Attenuated cardiovascular reactivity is related to higher anxiety and fatigue symptoms in truck drivers

Guest, Amber; Clemes, Stacy A.; King, James A.; Chen, Yuling; Ruettger, Katharina; Sayyah, Mohsen; Sherry, Aron P.; Varela-Mato, Verónica; Paine, Nicola J. · 2021 · OpenAlex-citations

DOI: 10.1111/psyp.13872

archive: archived pipeline: cataloged verified

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Summary

This study investigates the relationship between psychological symptoms—specifically depression, anxiety, and fatigue—and cardiovascular reactivity (CVR) to acute stress in truck drivers. While elevated CVR is traditionally linked to disease pathogenesis, recent evidence suggests that attenuated (reduced) CVR also indicates autonomic dysregulation and poor health outcomes. Truck drivers face high levels of occupational stress and psychological distress, yet little is known about how these conditions affect their physiological stress responses. The researchers hypothesized that higher symptoms of depression, anxiety, and fatigue would be associated with attenuated cardiovascular responses. The study utilized baseline data from the “Structured Health Intervention For Truckers” (SHIFT) randomized controlled trial, involving 386 long-haul truck drivers recruited from 25 depots in the Midlands region of the United Kingdom. Participants completed the Hospital Anxiety and Depression Scale (HADS) and the Occupational Fatigue Exhaustion/Recovery Scale (OFER-15) to assess psychological symptoms. Cardiovascular measures, including systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR), were recorded at rest and during a stressor protocol consisting of a Stroop Colour-Word test and a Mirror Tracing task. CVR was calculated as the difference between stress-induced and resting measures. Multivariate regression analyses were performed to determine relationships between psychological variables and CVR, adjusting for nine covariates including age, BMI, medication use, smoking, and alcohol consumption. The results demonstrated that higher symptoms of persistent fatigue were significantly related to reduced SBP reactivity ($\beta = -.236, p = .009$) and reduced DBP reactivity ($\beta = -.257, p = .005$) in the combined model. Higher anxiety symptoms were also significantly associated with reduced SBP reactivity ($\beta = -.164, p = .016$). In separate models, persistent fatigue showed significant negative relationships with SBP, DBP, and HR reactivity, while chronic and acute fatigue were negatively associated with HR reactivity. A positive trend was observed between acute fatigue and DBP reactivity ($\beta = .169, p = .052$). No significant relationships were found between depressive symptoms and any cardiovascular reactivity measures after adjusting for covariates. The findings indicate that in a population of truck drivers, anxiety and persistent fatigue are linked to attenuated SBP reactivity, suggesting a blunted physiological response to stress. This dysregulation may have serious implications for cardiovascular disease risk in this occupational group. The study highlights the need for future research to establish the causal effects of these associations and to identify the underlying physiological mechanisms connecting psychological distress and cardiovascular health in high-stress professions.

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• truck driver fatigue

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• Empirical Findings: physiological data