Endocrine and haemodynamic stress responses to an arithmetic cognitive challenge.

OBJECTIVE: We aimed at developing and validating a simple, highly repeatable computer-based tool, which could be employed to simulate the effects of an acute mental stress on endocrine and haemodynamic stress responses. METHODS: Fifteen subjects underwent a mental cognitive challenge, employing an ad hoc designed web tool (available at http://bagame.altervista.org) that proposed a series of random arithmetic operations (addictions or subtractions) between one- to three-digit numbers for 10 minutes. We measured plasma epinephrine, norepinephrine, cortisol, and ACTH, in addition to heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure throughout the test. RESULTS: The arithmetic mental challenge promptly activated the sympatho-adrenomedullary axis (epinephrine +112±24%, p<0.05; norepinephrine +37±13%, p<0.004) and the hypothalamic-pituitary-adrenocortical axis (cortisol +25±7%, p<0.008; ACTH +97±44%, p<0.008), which in turn exerted stimulatory effects on the cardiovascular system (HR +18±4%, p<0.05; SBP +112±24%, p<0.05; DBP +34±8%, p<0.05) in all subjects, without any symptoms and regardless of the individuals' mental arithmetic ability. CONCLUSIONS: We developed and validated a computer-based tool that is effective for simulating endocrine and haemodynamic responses to an acute mental stress. This novel tool is easy-to-use, freely-accessible, and it can be employed to further investigate stress-related pathophysiological mechanisms and their role in cardiovascular diseases.