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

Amber J. Guest, Stacy A. Clemes, James A. King, Yu‐Ling Chen, Katharina Ruettger, Mohsen Sayyah, Aron Sherry, Veronica Varela‐Mato, Nicola J. Paine

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)
4 Downloads (Pure)


Depression and anxiety have been linked with reduced stress-induced cardiovascular reactivity (CVR), which could be indicative of autonomic dysregulation. Less is known about the association between work-related fatigue and CVR. Truck drivers experience high levels of depression, anxiety, and fatigue, with repeated psychophysiological stressors on the road, yet little is known about the effects of these conditions on their CVR. Three hundred eighty six truck drivers completed the Hospital Anxiety and Depression Scale (HADS) and the Occupational Fatigue Exhaustion/Recovery Scale (OFER-15). Systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR) were measured at rest and during a stressor protocol to measure CVR. Multivariate regression analyses were used to determine relationships between variables and adjusted for nine key covariates. Higher symptoms of persistent fatigue were related to a reduced SBP reactivity (β = −.236, p = .009) and reduced DBP reactivity (β = −.257, p = .005), whereas there was a positive trend between acute fatigue and DBP reactivity (β = .169, p = .052). Higher symptoms of anxiety were related to a reduced SBP reactivity (β = −.164, p = .016). This study demonstrated in a population of truck drivers that both anxiety and persistent fatigue were related to an attenuated SBP reactivity in a combined model, whereas there was a positive trend between acute fatigue solely and DBP reactivity. These novel findings may have serious implications for cardiovascular disease risk in truck drivers, and future research should attempt to establish the causal effect of these associations and the underlying physiological mechanisms.
Original languageEnglish
Article numbere13872
Number of pages12
Issue number9
Early online date4 Jun 2021
Publication statusPublished - 4 Sept 2021

Bibliographical note

The authors would like to thank all the truck drivers who participated in this study.
The data presented in this paper were collected as part of the baseline measures from the “Structured Health Intervention For Truckers (SHIFT)” randomized controlled trial, which is funded by the NIHR Public Health Research Programme (reference: NIHR PHR 15/190/42). SAC, JAK, AS and NJP are supported by the NIHR Leicester Biomedical Research Centre—Lifestyle theme. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The first author (AG) has received funding for their PhD Studentship from the Colt Foundation (reference: JD/618). The Colt Foundation had no role in study design; election, synthesis, and interpretation of data; writing of the report; or the decision to submit the manuscript for publication


  • anxiety
  • blood pressure
  • depression
  • stress reactivity
  • cardiovascular reactivity
  • fatigue stress
  • heart rate


Dive into the research topics of 'Attenuated cardiovascular reactivity is related to higher anxiety and fatigue symptoms in truck drivers'. Together they form a unique fingerprint.

Cite this