Emotional irritation before mental stress is associated with enhanced peripheral norepinephrine

Research suggests equivocal findings on associations of catecholamines and mood. Our study investigated the associations of emotional state, blood pressure and catecholamines in 55 healthy males undergoing mental stress. We especially checked the reported link between norepinephrine (NE) and emotional irritation. Blood pressure (SBP, DBP) and heart rate (HR) were continuously monitored. NE and epinephrine (EPI) were measured before, after, and 20 minutes after stress. Participants were divided into irritated versus non-irritated and anxious versus non-anxious subjects by median split on their baseline questionnaires. The task elicited significant cardiovascular, hormonal, and psychological stress responses. NE levels were significantly correlated with irritation before stress. Irritated subjects showed significantly higher DBP and NE than non-irritated subjects. The higher NE and DBP levels in the irritated participants suggest detrimental psycho-physiological interrelations promoting the development of stress-mediated cardiovascular diseases. Heightened emotional irritation before stress may be regarded as a psychological risk factor.     

Gender,attachment, and relationship duration on cardiovascular reactivity to stress in a laboratory study of dating couples

Stress related to relationship events has been a strong predictor of cardiovascular reactivity. This four‐phase laboratory study used a multiple‐nested design to examine variations in diastolic blood pressure (DBP) and rate‐pressure product (RPP: pulse rate [PR] × systolic blood pressure [SBP]) as a function of stress appraisal using 33 college‐aged dating couples. Individual participants filled out questionnaires designed to assess the length of their relationships (couple‐level factor), gender and attachment styles (individual‐level factors); watched a film clip depicting relationship distress; discussed relationship problems; then received instruction for relaxation. Individuals’ self‐reported stress and negative affect levels (experimental phase‐level factors), DBP, SBP, and PR were also measured at each study phase. Hierarchical linear modeling analyses revealed that relationships with longer duration were associated with higher levels of DBP and RPP as perceived stress levels increased. Also, as perceived stress levels increased, men or individuals high in the anxiety dimension of attachment showed higher DBP and RPP reactivity, whereas individuals high in the avoidance dimension of attachment showed lower RPP reactivity. As the negative affect level increased, individuals high in the avoidance dimension of attachment showed lower RPP reactivity. Findings imply that under relationship stress, individuals high in avoidance or anxiety dimensions of attachment may be vulnerable to a range of physical symptoms, such as cardiovascular disease or hypertension.     

Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men

This study investigated cardiovascular responses to two stressors known to elicit either beta-adrenergic (mental arithmetic) or alpha-adrenergic (forehead cold pressor) reactivity in Black and White men. Participants in each group were selected for presence or absence of parental hypertension. Based on previous research, Blacks were expected to show smaller cardiovascular responses to the beta-adrenergic mental arithmetic task and greater responses to the alpha-adrenergic cold pressor relative to the Whites. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, forearm blood flow, and forearm vascular resistance were assessed during a resting baseline, a prestress period, and during and after each experimental procedure. Unlike previous findings, no significant racial differences in cardiovascular responses were found during either task. However, Black participants had significantly higher SBP and DBP levels throughout the cold pressor periods. Parental history did not significantly influence cardiovascular responses in either group. The results are discussed in relation to previous research on racial differences in stress reactivity and their implications for future research.     

Cardiovascular reactivity and central adiposity in older African Americans.

This study examined central adiposity, as measured by waist circumference (WC), in relation to mental-stress induced systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) responses, body composition, the metabolic syndrome, and health practices in 22 older, African American men and women (ages 52-79 years). The high WC (> 100 cm) group showed significantly greater SBP, DBP, and HR reactivity, greater fasting insulin levels, lower high density lipoprotein cholesterol levels, greater fat mass in both truncal and peripheral regions, and greater body mass index as compared to the low WC (< 100 cm) group. Groups were comparable with respect to fat-free mass, peak oxygen consumption (VO2), leisure time activity, dietary intake, resting blood pressure, and other metabolic variables. The findings support a clustering of metabolic and mental stress risk factors that may predispose older African Americans to increased cardiovascular and metabolic disease.     

