OBJECTIVES: 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.
METHODS: 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.
RESULTS: 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 coefficients > 0.2, p < 0.05). 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 (p < 0.05). 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 (p < 0.05).
CONCLUSIONS: 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.