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European Heart Journal 1997 18(5):807-815;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Effects of mental and physical stress on platelet function in patients with stable angina pectoris and healthy controls

N. H. Wallén*,{ddagger}, C. Held{dagger}, N. Rehnqvist{dagger} and P. Hjemdahl*,

*Department of Clinical Pharmacology, Karolinska Hospital Stockholm, Sweden
{dagger}Department of Medicine, Danderyds Hospital and Karolinska Institute Stockholm, Sweden
{ddagger}Department of Physiology and Pharmacology, Karolinska Institute Stockholm, Sweden

Received 23 October 1996; accepted 30 October 1996.

Correspondence: Dr Paul Hjemdahl, Department of Clinical Pharmacology, Karolinska Hospital, S-171 76 Stockholm, Sweden

Abstract

The effects of mental and physical stress on platelet function in patients with stable angina pectoris and healthy controls were investigated. Platelet function was studied at rest, and during mental stress (colour word test), or after exercise (bicycle ergometry), in 113 angina patients (21 on aspirin) and 50 matched controls. Platelet function was assessed by filtragometry ex vivo (reflecting platelet aggregability), by measuring platelet secretion (ß thromboglobulin and platelet factor 4 levels in plasma), and by Born aggregometry in vitro.

At rest, platelet function did not differ between patients and controls. Exercise increased platelet aggregability and secretion similarly in both groups. Aspirin did not attenuate the platelet activating effect of exercise despite inhibition at rest. Mental stress increased heart rate, blood pressure and plasma catecholamines, but platelet responses were highly variable. However, mental stress tended to shorten filtragometry readings in patients but not in controls (P<0·05 between the groups); plasma ß-thromboglobulin showed a similar difference between patients and controls (P<0·05 between the groups; aspirin-treated patients included).

Physical exercise activates platelets in patients with stable angina pectoris and healthy controls. Aspirin is not an effective inhibitor of exercise-induced platelet aggregation. Platelet responses to mental stress are variable, but more pronounced in angina patients.

Key Words: Platelet aggregation • platelet secretion • physical exercise • mental stress • ischaemic heart disease


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