Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives

Cardiovascular reactivity to video game and mental arithmetic stressors was compared among three groups of men: aerobically trained mild hypertensives, untrained mild hypertensives, and a comparison group of untrained normotensives. Relative to the untrained hypertensives, the trained hypertensives reacted to the video game with marginally smaller systolic blood pressure and diastolic blood pressure, but there were no significant differences between these groups in reactivity during the mental arithmetic task. Comparisons between each hypertensive group and the normotensive group showed that blood pressure (BP) reactivity of normotensives during the video game was generally similar to that of trained hypertensives but smaller than that of untrained hypertensives. These results indicate that aerobic training, which has been found to reduce resting BP in mild hypertensives, may also exert a favorable impact in reducing cardiovascular reactivity of hypertensives during some stressful situations.     

Neuropeptide and cardiovascular responses to intravenous catheterization in normotensive and hypertensive blacks and whites

Research suggests that heightened cardiovascular and neuroendocrine (typically catecholamine) responses to stressors may lead to the development of hypertension and that there may be race differences in patterns of reactivity that are potentially pathogenic. Certain neuropeptides exert profound effects on blood pressure (BP) and heart rate (HR), yet no published studies have examined relationships between these peptides, hypertensive status, race, and reactivity. Seventeen Black and 20 White normotensive and borderline-hypertensive male 19- to 50-year-olds underwent intravenous catheterization while cardiovascular and neuropeptide responses to the stress of being catheterized were examined. Results indicate that, in response to the stressor, Black hypertensives, showed significantly lower endorphin levels compared to Black normotensives, and White hypertensives showed significantly higher levels of beta-endorphin compared to White normotensives. Groups were not significantly different in endorphin levels at recovery. Black hypertensives also showed significantly higher stressor-induced HR and systolic and diastolic BP compared to White hypertensives and normotensives. Lower levels of beta-endorphin and lower urine sodium excretion were associated with higher BP and HR.     

Blood pressure estimation and beliefs among normotensives and hypertensives

Although health professionals believe that blood pressure (BP) is asymptomatic, most diagnosed hypertensives are confident that they experience specific symptoms and emotions that help them detect their BP levels. Several months after screening interviews that elicited subjects' BP beliefs, 14 medicated hypertensives, 15 nonmedicated mild hypertensives (diastolic BP greater than or equal to 90 mm Hg), 39 normotensives, and 13 hypotensives (systolic BP less than or equal to 100 mm Hg) participated in a 1- to 2-hr laboratory experiment that assessed each subject's symptoms, moods, and estimates of systolic BP (SBP) relative to actual SBP levels. Several self-reports and autonomic measures were collected 45 times during and after each of 22 tasks. Subjects never received SBP feedback during the experiment. Within-subject correlations indicated that all subject groups could estimate SBP at levels greater than chance (mean estimated SBP-actual SBP correlation = .25). Further, 68% of the subjects evidenced at least one significant symptom-SBP correlation. Although medicated hypertensives believed they could estimate their BP more accurately than other groups by using their symptoms and emotions, they were actually no more accurate than the other groups. They also evidenced far fewer empirically derived symptom-SBP and emotion-SBP correlations than any other group. Overall, BP beliefs were largely inaccurate. If these erroneous beliefs can be eliminated, subjects may be able to estimate BP fluctuations more accurately.     

Blood pressure and personality

Three groups of 18-yr-old male Ss were selected from a representative Swedish population according to strict blood-pressure criteria: hypertensives (systotic blood pressure above 146 and diastolic above 90), on two occasions, normotensives (systolic blood pressure between 124 and 131, population mean = 128) and hypotensives (systolic blood pressure between 100 and 106). As a part of a broad multidisciplinary study, personality inventory scales and unpleasantness ratings for various types of situations were administered. The findings for the hypertensives indicated lower assertiveness and higher anxiety-proneness, whereas the hypotensives, compared to normotensives, showed a more impulsive, acting-out personality pattern. The hypertensive group was subdivided according to digital vasoconstriction criteria. The non-vasoconstricted subgroup showed a more impulsive and ‘anger-out’ personality pattern, whereas the pattern obtained in the vasoconstricted subgroup was more similar to the classical hypertensive personality, characterized by anxiety and unexpressed anger.     

