One-day acceptance and commitment therapy (ACT) workshop improves anxiety but not vascular function or inflammation in adults with moderate to high anxiety levels in a randomized controlled trial.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Anxiety is associated with a 26% higher risk of cardiovascular disease and a 48% higher risk of cardiac mortality.

“a meta-analysis on the relationship between anxiety and cardiovascular outcomes that included the end points of cardiac death, myocardial infarction, and cardiac events demonstrated a 26% increased risk of having CVD and a 48% increased risk of cardiac mortality [6].”

• cites [6] sourcePartly supported

  The Discussion reports a 26% increased risk of incident coronary heart disease (CHD) and a 48% increased risk of cardiac death among anxious people. The figures match the claim, but the source studied CHD in initially healthy individuals, not cardiovascular disease broadly. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

Anxiety is not associated with peripheral conduit artery endothelial function measured by brachial artery flow-mediated dilation, suggesting that endothelial dysfunction in anxiety is selective to the resistance artery microcirculation.

“In contrast, there was no association between anxiety and peripheral conduit artery endothelial function as assessed by brachial artery flow-mediated dilation (FMD), suggesting that vascular endothelial dysfunction in individuals with anxiety is selective to the resistance artery microcirculation rather than larger conduit muscular arteries.”

• cites [11] sourcePartly supported

  The Results and the Discussion’s ‘Resistance versus conduit vessels’ section report no association between anxious symptoms and brachial FMD, alongside an association with resistance-vessel dysfunction in participants with atherosclerosis. The claim extends that pattern to individuals with anxiety generally, although the reported resistance-vessel finding is specific to participants with atherosclerosis. The study also reports vascular smooth muscle dysfunction, not only endothelial dysfunction. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim.

In adults with atherosclerosis, anxiety is independently associated with lower forearm resistance microvascular function after adjustment for cardiovascular disease risk factors.

“Stillman et al. (2013) found a significant independent association between anxiety and decreased forearm resistance microvascular function after controlling for CVD risk factors in adults with atherosclerosis [11].”

• cites [11] sourcePartly supported

  The Discussion reports that anxiety was associated with impaired forearm resistance vessel function in participants with atherosclerosis, independently of most conventional risk factors. But the Results show that, in a model including BMI and other significant covariates, anxiety only trended toward significance (p=0.054); the claim omits this exception to its assertion of a significant independent association after risk-factor adjustment. No page numbers are available in our copy. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

Anxiety disorders are linked to cardiovascular disease risk factors such as hypertension and to clinical cardiovascular disease events.

“anxiety disorders are associated with cardiovascular disease (CVD) risk factors such as hypertension and also with clinical CVD events [5].”

• cites [5] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Each 0.66 SD in FMD is associated with an 18% higher risk of composite cardiovascular events and a 36% higher risk of myocardial infarction, resuscitated cardiac arrest, or death from coronary heart disease.

“Similar results were seen in another population-based study wherein each 0.66 standard deviation in FMD was associated with an 18% increased risk of composite cardiovascular events and 36% increase risk of myocardial infarction, resuscitated cardiac arrest or coronary heart disease death [23].”

• cites [23] sourcePartly supported

  The Results report an inverse association between FMD and cardiovascular events, and the Methods and Results summary gives a fully adjusted hazard ratio of 0.84 per one SD higher FMD—approximately 19% higher risk in the opposite direction. But that summary defines the SD as 2.8 percentage points of FMD, not 0.66 SD. The Results also report associations with MI and cardiovascular death, but the available passages do not substantiate a 36% increase for the specified coronary-event composite. (LLM, conf=0.87)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

The aortic augmentation index is a poor marker of arterial stiffness, and whether it predicts cardiovascular events in aging is controversial.

“However, aortic augmentation index is not a good marker of arterial stiffness and it is controversial as to whether it predicts CVD events in aging [9].”