Cardiovascular intraindividual variability in later life: the influence of social connectedness and positive emotions

Healthy normotensive men and women (N=33) underwent a 60-day diary assessment of emotions and cardiovascular functioning. Individual differences in social connectedness and mood were measured in questionnaires, and positive emotions, negative emotions, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed daily for 60 consecutive days. Results confirmed that the cardiovascular undoing effect of positive emotions is evident primarily in the context of negative emotional arousal. The daily associations between positive emotions and cardiovascular outcomes were linked to individual differences in social connectedness. Controlling for individual differences in mood levels, multilevel regression analyses showed that social connectedness predicted extended positive emotion, diminished SBP and DBP reactivity, and more rapid SBP recovery from daily negative emotional states.     

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.     

Loneliness accentuates age differences in cardiovascular responses to social evaluative threat

The effects of aging and loneliness on cardiovascular stress responses were examined in 91 young (18-30 years) and 91 older (65-80 years) normotensive adults. Participants completed the revised UCLA Loneliness Scale and a modified version of the Trier Social Stress Test. Piece-wise linear growth-curve analysis was used to model group differences in resting, reactivity, and recovery levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP). Replicating and extending prior research, analyses revealed age-related increases in resting SBP and DBP. Adjusting for demographics and health covariates, interactions were found for SBP in which age differences in stress reactivity and recovery were greater among lonely than nonlonely participants. Findings provide further evidence that loneliness interacts with age to augment cardiovascular risk to social evaluative threat.     

Cardiovascular reactivity and interpersonal influence: active coping in a social context

Previous studies have demonstrated that effortful attempts to secure positive outcomes or avoid negative outcomes produce significant increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR). Although these effects of active coping on cardiovascular reactivity are central in current psychosomatic theories, virtually all of the research to date has used impersonal, asocial tasks. Our two studies examined the cardiovascular effects of effortful attempts to influence other people. In Study 1, male subjects attempting to influence the opinions of their discussion partner to improve their own chances of winning money displayed significantly greater SBP, DBP, and HR reactivity. In Study 2, we obtained similar effects on SBP and DBP reactivity in men and women, while both preparing an influence attempt and making that attempt. Furthermore, reactivity levels were larger as the magnitude of incentive for successful persuasion increased. Implications of this interpersonal equivalent of active coping for the development of cardiovascular disease are discussed.     

Gender differences in cardiovascular and hypothalamic-pituitary-adrenal axis responses to psychological stress in healthy older adult men and women

Gender differences in the neuroendocrine and cardiovascular response to psychological stress may contribute to the gender differences in the prevalence of diseases associated with hypothalamic-pituitary-adrenal (HPA) axis reactivity such as cardiovascular disease (CVD), diabetes and hypertension. We measured plasma ACTH, cortisol, heart rate (HR), and blood pressure (BP) responses in 8 men and 8 women (55-75 years) exposed to the Matt Stress Reactivity Protocol (MSRP), a psychological challenge. The MSRP elicited significant increases in HR, systolic-, and diastolic BP, ACTH and cortisol (all p<0.01). Men had significantly greater cortisol and diastolic BP responses compared to women (p<0.05). Additionally, a positive correlation between the ACTH and cortisol responses was only found in the males (r=0.71, p<0.05). There were no group differences in HR, systolic BP, or ACTH responses. We conclude, that among older adults, men respond to psychological stress with greater increases in cortisol, compared to women. This greater activation of the HPA axis could translate into an elevated risk for CVD, diabetes and hypertension and may be related to the higher prevalence of these diseases in males. Gender differences in brain structures and/or cognitive processes may be responsible for these sexually dimorphic stress responses.     

Cardiovascular and neurohumoral responses to behavioral challenge as a function of race and sex

Cardiovascular and hormonal responses to a structured interview, an electronic video game, a cold pressor test, and exercise on a bicycle ergometer were assessed in eighty-three 25- to 44-year-old normotensive Black and White men and women. Blacks showed significantly greater diastolic blood pressure (DBP) responses than Whites during the cold pressor test, which were not accounted for by an increase in plasma catecholamines. Exercise produced reliably greater systolic blood pressure (SBP) increases in Black women than in Black men or White women. Men showed significantly greater SBP and DBP changes than women during the video game. These findings suggest that the pattern of physiological reactivity elicited by challenge is related to the race and sex of the subjects.     

