Does mental arithmetic before head up tilt have an effect on the orthostatic cardiovascular and hormonal responses?

Passive head up tilt (HUT) and mental arithmetic (MA) are commonly used for providing mental and orthostatic challenges, respectively. In animal experiments, even a single exposure to a stressor has been shown to modify the response to subsequent stress stimulus. We investigated whether MA applied before HUT elicits synergistic responses in orthostatic heart rate (HR), cardiac output (CO), heart rate variability and arterial blood pressure. The 15 healthy young males were subjected to two randomized protocols: (a) HUT and (b) HUT preceded by MA, with sessions randomized and ≥2 weeks apart. Beat to beat continuous hemodynamic variables were measured and saliva samples taken for hormonal assay. HUT alone increased HR from 59±7 (baseline) to 80±10 bpm (mean±SD) and mean blood pressure (MBP) from 88±10 to 91±14 mmHg. HUT results after MA were not different from those with HUT alone. The activity of alpha amylase showed differences during the experiments irrespective of the protocols. We conclude that mental challenge does not affect orthostatic cardiovascular responses when applied before; the timing of mental loading seems to be critical if it is intended to alter cardiovascular responses to upright standing.     

Interaction of mental and orthostatic stressors

We assessed hemodynamic responses induced by orthostatic and mental stressors, using passive head up tilt (HUT) and mental arithmetic (MA), respectively. The 15 healthy males underwent three protocols: (1) HUT alone, (2) MA in supine position and (3) MA+HUT, with sessions randomized and ≥2 weeks apart. In relation to baseline, HUT increased heart rate (HR) (+20.4±7.1 bpm; p<0.001), mean blood pressure (MBP) (+4.7±11.3 mmHg; p<0.05), diastolic blood pressure (DBP) (+6.1±11.6 mmHg; p<0.05) and total peripheral resistance (TPR) (+155±232 dyne*s/cm⁵; p<0.001) but decreased stroke volume (SV) (?33.1±13.4 ml; p<0.001) and cardiac output (CO) (?0.6±1.0 l/min; p<0.01). MA increased HR (+8.0±6.0 bpm; p<0.001), systolic blood pressure (SBP) (+9.0±7.7 mmHg; p<0.001), MBP (+10.0±6.5 mmHg; p<0.001), DBP (+9.5±7.2 mmHg; p<0.001) and CO (+0.6±0.8 l/min; p<0.01). MA+HUT increased HR (+28.8±8.4 bpm; p<0.001), SBP (+4.6±14.3 mmHg; p<0.05), MBP (+11.2±11.6 mmHg; p<0.001), DBP (+13.5±10.1 mmHg; p<0.001) and TPR (+160±199 dyne*s/cm⁵; p<0.001) but SV (?34.5±14.6 ml; p<0.001) decreased. Mental challenge during orthostatic challenge elicited greater increases in heart rate, despite similar reductions in stroke volume such as those during orthostatic stress alone. Overall, cardiac output decreases were less with combinations of mental and orthostatic challenges in comparison to orthostasis alone. This would suggest that carefully chosen mental stressors might affect orthostatic responses of people on standing up. Therefore, additional mental loading could be a useful countermeasure to alleviate the orthostatic responses of persons, particularly in those with histories of dizziness on standing up or on return to earth from the spaceflight environment of microgravity.