• cites [9] sourcePartly supported

  The passage labeled Abstract (page unavailable) says augmentation index is a relatively imprecise measure of any particular arterial property because wave reflection and pulse-wave velocity can change separately with age. That supports the claim that it is a poor marker of stiffness, but the passages found do not address whether augmentation index predicts cardiovascular events or whether that question is controversial. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT has been delivered successfully in various formats, including one-day group workshops.

“has been successfully implemented in varied delivery formats [14–16], including one-day group workshops [17, 18].”

• cites [14] sourceSupported
• cites [15] sourceSupported
• cites [16]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites [17] sourceSupported
• cites [18] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A similarly sized trial of mindfulness-based stress reduction for generalized anxiety disorder showed reductions in TNF-α, IL-6, and ACTH, but TNF-α was measured in the context of the Trier Social Stress Test, and this was interpreted as greater stress resilience.

“A similarly sized trial of mindfulness-based stress reduction for generalized anxiety disorder did show reductions in TNF-α, although TNF-α was measured in the context of a challenge, the laboratory-based Trier Social Stress Test (TSST). Similar differences were observed for interleukin-6 and adrenocorticotropic hormone (ACTH). This was interpreted as a greater increase in stress resilience, as”

• cites [44] sourceSupported

May combine two claims.

The one-day ACT workshop produced sustained reductions in anxiety on the BAI over 12 weeks, but this effect did not extend to anxiety measured by the STAI.

“Consistent with our previous findings [33, 34], the one-day ACT workshop yielded sustained reductions in anxiety as measured by our primary outcome, the BAI, sustained over 12 weeks [20], although this finding was not robust enough to extend to anxiety as measured by the STAI.”

• cites [33] sourcePartly supported

  The Results report that the one-day ACT-IM workshop reduced anxiety relative to treatment as usual at 12 weeks, supporting the general claim of a sustained anxiety benefit. But the paper measured anxiety with the HRSA as a secondary outcome; its stated primary outcome was quality of life. It does not report BAI or STAI results, so it cannot support the claim about those measures. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [34] sourceCould not verify

  The Methods > Measures section lists depression and functioning measures, while Results > Outcome analyses reports improvements in depression and functioning over 12 weeks. Searches for BAI, STAI, and anxiety reductions found no passage reporting either anxiety outcome, so this copy cannot verify the attributed contrast. (LLM, conf=0.77)

  Experimental — accuracy not yet measured
• cites [20]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The sample predominantly consisted of non-pregnant, premenopausal females, which may represent a less vulnerable life stage for the physiological effects of stress.

“The sample predominantly consisted of non-pregnant, premenopausal females, which may represent a less vulnerable life stage of for the physiological effects of stress [47].”

• cites [47] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In samples with coronary artery disease, a State-Trait Anxiety Inventory state anxiety score of at least 40 has 84% sensitivity and 56% specificity, and a trait anxiety score of at least 45 has 89% sensitivity and 56% specificity for detecting an anxiety disorder.

“In samples with coronary artery disease, a state anxiety score of ≥40 has a sensitivity of 84% and a specificity of 56% while trait anxiety has 89% sensitivity and 56% specificity at a threshold of ≥45 for the presence of an anxiety disorder [31].”

• cites [31] sourcePartly supported

  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

TNF-α has not been as well-studied in its association with anxiety, although higher levels have been reported in generalized anxiety disorder.

“TNF-α has not been as well-studied in its association with anxiety, although higher levels have been reported in generalized anxiety disorder [43].”

• cites [43] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Stillman et al. (2013) demonstrated that forearm resistance artery function was associated with anxiety in older adults with atherosclerosis, but there was no relation with peripheral conduit artery endothelial function as assessed by brachial artery FMD.

“Stillman et al. (2013) demonstrated that forearm resistance artery function, as assessed by in response to intra-brachial artery infusions of endothelial-dependent and –independent pharmacological agonists, was associated with anxiety in a cohort of older adults with a history of atherosclerosis. In contrast, there was no relation with peripheral conduit artery endothelial function as assessed by”

• cites [11] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

In mood disorders, vasculopathy has been associated with the long-term course of illness and in proportion to symptom burden or persistence of mood symptoms.