Differences in personality between sustained hypertension,isolated clinic hypertension and normotension

The aim of this study was to determine whether there are differences in personality between hypertension and normotension. Forty‐two male patients with essential hypertension were divided into two groups after self‐assessment of blood pressure, 18 with sustained hypertension and 24 with isolated clinic (white coat) hypertension, and were compared with 25 men with normotension on Spielberger's State‐Trait Anxiety Inventory and the Jenkins Activity Survey. In line with hypotheses, the sustained hypertensive group showed higher levels of trait anxiety, Type A behaviour pattern, and hard‐driving behaviours/competitiveness than the normotensive group, whereas isolated clinic hypertensives occupied an intermediate position between those two groups. Results provide support to the hypothesised relationship between personality and hypertension and stress the need of distinguishing sustained hypertension from isolated clinic hypertension. Copyright © 2006 John Wiley & Sons, Ltd.     

The effects of muscle relaxation and stress on the blood pressure levels of normotensives

Shoemaker and Tasto (1975) found that progressive muscle relaxation lowers the blood pressure levels of essential hypertensives to within a normal range under laboratory conditions. As a sequel to this study the effects of muscle relaxation and stress on the blood pressure levels of normotensives were studied. One group was taught relaxation, one group was stressed, one group read, and one group did nothing. Blood pressure measurements taken immediately after the completion of these tasks indicated that muscle relaxation does not lower the blood pressure levels of normotensives but that stress significantly raises both the systolic and diastolic levels.Level of arousal can, at least in one sense, be viewed as occurring on a dimension defined by extreme anxiety at one end and extreme relaxation at the other. Research on the physiological correlates and/or defining properties of arousal has produced inconsistent and equivocal results. Little work has been done relating blood pressure levels to arousal, however. Shoemaker and Tasto (1975) found a consistent and predictable drop in the blood pressure levels of essential hypertensives as a result of progressive muscle relaxation. In their study those subjects with the highest blood pressure levels showed the greatest drop while those with moderately high levels showed moderate drops and those with the lowest levels (yet still above normal) showed the least amount of change. The amount by which blood pressure dropped as a result of progressive relaxation was positively correlated with the pretreatment level of blood pressure. The result of progressive relaxation was to lower blood pressure levels to within a normal range, with all subjects appearing to approach a lower asymptotic level. Because of the consistent picture which began to emerge, the question arose as to whether blood pressure might be a reliable physiological correlate of the relaxation-anxiety dimension.The more specific questions emanating from this issue were: what effect does progressive relaxation have on the blood pressure levels of normotensives; what effect does stress have on the blood pressure levels of normotensives; and, what effect does stress have on the blood pressure levels of essential hypertensives? Since we could not immediately foresee the benefits that would outweigh the potential harm that might arise by placing hypertensives under stress, this study was limited to addressing the first two questions.Since the blood pressure levels of normotensives are probably at an optimal level for the physiological functioning of the organism, lower levels would be physiologically nonadaptive. and thus progressive relaxation should not lower the blood pressure levels of normotensives as it does those of essential hypertensives. On the other hand, if the elevated blood pressure levels of essential hypertensives are at least in part the result of a stress reaction, it would be expected that the blood pressure levels of normotensives might rise under stress conditions.     

Persistence and relapse of reinforced behavioral variability

The present study examined persistence and relapse of reinforced behavioral variability in pigeons. Pigeons emitted four‐response sequences across two keys. Sequences produced food according to a lag schedule, in which a response sequence was followed by food if it differed from a certain number of previous sequences. In Experiment 1, food was delivered for sequences that satisfied a lag schedule in both components of a multiple schedule. When reinforcement was removed for one component (i.e., extinction), levels of behavioral variability decreased for only that component. In Experiment 2, food was delivered for sequences satisfying a lag schedule in one component of a multiple schedule. In the other component, food was delivered at the same rate, but without the lag variability requirement (i.e., yoked). Following extinction, levels of behavioral variability returned to baseline for both components after response‐independent food delivery (i.e., reinstatement). In Experiment 3, one group of pigeons responded on a lag variability schedule, and the other group responded on a lag repetition schedule. For both groups, levels of behavioral variability increased when alternative reinforcement was suspended (i.e., resurgence). In each experiment, we observed some evidence for extinction‐induced response variability and for variability as an operant dimension of behavior.     

Effects of beta blockade with metoprolol on simple and complex task performance

The effect of treatment with the beta-blocker metoprolol on several indicants of task performance was investigated. Twenty-five male hypertensives were treated for 2 weeks each with drug and placebo in a double-blind crossover design. Comparisons to 25 matched untreated normotensives were made. Participants responded twice to a Mood Adjective Check List (MACL) and the Stroop Color-Word Test. In addition, they participated in two parallel decision-making simulations. Normotensives and hypertensives on drug or placebo did not differ on MACL and Stroop scores. Comparisons on 12 validated simulation measures showed that drug treatment with metoprolol aided complex task performance. Drug treatment improved strategic capacity and the ability to deal effectively with emergencies. Preliminary evidence that treatment with metoprolol might help restore performance capacity that may have been lost due to hypertensive disease was also obtained.     

