Rapid onset blood pressure reactivity to acute stress in young adults with major depressive disorder

• Joy Mochache, Nutritional Science, University of Delaware

• Jody Greaney, Health Behavior and Nutrition Sciences, University of Delaware

Rapid onset blood pressure reactivity to acute stress in young adults with major depressive disorder
Joy Mochache, Ashley Darling, Aaron Autler, Madison Evering, and Jody Greaney

Major depressive disorder (MDD) is an independent, non-traditional cardiovascular disease (CVD) risk factor, but the biological underpinnings remain incompletely understood. Exaggerated cardiovascular reactivity and delayed recovery from acute stress may contribute to increased CVD risk, yet few studies have comprehensively examined these responses in young otherwise healthy adults with MDD. Accordingly, this study tested the hypotheses that young adults with MDD would exhibit (1) greater heart rate (HR) and blood pressure (BP) reactivity to the cold pressor test (CPT; an acute sympathoexcitatory stress stimulus) and (2) blunted HR and BP recovery compared to non-depressed young adults. In 42 healthy adults (HA; 27 female; resting HR: 71±10 bpm; resting BP: 116±9/73±6 mmHg) and 39 unmedicated adults with MDD (31 female; resting HR: 72±9 bpm; resting BP: 112±8/73±6 mmHg), HR (electrocardiogram) and beat-to-beat BP (finger photoplethysmography) were continuously measured during immersion of the non-dominant hand in an ice slurry (2-min) and during post-immersion recovery (2-min). Data were analyzed in 10-sec bins and calculated as the onset (i.e., slope of the response in the first 10-sec of immersion), reactivity (i.e., magnitude of the peak difference between immersion and baseline), recovery (i.e., magnitude of the difference between immersion and post-immersion), and rebound (i.e., magnitude of the difference between post-immersion and baseline). Young adults with MDD exhibited steeper BP onset slopes compared to HA (e.g., mean arterial pressure (MAP): 0.14±0.54 HA vs. 0.46±0.63 ΔmmHg/10-sec MDD, p=0.02). BP recovery was attenuated in adults with MDD (e.g., MAP: ∆20±9 HA vs. ∆16±9 mmHg MDD, p = 0.03). No group differences were observed in either BP reactivity or rebound or any parameter of HR (all p>0.05). These data indicate that young adults with MDD exhibit more rapid BP reactivity onset and delayed BP recovery, such alterations in the pressor response to acute stress tmay increase future CVD risk.