“In mood disorders, for example, vasculopathy has been associated with the long-term course of illness and in proportion to symptom burden or the persistence of mood symptoms [45].”

• cites [45] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Many but not all studies have found an association between anxiety and CRP.

“Many [35– 41], but not all [42] studies have found an association between anxiety and CRP.”

• cites [35] sourceSupported
• cites [36] sourceSupported
• cites [37] sourceNot checked — no full text of the source
• cites [38] sourceNot checked — no full text of the source
• cites [39] sourceSupported
• cites [40] sourcePartly supported

  The Discussion (p. 12) reports no association for several anxiety disorder subtypes, and the Sample characteristics section (p. 11) reports no baseline hsCRP difference among the agoraphobia groups. But the study did find that current anxiety disorders overall, particularly agoraphobia, were associated with a steeper increase in hsCRP over follow-up. It therefore supports the ‘not all’ qualification only for particular comparisons, not as a study finding no anxiety–CRP association. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [41] sourceNot checked — no full text of the source
• cites [42] sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Controls had lower peak forearm blood flow at baseline (χ2=4.40, p=0.04).

“as well as overall lower peak forearm blood flow (χ2=4.40, df=1, p=0.04)”

Probably not a substantial claim: may not pass S3 (load-bearing).

Controls had higher carotid artery beta-stiffness at baseline (χ2=4.01, p=0.05).

“Controls had higher carotid artery beta-stiffness at baseline (χ2=4.01, df=1, p=0.05)”

May combine two claims.

In the current study, forearm microvascular endothelial function (peak forearm blood flow) and macrovascular endothelial function (brachial artery FMD) were not associated with anxiety levels, and the ACT intervention did not improve peak forearm blood flow after 12 weeks compared with controls.

“In the current study, forearm microvascular endothelial function (peak FBF) and macrovascular endothelial function (brachial artery FMD) were not associated with anxiety levels in our cohort and the one-day ACT intervention did not result in improved peak FBF after 12 weeks compared with non-ACT controls.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Controls had non-significantly higher baseline flow-mediated dilation.

“and a non-significantly higher baseline FMD.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

ACT is effective for treating anxiety, depression, and other chronic conditions.

“It is effective in treating anxiety and depression as well as other chronic conditions [13]”

• cites [13] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In the laboratory, cfPWV had a within-subject coefficient of variation of 2.1% among 9 adults measured on two visits one week apart.

“Within-subject coefficient of variation for cfPWV in our laboratory was 2.1% for 9 adults measured on two visits separated by one week.”

Classified as probably not a substantial claim.

The rate of change in limb circumference during venous occlusion correlates highly with arterial blood inflow into the limb.

“Absolute blood flow was determined by the rate of change of limb circumference (e.g., slope) during the five- second venous occlusion which has been validated to correlate highly to arterial blood inflow into the limb [28].”

• cites [28] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

A staff member who did not perform outcome assessments kept the allocation sequence secure.

“The sequence was secured by a staff member not involved in performing outcome assessments.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The trial was conducted at a single site and used single blinding with blinded outcome assessment.

“This was a single site, single blind (blinded outcome assessment) clinical trial of a one-day ACT intervention (compared to wait list control) conducted at the University of Iowa Hospitals with participants recruited between November 2014 and November 2015.”

Classified as probably not a substantial claim. May combine two claims.

The sample-size calculation aimed for 43 participants per group, giving 80% power at alpha=.05 to detect a 0.5 SD primary BAI effect, with a 0.4 within-person correlation over three measurements and 10% attrition.

“The study was powered to detect a 0.5 SD effect size in the primary outcome (BAI) assuming a 0.4 within subject correlation in outcome measures assessed at three time points at 80% power with alpha=.05 with an estimated 10% dropout rate for a target of 43 participants per group.”

Probably not a substantial claim: may not pass S3 (load-bearing).