Electrocortical signs of arousal in response to darkness and the assessment of type A behavior in professional drivers with and without cardiovascular disease

Background and Aims  In night driving, the fatal accident rate is about four times that in daytime. There is a lack of published studies of the effect of darkness on electrocortical responses in professional drivers (PD). Aim: Assessing relations between electroencephalographic (EEG) reactions to enforced darkness reminiscent of night driving, and untoward behavioral response patterns, notably Type A behavior. Methods  PD: 13 with ischemic heart disease, 12 hypertensives (HTN), 10 borderline hypertensives and 34 normotensives, and 23 non-PD controls. Five minutes of electroencephalographic recording with eyes closed, and subsequently 3 minutes exposure to darkness. EEG parameters were: alpha abundance, amplitude and frequent. Type A behavior (TAB) was assessed by observation and by questionnaire. Results  Alpha abundance diminished significantly for darkness compared to spontaneous recording for all groups. No between-group differences were found for EEG. There were no significant differences in EEG between drivers with IHD or HTN taking versus not taking centrally active β-blockers. Drivers with IHD were the only group to show significant increase in dominant α frequency at darkness. The IHD group also had the highest TAB questionnaire scores and the heaviest exposure to professional driving. Type A scores were significantly correlated with dominantt alpha frequency during darkness. Low availability of attachment and special driving hazards best predicted TAB scores in driven. There was a significance between group difference with respect to Symbolic Aversiveness at the work place comparing each driver group with the non-PD control group. Conclusions  Exposure to darkness reminiscent of night driving can elicit central arousal, in conflict with circadian rhythm, and in combination with other driving hazards which contribute to symbolic aversiveness, the essence of driving. And low availability of social attachment could contribute to sustained, and in turn to the development of Type A behavior in professional drivers.     

Blood pressure reactivity to active and passive behavioral conditions in hypertensives and normotensives

Blood pressure reactivity and passive behavioral tasks was studied in patients with mild essential hypertension and normotensive controls. The passive condition included 10 presentations of a 6 sec, 78 dB, 1000 Hz tone without any response requirements. In the active condition subjects were given an additional 10 tone presentations and asked to press a push-button at tone termination. The absolute and percent increase in systolic blood pressure from rest was greater in hypertensives than normotensives in response to the active condition but similar to the passive condition. It is concluded that patients with hypertension compared to normotensive controls show exaggerated blood pressure reactivity to tasks involving active but not passive coping efforts. Since the tasks used to induce active and passive coping in the present study were identical apart from coping requirements, the notion that the activity dimension in and of itself modulates reactivity differences between patients and controls is supported.     

Neuropsychological correlates of hypertension: review and methodologic considerations.

Essential hypertension is a chronic disorder having many potential physical and behavioral sequelae. This article evaluates the impact of hypertension on neuropsychological test performance. First, cross-sectional and longitudinal studies that examine the neuropsychological correlates of hypertension are reviewed. In general, hypertensives are found to perform more poorly than normotensives, particularly on tests of memory, attention, and abstract reasoning, and less consistently on tests of perception, constructional ability, mental flexibility, and psychomotor speed. Next, the influence of variables that may moderate relationships between hypertension and neuropsychological performance--such as age, education, and medication usage--are examined. Finally, potential mechanisms, both physiological and psychological, underlying associations between hypertension and neuropsychological performance are discussed.     

Different responses in word association tests in normotensive and hypertensive subjects]

Activation of latent associations by word stimuli of different emotional relevance as well as the accompanying electrophysiological tracings reveal statistically significantly characteristics in juvenile essential (arterial) hypertensives as compared to normotensives. This applies to the verbal reactions as well as to the electrophysical concomitants. Under additional cognitive demands both groups achieve better performance. This rise is significantly greater, however for hypertensives than for normotensives. Our special recording system permitted exact phonographic registration of the verbal stimulus and reaction as well as of the PGR.     

Assessing emotional processing difficulties in normotensive individuals with high and isolated blood pressure elevations

This study examined the effect of sense modality (auditory/visual) on emotional dampening (reduced responsiveness to emotions with elevation in blood pressure). Fifty‐six normotensive participants were assessed on tasks requiring labelling and matching of emotions in faces and voices. Based on median split of systolic and diastolic blood pressures (SBP and DBP, respectively), participants were divided into low BP, high BP and isolated BP groups. On emotion‐labelling tasks, analysis revealed reduced emotion recognition in the high BP than the low BP group. On emotion‐matching tasks, reduced emotion recognition was noted in high and also isolated BP group as compared to low BP group for the task that required matching a visual target with one of the four auditory distractors. Our findings show for the first time that even isolated elevations in either SBP or DBP may result in emotional dampening. Furthermore, the study highlights that the emotional dampening effect generalises to explicit processing (labelling) of emotional information in both faces and voices—and that these effects tentatively occur during more pragmatic and covert (matching) emotion recognition processes too. These findings require replication in clinical hypertensives.     