Defense mechanisms and physiological reactivity to stress

The relation between the use of defense mechanisms and autonomic nervous system reactivity, under conditions of laboratory stress, was studied in 78 men and women. Both diastolic blood pressure (DBP) and skin conductance level (SCL) were monitored during exposure to ten stress tasks; concurrently, the use of three defense mechanisms was assessed by coding Thematic Apperception Test stories. Autonomic reactivity was found to be related to defenses; the nature of that relation differed across the defenses. DBP, typically found to be associated with cognitive work, was higher in those individuals who used more Identification, a defense that requires greater cognitive activity. The use of Projection, on the other hand, was associated with lower DBP. In addition, the use of Identification showed a tendency to be associated with lower SCL.     

Do behavioral responses mediate or moderate the relation between cardiovascular reactivity to stress and parental history of hypertension?

To examine whether differences in behavioral responses to stress mediated or moderated the relation between cardiovascular response to stress and parental history of hypertension, 64 healthy undergraduates-16 men with hypertensive parents (PH+), 16 men without hypertensive parents (PH-), 16 PH+ women, and 16 PH- women-participated in a mental arithmetic task, mirror tracing task, and 2 interpersonal role plays. PH+ participants exhibited higher resting heart rates than PH- participants and higher resting systolic blood pressures (SBPs) than PH- women. PH+ participants exhibited greater SBP responses to tasks and engaged in more negative verbal and nonverbal behavior across tasks than PH- counterparts. Differences in behavioral responding neither mediated nor moderated the observed relation between parental history status and SBP response to stress.     

The influence of gender, hypertension risk, and aerobic fitness on cardiovascular responses to laboratory-induced stress

The study sought to evaluate the influence of gender, hypertension risk, and aerobic fitness on cardiovascular responses to laboratory-induced stress. Sixty nonsymptomatic subjects (30 males, 30 females) participated in the experiment. Half of the subjects had at least one biological parent with hypertension, while half had no parental history of hypertension and served as comparison subjects. Subjects completed a laboratory procedure measuring cardiovascular responses (i.e., pulse rate and blood pressure) while performing stressful laboratory tasks (i.e., the Stroop Color Naming Test and a sham IQ test). Aerobic fitness (i.e., VO_2max using the Bruce protocol) was also determined using a submaximal treadmill test in the laboratory. Results suggest that males with a family history of hypertension were more stress responsive based on systolic blood pressure, while females were more stress-responsive according to pulse rate activity. Fitness levels were significantly associated with diastolic blood pressure throughout the stress and recovery periods but were unrelated to pulse rate and systolic blood pressure.     

Are changes in blood pressure and total cholesterol related to changes in mood? An 18-month study of men and women.

The authors investigated the within-person association of reported mood with blood pressure and total cholesterol (TC) levels, each assessed 4 times over an 18-month period in 128 men and 154 women. Change over time in tense arousal was significantly positively associated with changes over time in systolic blood pressure (SBP) and diastolic blood pressure (DBP) but not TC. A change in hedonic tone was significantly associated with SBP (an increase in negative affect was associated with an increase in SBP) but not with DBP or TC. There were no sex differences in associations of mood with SBP or TC. However, increases in tense arousal and negative affect were significantly associated with an increase in DBP for women but not men.     

Type A behavior, personality hardiness, and cardiovascular responses to stress

Type A behavior and hardiness were examined as predictors of cardiovascular responses to stress in 68 male undergraduates. Systolic and diastolic blood pressure (SBP and DBP) and heart rate were monitored while subjects performed a difficult mirror-tracing task. Type A assessments based on the Structured Interview, but not those based on the Jenkins Activity Survey, were associated with significantly enhanced SBP and DBP elevations. Hardiness was associated with significantly reduced DBP responsiveness. In addition, a significant interaction indicated that the Type B-high hardiness group showed the least DBP reactivity. A near-significant interaction (p = .06) suggested that Type B-high hardiness subjects also reported the least anger. Further exploration of the data indicated that the challenge component of hardiness accounted for its relationship to DBP reactivity. These results have implications both for the psychophysiologic study of Type A behavior and for understanding the health-promoting effects of hardiness.     