In the laboratory, carotid artery β-stiffness index had an intra-observer coefficient of variation of 11.3% among 4 adults measured one week apart.

“The intra-observer CV for carotid artery β-stiffness index in our lab for 4 adults separated by one week was 11.3%.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Staff who performed vascular assessments were blinded to group assignment.

“Staff involved in scheduling and running visits were aware of assignment, but those performing vascular assessments were blinded.”

Probably not a substantial claim: may not pass S3 (load-bearing).

cfPWV and carotid β-stiffness index are strong independent predictors of cardiovascular disease risk.

“carotid-femoral pulse wave velocity (cfPWV) and carotid β-stiffness index, both strong independent predictors of CVD risk (1,19).”

• cites [1] sourceNot checked — no full text of the source
• cites [19] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In patients with hypertension, anxiety scores correlate with the cardio-ankle vascular index.

“In patients with hypertension, anxiety scores have been correlated with the cardio-ankle vascular index, a measure of arterial stiffness [10].”

• cites [10] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Randomization was computer-generated without stratification or blocking.

“Randomization was generated by a computer program without stratification or blocking.”

Classified as probably not a substantial claim.

A 0.66 SD reduction in brachial artery FMD is associated with a 30% higher risk of cardiovascular events.

“In a study of brachial artery FMD, a reduction in FMD of 0.66 SD was associated with a 30% increased risk of cardiovascular events [22].”

• cites [22] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

High anxiety is associated with lower brachial artery flow-mediated dilation after adjustment for confounders, and this association is selective to trait rather than state anxiety.

“However, Narita et al. (2006) found a significant association between high anxiety and lower brachial artery FMD after adjusting for confounding factors but the relation was selective to trait (dispositional tendency to be anxious) rather than state (transient emotional response) anxiety [12].”

• cites [12] sourceNot checked — no full text of the source

May combine two claims.

Existing evidence links high chronic anxiety to arterial stiffness and vascular endothelial dysfunction, but which vascular beds are most affected remains mixed.

“Thus, the existing evidence suggests that high chronic anxiety levels are associated with arterial stiffness and vascular endothelial dysfunction but results are mixed regarding which vascular beds are most affected by anxiety.”

• cites [7] sourceNot checked — no full text of the source
• cites [8] sourceNot checked — no full text of the source
• cites [12] sourceNot checked — no full text of the source

May combine two claims.

In otherwise healthy young and middle-aged persons with moderate to high baseline anxiety, the ACT intervention produced small to moderate effects on anxiety scores but no improvements in micro- or macrovascular endothelial function or arterial stiffness after 12 weeks compared with a time-control condition.

“In conclusion, we found that otherwise healthy young and middle-aged persons with moderate to high baseline anxiety demonstrated small to moderate effects on anxiety scores but not improvements in micro- or macro-vascular endothelial function or arterial stiffness after 12 weeks following the ACT intervention compared with the time-control condition.”

Classified as probably not a substantial claim.

Yeragani et al. (2006) found that patients with high anxiety had significantly higher brachial-ankle pulse wave velocity compared with controls with low anxiety.

“Yeragani et al. (2006) found that the patients with high anxiety had significantly higher brachial-ankle PWV compared with controls with low anxiety [7].”

• cites [7] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The linear models were adjusted for age, education, and body mass index because these variables remained imbalanced after randomization.

“Models were first run as unadjusted analyses and subsequently adjusted for age, education, and body mass index (BMI), which remained imbalanced following randomization.”

May combine two claims.

In this study, within-subject reproducibility of baseline brachial artery diameter and flow-mediated dilation percentage was excellent, with coefficients of variation of 1.2% and 7.3% for measurements taken 8 weeks apart.

“Our within-subject reproducibility of baseline diameter and FMD% is excellent with a coefficient of variation of 1.2% and 7.3%, respectively, for measurements 8 weeks apart.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In this sample, the STAI-State and STAI-Trait showed poor internal consistency (Cronbach's alpha 0.57 and 0.51), while the BAI showed acceptable internal consistency (Cronbach's alpha 0.70).