Associations of blood pressure with self-report measures of anger and hostility among black and white men and women

This study examined associations between blood pressure (BP) and dispositional variables pertaining to anger and hostility. Black and White 25- to 44-year old male and female normotensives and unmedicated mild to moderate hypertensives completed four reliable self-report scales--the Cook-Medley Hostility (Ho) Scale, the Trait Anger subscale of the State-Trait Anger Scale (STAS-T), and the Cognitive Anger and Somatic Anger subscales of the Cognitive-Somatic Anger Scale--plus the Framingham Anger Scale and the Harburg Anger Scale. They also engaged in three laboratory tasks--Type A Structured Interview (SI), a video game, and a cold pressor task--that elicit cardiovascular reactivity. Ambulatory BP readings at home and at work were also obtained from most subjects. Blacks had significantly higher Ho and lower STAS-T scores than did Whites. Women reported higher levels of somatic anger than did men. White women showed significant positive correlations between STAS-T and systolic BP (SBP) and diastolic BP (DBP) both at rest in the laboratory and during the SI. Black women revealed significant positive relationships between STAS-T and SBP and DBP at rest in the laboratory and at work as well as with DBP during the cold pressor test. For Black men, cognitive anger and DBP at rest were positively related. In contrast, White men revealed significant negative correlations between Ho scores and SBP at rest and during the video game; these men also showed significant negative relationships between somatic anger and SBP and DBP reactivity during the cold pressor test. Women, but not men, showed significant positive relationships between all four anger measures and ambulatory BP at work. Whereas main effects relating anger and cardiovascular measures were not apparent as a function of race, Blacks demonstrated significantly greater SBP and DBP reactivity than Whites during the cold pressor test, with the converse occurring during the SI. Men demonstrated significantly greater DBP reactivity than women during the video game. The present findings indicate that self-reports on anger/hostility measures and cardiovascular responses to behavioral tasks differ as a function of race but that relationships between anger and BP regulation need to take into account possible race-sex interactions and selection of anger/hostility measures.     

Poor emotional responsiveness in clinical hypertension: Reduced accuracy in the labelling and matching of emotional faces amongst individuals with hypertension and prehypertension

Psychological factors are known to play an important part in the origin of many medical conditions including hypertension. Recent studies have reported elevated blood pressure (even in the normal range of variation) to be associated with a reduced responsiveness to emotions or ‘emotional dampening’. Our aim was to assess emotional dampening in individuals with more extreme blood pressure levels including prehypertensives (N = 58) and hypertensives (N = 60) by comparing their emotion recognition ability with normotensives (N = 57). Participants completed novel facial emotion matching and facial emotion labelling tasks following blood pressure measurement and their accuracy of emotion recognition and average response times were compared. The normotensives demonstrated a significantly higher accuracy of emotion recognition than the prehypertensives and the hypertensives in labelling of facial emotions. This difference generalised to the task where two facial halves (upper & lower) had to be matched on the basis of emotions. In neither the labelling nor matching emotion conditions did the groups differ in their speed of emotion processing. Findings of the present study extend reports of ‘emotional dampening’ to hypertensives as well as to those at-risk for developing hypertension (i.e. prehypertensives) and have important implications for understanding the psychological component of such medical conditions as hypertension.     

Auditory startle in normotensive and hypertensive rats

In the present experiment auditory startle was examined in male and female rats of the spontaneously hypertensive (SHR) and Wistar-Kyoto normotensive (WKY) strains and borderline hypertensive rats (BHR) derived from cross-breeding SHR females with WKY males. The magnitude of auditory startle declined over trials and was significantly higher in WKYs than in both SHRs and BHRs which did not differ from each other. These data add to an increasing body of literature concerning behavioral differences between hypertensive and normotensive rats and are discussed as they relate to the possible strain differences in either behavioral reactivity or tonic fear.     

