• P F Miller, K C Light, E E Bragdon, M N Ballenger, M C Herbst, W Maixner, A L Hinderliter, S S Atkinson, G G Koch, and D S Sheps.
• Department of Medicine, University of North Carolina School of Medicine, Chapel Hill.
• J Psychosom Res. 1993 Jul 1; 37 (5): 455-65.

UnlabelledWe compared symptomatic, hemodynamic and opioid responses of heart disease patients to exercise testing and a stressful public speaking task. Plasma beta-endorphins were measured at rest and immediately post stress. Nineteen of 50 patients had angina during exercise; 31 had asymptomatic ischemia. No patient had angina during the speech, but two had ECG changes and 39% had radionuclide changes indicating ischemia. Patients with asymptomatic ischemia on exercise had a significantly greater beta-endorphin response than those with angina. Public speaking elicited a significantly larger beta-endorphin increase relative to change in double product (an index of stress) than did exercise.Conclusions(1) Patients with silent vs painful ischemia experience a greater beta-endorphin response to exercise. (2) beta-endorphin response to a speech stressor is greater than to exercise when controlled for an index of stress. (3) Increased beta-endorphin response to a speech stressor may partially explain the predominance of silent ischemia during psychological stress.

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