“Among our study sample, the STAI demonstrated poor internal consistency for both the STAI-State (Cronbach’s alpha 0.57) and the STAI-Trait (Cronbach’s alpha 0.51), in contrast to the BAI, which demonstrated acceptable internal consistency (Cronbach’s alpha 0.70) in this study sample.”

Probably not a substantial claim: may not pass S3 (load-bearing).

At baseline, control participants were older than ACT participants (mean age 37.1 vs 33.0 years, p=.02).

“Control participants were older (mean age of 37.1 ± 10.1(SD) vs. 33.0 ± 8.7 years, χ2=5.3, df=1, p=.02)”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Forty-four participants were randomized to the ACT group and 28 to the control group.

“Forty-four individuals (29 females and 15 males) were randomized into the intervention group, and 28 individuals (20 females, and 8 males) were randomized into the control group.”

May combine two claims.

Exploratory measures of inflammation were not comprehensive, and other physiological outcomes relevant to anxiety, such as ACTH or other hypothalamic-pituitary axis measures, were not measured.

“our exploratory measures of inflammation were not comprehensive and other physiological outcomes that may be relevant to anxiety, such as ACTH or other hypothalamic-pituitary axis measures were not measured.”

May combine two claims.

The trial was relatively small and, while adequately powered for the primary anxiety outcome, may not have had adequate power to detect subsequent physiological changes.

“This clinical trial was relatively small and, while adequately powered to study changes in the primary anxiety outcome, may not have had adequate power to detect subsequent physiological changes with anxiety.”

Probably not a substantial claim: may not pass S3 (load-bearing).

At baseline, control participants were overrepresented among those without a college degree (p=.03).

“and were overrepresented in those without a college degree (Mantel-Haenszel χ2=4.55, df=1, p=0.03 for education level).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

C-reactive protein and tumor necrosis factor-alpha were not pre-specified in the trial registration and were therefore evaluated as exploratory outcomes.

“CRP and TNF-α were not pre-specified in registration and were therefore evaluated as exploratory outcomes.”

Classified as probably not a substantial claim.

Linear mixed models were not adjusted for blood pressure because there was no significant between-group difference in blood pressure.

“A statistically significant change in post-intervention blood pressure would indicate a need to account for the effects of blood pressure when modeling cfPWV and carotid β-stiffness; as such, linear mixed models were not subsequently adjusted for blood pressure.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Adherence to ACT techniques was not measured over follow-up and may have decayed.

“Adherence to ACT techniques was not measured over follow-up and may have been subject to decay.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The cohort was largely self-reported White.

“Finally, our cohort was largely self-reported White”

Classified as probably not a substantial claim. May combine two claims.

Peak forearm blood flow during reactive hyperemia is partly nitric oxide mediated and correlates with acetylcholine-induced forearm blood flow in essential hypertension, supporting its use as a non-invasive measure of nitric oxide-mediated microvascular endothelial function in forearm resistance arteries.

“Some studies report that peak FBF during reactive hyperemia is partly mediated by nitric oxide [29] and correlates with acetylcholine-induced forearm blood flow in persons with essential hypertension [30], therefore, it is a reasonable non-invasive measurement of nitric oxide-mediated microvascular endothelial function of forearm resistance arteries.”

• cites [29] sourceNot checked — no full text of the source
• cites [30] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

At baseline, the ACT and control groups did not differ significantly in race/ethnicity.

“or race/ethnicity (χ2=6.55, df=4, p=0.16 / (χ2=0.73, df=1, p=0.40)).”

Probably not a substantial claim: may not pass S3 (load-bearing).

At baseline, control participants had higher BMI than ACT participants (29.6 vs 26.1, p=.03).

“had higher BMI (29.6 ± 6.3 vs. 26.1 ± 4.8, χ2=4.99, df=1, p=.03)”

Probably not a substantial claim: may not pass S3 (load-bearing).

At baseline, the ACT and control groups did not differ significantly in sex distribution.