Sex differences in self-reported coronary-prone factors

The FABA self-report questionnaire on coronary-prone behaviour was applied to 628 GDR subjects (343 males, 285 females), who included students, blue- and white-collar workers, and hypertensive patients, all split into three age groups (18–30, 31–50, and 51–65 years). Four scales had been previously established by factor analysis: Work Obsession (WO), Dominance/Competition (DC), Reactive Uncontrol (RU), and Need for Planning (PN). Two-tailed MANOVA and ANOVA were applied to analyse the effects of sex, age, and type of respondent (i.e. student, worker, or hypertensive) on scale means, using the defined sub-groups. No significant sex differences on WO and PN were found. With regard to DC, males of all sub-groups consistently rated themselves as more dominant and competitive than females. These differences were highly significant. RU was higher only in female students and female hypertensives. There was a significant age effect on DC and PN: the older the workers and hypertensives of both sexes, the more dominant and obsessed with planning they were. No influence of the type of respondent was apparent. Results are discussed in the light of cross-cultural research on gender differences and the particular socio-economic situation of the former GDR. © 1998 John Wiley & Sons, Ltd.     

Behavioral variability in SHR and WKY rats as a function of rearing environment and reinforcement contingency.

The spontaneously hypertensive rat (SHR) may model aspects of human attention deficit hyperactivity disorder (ADHD). For example, just as responses by children with ADHD tend to be variable, so too SHRs often respond more variably than do Wistar-Kyoto (WKY) control rats. The present study asked whether behavioral variability in the SHR strain is influenced by rearing environment, a question related to hypotheses concerning the etiology of human ADHD. Some rats from each strain were reared in an enriched environment (housed socially), and others were reared in an impoverished environment (housed in isolation). Four groups--enriched SHR, impoverished SHR, enriched WKY, and impoverished WKY--were studied under two reinforcement contingencies, one in which reinforcement was independent of response variability and the other in which reinforcement depended upon high variability. The main finding was that rearing environment did not influence response variability (enriched and impoverished subjects responded similarly throughout). However, rearing environment affected body weight (enriched subjects weighted more than impoverished subjects) and response rate (impoverished subjects generally responded faster than enriched subjects). In addition, SHRs tended to respond variably throughout the experiment, whereas WKYs were more sensitive to the variability contingencies. Thus, behavioral variability was affected by genetic strain and by reinforcement contingency but not by the environment in which the subjects were reared.     

Race, borderline hypertension, and hemodynamic responses to behavioral stress before and after beta-adrenergic blockade

Blood pressure (BP) and hemodynamic responses (cardiac output [CO] and total peripheral resistance [TPR]) to a competitive reaction-time task, previously shown to increase beta-adrenergic activity, were compared in 20 Black and 20 White young men, once following infusion of saline placebo and later repeated after infusion of the nonselective beta-antagonist, propranolol. Both racial groups included subjects with marginal systolic BP (SBP) elevations (n = 6 Whites, n = 5 Blacks) and subjects with normal BP (n = 14 Whites, n = 15 Blacks). Blacks with marginal SBP elevations showed greater diastolic BP increases during the stressor than their White counterparts, both before and after beta-blockade. Both Blacks and Whites with marginal SBP elevations showed greater CO increases during the task than normotensives prior to blockade. Independent of BP status, Black subjects consistently showed higher TPR responses to the task than Whites (lesser decreases before blockade and greater increases after blockade). Blacks also showed greater diminution than Whites after blockade in ionotropic myocardial responses (stroke volume, pre-ejection period, and CO) to the stressor. The possible contributions of alpha-adrenergic and beta-adrenergic influences to these racial group differences are discussed.     

Today I'll use a condom, but who knows about tomorrow: a daily process study of variability in predictors of condom use

OBJECTIVE: Most models of health behavior change applied to condom use behavior have focused on individual differences in theoretical constructs to explain condom use or nonuse, while ignoring the possibility that day-to-day within-person changes in these constructs may contribute to understanding behavior. The goal of the present study was to investigate day-to-day variability in condom use attitudes, self-efficacy, and behavioral intentions and assess the utility of this variability in predicting the likelihood of condom use each day. DESIGN: A 30-day Web-based structured daily diary was used to collect daily reports of sexual behaviors and data on theoretical predictors of condom use behavior from sexually active college students (N = 116). MAIN OUTCOME MEASURES: The authors investigated whether condom use attitudes, self-efficacy, and behavioral intentions vary day to day; whether this within-person variability predicts condom use behavior; and whether negative affective states explain this variability. RESULTS AND CONCLUSIONS: Within-person variability was found for each of the constructs. Within-person day-to-day changes in behavioral intentions and attitudes predicted the instances in which an individual used a condom and daily negative affect partially explained within-person day-to-day changes in behavioral intentions and self-efficacy. Implications for models of health behavior change and for behavior change interventions are discussed.