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Abstract

Background: Human Resilience may be evaluated from the Autonomic nervous system (ANS) function. We tested the hypothesis that Pressure Pain Sensitivity of the chest bone (PPS) may be used as a marker for ANS function using the PPS response to a Tilt Table Test (TTT). Objectives: â?¢ To test the claim of an association between PPS and systolic blood pressure and heart rate responses to TTT; â?¢ To test the prediction that a reduction of PPS raises the TTT response and lowers risk factors for ANS dysfunction (ANSD). Methods: Cross-sectional study: In 361 patients with stable ischemic heart disease we measured PPS, SBP, and HR during TTT. Intervention study: We reassessed subjects with persistent stress who concluded a stress intervention trial by a second TTT. Results: Cross-sectional study: Resting PPS and the PPS response to TTT were correlated(r=- 0.37). The PPS response to TTT was correlated with that of SBP (r=0.44) and HR (r=0.49), and with the number of risk factors for ANSD(r=- 0.21) (all p<0.0001). Intervention study: A reduction in resting PPS was associated with an increment in PPS response to TTT (r= â??0.52, p< 0.0001). The greater this increment, the greater was the reduction in ANSD risk factors (r= - 0.23; p=0.003). Conclusion: The results are consistent with the hypothesis that PPS at rest and in response to TTT reflects ANS function and thus represent a marker for Human Resilience.

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