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Menopausal Status in Relation to Cardiovascular Stress Reactivity in Healthy Japanese Participants

Hirokawa, Kumi PhD; Nagayoshi, Mako PhD; Ohira, Tetsuya MD, PhD; Kajiura, Mitsugu MD; Kitamura, Akihiko MD; Kiyama, Masahiko MD; Okada, Takeo MD; Iso, Hiroyasu MD, PhD

doi: 10.1097/PSY.0000000000000121
Original Articles

Objective To investigate the hypothesis that postmenopausal women demonstrate greater cardiovascular stress reactivity during mental stress tasks than do both premenopausal women and men.

Methods The study included 979 Japanese participants (338 men and 641 women [238 postmenopausal]) aged 16 to 82 years. Blood pressure, heart rate, heart rate variability, and peripheral blood flow were measured at rest and during a mirror drawing stress task and a maze task. Differences between measured variables during tasks and at rest were calculated and considered to represent reactivity to stress. Analyses were adjusted for age and other potential confounding factors.

Results After adjusting for multiple factors, significant group effects were found for systolic blood pressure (SBP), diastolic blood pressure, heart rate, low-frequency (LF), LF/high-frequency, and peripheral blood flow (effect size: partial η2 = 0.015, 0.011, 0.013, 0.013, 0.008, and 0.009, respectively). Postmenopausal women were more reactive than men to stress for SBP (15.4 ± 0.8 versus 11.7 ± 0.6 mm Hg), diastolic blood pressure (10.4 ± 0.6 versus 8.0 ± 0.5 mm Hg), heart rate (2.7 ± 0.5 versus 0.7 ± 0.4 beats/min), LF (23.0 ± 5.2 versus 3.2 ± 3.8 ms2/Hz), and peripheral blood flow (−39.0 ± 3.8 versus −25.9 ± 2.8 Laser Doppler Perfusion Units) and more reactive than premenopausal women (p < .050) for SBP (15.4 ± 0.8 versus. 12.4 ± 0.5 mm Hg) and LF/high-frequency (1.7 ± 0.1 versus 1.3 ± 0.1).

Conclusions Postmenopausal Japanese women evidenced greater cardiovascular stress reactivity during mental stress tasks than did Japanese men or premenopausal women. Cardiovascular hyperreactivity could play a role in the higher risks of cardiovascular diseases in postmenopausal women.

From the Department of Nursing (K.H.), Baika Women’s University, Ibaraki, Osaka, Japan; Department of Social and Environmental Medicine (M.N., T.O., H.I.), Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Department of Cardiovascular Disease Prevention (M.K., A.K., M.K., T.O.), Osaka Medical Center for Cancer and Cardiovascular Disease Prevention, Higashinari-ku, Osaka, Japan; and Department of Epidemiology (T.O.), Fukushima Medical University, Hikariga-oka, Fukushima, Japan.

Address correspondence and reprint requests to Tetsuya Ohira, MD, PhD, Department of Epidemiology, Radiation Medical Science Center, Fukushima Medical University, Hikariga-oka, Fukushima 960-1295, Japan. E-mail:

Received for publication July 25, 2013; revision received August 10, 2014.

Copyright © 2014 by American Psychosomatic Society
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