, two 1-h sessions per week, n = 22, 68% on medication) and a doctor advice group receiving traditional physician-guided recommendations on cardiovascular risk factor modification (DAG, n = 11, 73% on medication). Two-way repeated-measures ANOVA time-group statistics was applied. RESULTS: During soccer training, average HR was 155 ± 9 bpm or 85% ± 7% HRmax. In STG, systolic and diastolic blood pressures decreased (P < 0.01) over 6 months from 151 ± 10 to 139 ± 10 mm Hg and from 92 ± 7 to 84 ± 6 mm Hg, respectively, with smaller (P < 0.05) decreases in DAG (from 153 ± 8 to 145 ± 8 mm Hg and from 96 ± 6 to 93 ± 6 mm Hg, respectively). In STG, V˙O2max increased (P < 0.01) from 32.6 ± 4.9 to 35.4 ± 6.6 mL·min-1·kg-1 and relative V˙O2 during cycling at 100 W was lowered (P < 0.05) from 55% ± 7% to 50% ± 8% V˙O2max over 6 months, with no changes in DAG. In STG, resting HR was lowered by 8 ± 11 bpm (P < 0.05), and the augmentation index (a measure of arterial stiffness) was lowered (P < 0.05) by 7.3 ± 14.0 over 6 months, with no change in DAG. CONCLUSIONS: Six months of soccer training improved aerobic fitness, reduced blood pressure, and resulted in an array of other favorable effects on cardiovascular risk profile for untrained middle-age hypertensive men. Soccer training, therefore, may be a better nonpharmacological treatment for hypertensive men than traditional physician-guided advice.