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To evaluate the possible association between pressure pain sensitivity of the chest bone (PPS) and cardiovascular physiological factors related to persistent stress in connection with a three-month PPS-guided stress-reducing experimental intervention programme.Forty-two office workers with an elevated PPS (≥ 60 arbitrary units) as a sign of increased level of persistent stress, completed a single-blinded cluster randomized controlled trial. The active treatment was a PPS (self-measurement)-guided stress management programme. Primary endpoints: Blood pressure (BP), heart rate (HR) and work of the heart measured as Pressure-Rate-Product (PRP); Secondary endpoints: Other features of the metabolic syndrome.PPS decreased and changes in PPS after the intervention period were significantly associated with HR, PRP, body mass index (BMI) and visceral fat index (all correlation coefficients0.2, p0.05). Compared to the control cluster group, the active cluster group obtained a significant reduction in PPS, Low-density lipoprotein (LDL) cholesterol and total number of elevated risk factors (p0.05). On an individual level, significant and clinically relevant between-group reductions were observed in respect to BP, HR, PRP, total and LDL cholesterol, and total number of elevated risk factors (p0.05).The stress intervention method applied in this study induced a decrease in PPS which was associated with a clinically relevant decrease in resting blood pressure, heart rate, work of the heart and serum cholesterols.

Background: During sports competitions, the performance of athletes may be negatively affected by persistent stress and autonomic nervous system (ANS) dysfunction, both of which can be assessed by pressure pain sensitivity (PPS) at the chest bone. Objectives: To test the association between PPS and sports performance; does a reduction of an elevated PPS improve performance stability and overall performance in Olympic sailors? Methods: The case study included two male athletes during eight months of observation prior to and during Olympic sailing. The daily PPS self-measurements served as feedback guide for persistent stress and ANS dysfunction. Performance stability, overall performance and PPS measure were assessed at three intervals. Results: At baseline, the median PPS was 83, the performance stability was inferior to the mean top 10 competitors, and the overall performance was rank eight. During the observation period, PPS, performance stability and overall performance improved incrementally and significantly. This eventually led the sailors to achieve an Olympic Gold. The PPS, performance stability, and overall performance were all internally closely associated (correlation coefficients: r > 0.70; p < 0.001). Conclusion: The study may suggest a link between persistent stress and ANS dysfunction as assessed by PPS on one side and performance stability and overall performance on the other side.