Brain imaging could help predict stress-related CVD risk

Researchers have found a distinctive reactionary pattern in the brain that could be used to identify individuals at greater risk for hypertension and cardiovascular disease (CVD) as a result of psychological stressors.

The study, published in the Journal of the American Heart Association, included 157 men and 153 women aged 30 to 51 from the Pittsburgh Imaging Project, an ongoing longitudinal study of how the brain influences CVD risk.

Participants underwent MRI while taking a battery of stress tests. Heart rate and blood pressure was measured both at rest and during the stress period.

Using cross-validation and machine learning, researchers identified a specific sequence of brain activity that predicted the size of the volunteers’ blood pressure and heart rate reactions to the stress tests.

“Importantly, the brain areas that were especially predictive of individual differences in stressor‐evoked cardiovascular reactivity included those that are implicated in appraising psychological stressors and regulating the cardiovascular system through autonomic pathways,” wrote lead author Peter Gianaros, PhD, a psychology professor at the University of Pittsburgh, and colleagues. “Among other areas, these included forebrain cortical areas within the medial prefrontal cortex, anterior cingulate cortex, and insula as well as areas of the basal ganglia, extended amygdala, hippocampus, midbrain, and cerebellum.”

Gianaros et al. noted their study population was middle-aged, mostly white and otherwise healthy without a history of CVD or chronic illness, so the results may not be applicable to a general population.

However, they believe their brain-based model for determining CVD risk could have future clinical impact.

“This kind of work is proof-of-concept, but it does suggest that, in the future, brain imaging might be a useful tool to identify people who are at risk for heart disease or who might be more or less suited for different kinds of interventions, specifically those that might be aimed at reducing levels of stress,” Gianaros said in a statement. “It’s the people who show the largest stress-related cardiovascular responses who are at the greatest risk for poor cardiovascular health and understanding the brain mechanisms for this may help to reduce their risk.”