“At baseline, participants did not significantly differ by sex distribution (χ2=0.24, df=1, p=0.62)”

Probably not a substantial claim: may not pass S3 (load-bearing).

Of 87 adults who consented, 15 were excluded or lost after consent, leaving 72 adults randomized to ACT or control.

“As previously reported, a total of 87 adults were consented into the study and 15 were excluded or lost to follow up after consent, leaving a total of 72 adults enrolled and randomized to ACT or control.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Carotid β-stiffness was not pre-specified as a component of the clinical trial.

“The fourth vascular outcome included in this analysis, carotid β-stiffness, was not pre-specified as a component of the clinical trial.”

May combine two claims.

The ACT intervention had no effect on peak forearm blood flow, brachial flow-mediated dilation, or carotid-femoral pulse wave velocity.

“The ACT intervention had no effect on microvascular function, measured by peak forearm blood flow, conduit macrovascular endothelial function measured by brachial FMD, or aortic and carotid artery stiffness, assessed by carotid-femoral PWV.”

May combine two claims.

The lack of replication of previous findings together with poor internal consistency of the STAI may suggest that the STAI is not unidimensional for anxiety within this study sample.

“This lack of replication of our previous findings in conjunction with the poor internal consistency demonstrated with the STAI may suggest that the STAI is not unidimensional for anxiety within our study sample.”

May combine two claims.

Narita et al. (2006) found a significant association between high anxiety assessed by the STAI and decreased endothelial function as measured by brachial artery FMD; specifically, STAI-Trait but not STAI-State was negatively correlated with brachial artery FMD.

“Narita et al., (2006) found a significant association between high anxiety, assessed by the STAI, and decreased endothelial function as measured by brachial artery FMD [12]. Specifically, they found that the STAI-Trait score but not the STAI-State was negatively correlated with brachial artery FMD.”

• cites [12] sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

No adverse events related to any study procedures occurred.

“There were no adverse events related to any study procedures.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The statistical analysis plan intended to assess anxiety as a mediator of changes in vascular or inflammatory outcomes, but this analysis was deferred because of negative results.

“The statistical analysis plan intended to assess anxiety as a mediator with any observed changes in vascular or inflammatory outcomes. This was ultimately deferred due to the negative results of this analysis.”

May combine two claims.

In contrast to the hypothesis, baseline State and Trait anxiety levels were not associated with either aortic or carotid artery stiffness, and the ACT intervention did not alter either aortic or carotid stiffness after 12 weeks.

“In contrast to our hypothesis, our study indicates that baseline State and Trait anxiety levels were not associated with either aortic or carotid artery stiffness, and the ACT intervention did not alter either aortic or carotid stiffness after 12 weeks.”

Classified as probably not a substantial claim. May combine two claims.

Seldenrijk et al. (2011) found that persons with current depression or anxiety had a higher aortic augmentation index compared with controls, and those with lifetime comorbid anxiety and depression had a higher augmentation index.

“Seldenrijk et al. (2011) found that persons with current depression or anxiety had a higher aortic AIx compared with controls and that persons with a lifetime comorbidity of anxiety and depression showed a higher augmentation index compared with controls.”

• cites [8] sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

The pre-specified secondary outcomes for this trial were carotid-femoral pulse wave velocity, flow-mediated dilation, and peak forearm blood flow.

“The pre-specified secondary outcomes of interest for this trial were cfPWV, flow-mediated dilation, and peak forearm blood flow.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Measures were not done in response to a stimulus or stress, such as the Trier Social Stress Test.

“Our measures were also not done in response to a stimulus or stress, such as the TSST.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Five participants in each group dropped out or were lost after baseline, and 39 (89%) in the ACT group and 23 (82%) in the control group completed the 12-week study.

“A total of 5 participants in the ACT group and 5 participants in the control group dropped out of the study or were lost to follow-up after baseline measurements and assessments at 12 weeks. Ultimately, 39 (89%) participants in the ACT group and 23 (82%) in the control group completed the 12-week study.”