Translational Research of the Acute Effects of Negative Emotions on Vascular Endothelial Health: Findings From a Randomized Controlled Study

Background Provoked anger is associated with an increased risk of cardiovascular disease events. The underlying mechanism linking provoked anger as well as other core negative emotions including anxiety and sadness to cardiovascular disease remain unknown. The study objective was to examine the acute effects of provoked anger, and secondarily, anxiety and sadness on endothelial cell health. Methods and Results Apparently healthy adult participants (n=280) were randomized to an 8‐minute anger recall task, a depressed mood recall task, an anxiety recall task, or an emotionally neutral condition. Pre−/post‐assessments of endothelial health including endothelium‐dependent vasodilation (reactive hyperemia index), circulating endothelial cell‐derived microparticles (CD62E+, CD31+/CD42−, and CD31+/Annexin V+) and circulating bone marrow‐derived endothelial progenitor cells (CD34+/CD133+/kinase insert domain receptor+ endothelial progenitor cells and CD34+/kinase insert domain receptor+ endothelial progenitor cells) were measured. There was a group×time interaction for the anger versus neutral condition on the change in reactive hyperemia index score from baseline to 40 minutes (P=0.007) with a mean±SD change in reactive hyperemia index score of 0.20±0.67 and 0.50±0.60 in the anger and neutral conditions, respectively. For the change in reactive hyperemia index score, the anxiety versus neutral condition group by time interaction approached but did not reach statistical significance (P=0.054), and the sadness versus neutral condition group by time interaction was not statistically significant (P=0.160). There were no consistent statistically significant group×time interactions for the anger, anxiety, and sadness versus neutral condition on endothelial cell‐derived microparticles and endothelial progenitor cells from baseline to 40 minutes. Conclusions In this randomized controlled experimental study, a brief provocation of anger adversely affected endothelial cell health by impairing endothelium‐dependent vasodilation.

背景 愤怒被激发与心血管疾病事件风险增加有关。将被激发的愤怒以及包括焦虑和悲伤在内的其他核心负面情绪与心血管疾病联系起来的潜在机制仍然未知。本研究目的是检验被激发的愤怒，其次是焦虑和悲伤对内皮细胞健康的急性影响。 方法与结果 明显健康的成年参与者（n = 280）被随机分配到8分钟的愤怒回忆任务、抑郁情绪回忆任务、焦虑回忆任务或情绪中性状态。对内皮健康进行了前后评估，包括内皮依赖性血管舒张（反应性充血指数）、循环内皮细胞衍生微粒（CD62E +、CD31 + / CD42 - 和CD31 + / 膜联蛋白V +）以及循环骨髓来源的内皮祖细胞（CD34 + / CD133 + / 激酶插入域受体 + 内皮祖细胞和CD34 + / 激酶插入域受体 + 内皮祖细胞）。从基线到40分钟，愤怒组与中性组在反应性充血指数得分变化上存在组×时间交互作用（P = 0.007），愤怒组和中性组反应性充血指数得分的平均±标准差变化分别为0.20±0.67和0.50±0.60。对于反应性充血指数得分的变化，焦虑组与中性组的组×时间交互作用接近但未达到统计学意义（P = 0.054），悲伤组与中性组的组×时间交互作用无统计学意义（P = 0.160）。从基线到40分钟，在愤怒、焦虑和悲伤组与中性组之间，内皮细胞衍生微粒和内皮祖细胞没有一致的具有统计学意义的组×时间交互作用。 结论 在这项随机对照实验研究中，短暂的愤怒激发通过损害内皮依赖性血管舒张对内皮细胞健康产生不利影响。