高血压患者应激反应特点及行为人格的关系研究

为了解高血压患者心血管反应的特征及与健康人群的差异,使用实验和问卷调查的方法对高血压患者和健康居民进行研究。结果显示,两组在任务期和恢复期的心血管反应差异显著（P〈0．05）;病例组的健康实践行为和消极应对方式水平较高,积极应对方式有待提升;健康实践行为和恢复期舒张压呈负相关,积极应对方式和任务期收缩压呈正相关（P〈0...     

Lipid reactivity to stress: II. Biological and behavioral influences.

This study examined behavioral and physiological influences on lipid concentrations during acute and chronic stressors. One hundred men (n = 92) and women (n = 8) were tested during a chronic stressor and during 2 acute stressors. During chronic stress, diet, physical activity, exercise, and sleep were examined. During the acute stressors, catecholamines, cortisol, plasma volume, and cardiovascular responses were examined. None of the behavioral influences could explain the lipid response to chronic stress. Responses of the atherogenic lipids to acute stressors were not solely reflecting hemoconcentration of the plasma but were moderately correlated with cardiovascular, epinephrine, and cortisol reactivity. Diastolic blood pressure reactors to the acute stressors had larger lipid responses to the chronic stressor than did nonreactors. Elevations in blood lipids during stress are not artifacts and may be clinically significant.     

Psychological stress tasks in the prediction of blood pressure level and need for antihypertensive medication: 9-12 years of follow-up.

Increased blood pressure (BP) reactivity to subtypes of psychological stimuli may differentially predict the development of future BP elevation or hypertension. The authors present the 9-12-year follow-up results of 82 (86%) of 95 male participants with different BP levels. They were healthy, untreated, and age-matched volunteers from a routine health checkup carried out on all 35-, 40-, and 45-year-olds from a medium-sized city. Intra-arterial systolic blood pressure (SBP) during the psychological tasks improved the prediction of future casual SBP and noninvasive 24-hr ambulatory SBP compared with predictions from casual diagnostic measurements. Diastolic blood pressure (DBP) was very useful when added to casual DBP in predicting the need for antihypertensive medication. Reactivity to active tasks especially predicts the need for antihypertensive medication.     

Blood pressure reactivity in adult male twins

The purpose of the present investigation was to examine possible genetic contributions to cardiovascular reactivity by contrasting patterns of association in 82 monozygotic (MZ) and 88 dizygotic (DZ) adult male twin pairs (age range = 21 to 61 years, M = 35 years). Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded during baseline and during a mental arithmetic task (i.e., serial subtraction). The task produced significant elevations in all three cardiovascular measures (i.e., 10 mmHg SBP, 8 mmHg DBP, and 6 bpm HR, respectively). Levels of SBP and DBP reactivity were significantly correlated in MZ pairs but not in DZ pairs. Statistical tests suggest a heritability estimate of about 50% that was marginally significantly for SBP and DBP changes during the task. There was no indication of a genetic influence on HR reactivity. Resting level and static task period measures of SBP, DBP, and HR demonstrated statistically significant heritability estimates of 60% to 80%.     

Type A behavior, family history of hypertension, and cardiovascular responsivity among black women

The purpose of this study was to determine the effects of Type A behavior and family history of hypertension on cardiovascular reactivity to mental stress in a group of employed black women. Measures of heart rate and of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken at rest, during a mental arithmetic task, and during the Type A Structured Interview (SI). Results indicated that the Type A behavior pattern was associated with SBP and DBP hyperresponsivity during the SI but not during mental arithmetic. Additionally, certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters either alone or in combination with Type A behavior. The results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominantly white samples also hold true for blacks. Replication of these findings with other subgroups of blacks, such as young females and middle-aged males, will help document the generality of these findings within the black population.