Autonomic Function and Cardiovascular Reactivity to Mental Stress in Patients with Anxiety Disorders: A Comparative Study with Healthy Controls
Keywords:
Anxiety disorders; autonomic nervous system; heart rate variability; mental stress; cardiovascular reactivity; sympathetic activity; parasympathetic activity; blood pressure.Abstract
Background: Anxiety disorders are associated with persistent psychological arousal and altered autonomic regulation. Changes in
heart rate variability (HRV), blood pressure and cardiovascular responses to acute mental stress may reflect impaired sympathovagal
balance. The present study was undertaken to compare resting autonomic function and cardiovascular reactivity to mental stress
among patients with anxiety disorders and healthy controls.
Materials and Methods: A comparative cross-sectional study was conducted among 60 patients diagnosed with anxiety disorders and
60 age- and sex-matched healthy controls. Participants underwent baseline assessment of heart rate (HR), systolic blood pressure (SBP),
diastolic blood pressure (DBP) and short-term HRV. Cardiovascular reactivity was assessed during a standardized mental arithmetic
stress test and during a post-stress recovery period. HRV parameters included SDNN, RMSSD, high-frequency (HF) power and LF/
HF ratio. Independent-samples t-test, paired t-test and repeated-measures analysis of variance were used for statistical comparison.
A p value <0.05 was considered statistically significant.
Results: Patients with anxiety disorders demonstrated significantly higher resting HR and lower RMSSD and HF-HRV compared
with healthy controls. During mental stress, patients showed a significantly greater increase in HR, SBP, DBP and LF/HF ratio and a
greater reduction in RMSSD compared with controls. Recovery of HR and SBP after cessation of stress was significantly slower in
patients than in controls. The between-group difference in cardiovascular reactivity was statistically significant for HR, SBP, RMSSD
and LF/HF ratio (p<0.001).
Conclusion: Patients with anxiety disorders demonstrated altered resting autonomic function, characterized predominantly by
reduced parasympathetic cardiac modulation, together with exaggerated cardiovascular reactivity and delayed recovery following
mental stress. Assessment of autonomic and cardiovascular stress responses may provide useful physiological markers of autonomic
dysregulation in anxiety disorders.
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