Type D personality is associated with a sensitized cardiovascular response to recurrent stress in men

The present study sought to examine the role of gender and Type D personality on cardiovascular reactivity to stress, by examining patterns of cardiovascular adaptation to recurrent laboratory-based stress. Cardiovascular data were collected from 76 students who, following an initial 10-min baseline period, underwent two cognitive stress tasks. Type D personality was assessed using the 16-item Type D scale. Adaptation of cardiovascular response to recurrent stress was examined by scrutinizing the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) across the procedure. Female participants and non-Type D males showed cardiovascular habituation to recurrent stress. For Type D males, however, cardiovascular sensitization was evident. The results implicate Type D personality in maladaptive cardiovascular responses, particularly in men, highlighting a possible direct mechanism of psychosomatic cardiovascular pathogenesis.     

Forced expiratory volume is associated with cardiovascular and cortisol reactions to acute psychological stress

It has been argued that blunted cardiovascular and cortisol reactions to acute psychological stress reflect a dysregulation of the neural system that supports motivation. We examined the association between forced expiratory volume in 1 s, an effort (hence motivation) dependent measure of lung function measured by spirometry, and cardiovascular and cortisol reactions to a battery of standard psychological stress tasks, assessed 7 years later. Irrespective of how it was expressed, low forced expiratory volume was associated with blunted heart rate and cortisol stress reactivity. The association survived adjustment for smoking, a range of anthropometric and sociodemographic covariates, and commitment to the stress tasks, as well as cognitive ability.     

Blunted cardiovascular and cortisol reactivity to acute psychological stress: A summary of results from the Dutch Famine Birth Cohort Study

The Dutch Famine Birth Cohort Study is a large population based study of late middle aged, overall healthy men and women whose health has been followed from 50 to 65 years of age. In a sample of 725 cohort members, an extensive psychological stress protocol was performed during which cardiovascular and cortisol responses were measured. In line with many previous studies, results showed that increased blood pressure responsiveness to the stress protocol was associated with an increased risk for hypertension 5 years later. However, decreased cardiovascular and/or cortisol stress reactivity were associated with obesity and the risk of becoming obese, symptoms of depression and anxiety, a poor self-reported health, poor lung function, and poor cognitive function (all p for statistical tests < 0.05). These associations generally survived adjustment for a range of potential confounders, including resting cardiovascular and cortisol activity, commitment to the stress tasks, sex, age, smoking and use of medication. Results from these studies agree with recent evidence that low biological reactivity to acute psychological stress may not always be beneficial for health but instead seems to be a marker for a range of negative health outcomes. Future studies have to point out whether low stress reactivity precedes or follows these negative health outcomes.     

Association of Type D personality with the autonomic and hemodynamic response to the cold pressor test

Mechanisms relating Type D personality to poor health are largely unknown, with autonomic nervous system function being a candidate. This study examined the physiologic response to cold stress. Undergraduates (N = 101, 84% female) underwent a cold pressor test. An electrocardiogram, impedance cardiogram, and blood pressure were recorded. Type D personality was assessed by self‐report questionnaire. Type D was associated with increased systolic and diastolic blood pressure reactivity. Exploratory analyses showed Type D men to respond with increased respiratory sinus arrhythmia (i.e., higher parasympathetic activity), and decreased pre‐ejection period (i.e., larger sympathetic activity), while Type D women showed a reciprocal response pattern. In conclusion, Type D personality was associated with an exaggerated hemodynamic response to cold stress, which may contribute to an increased risk of hypertension in Type D individuals.     

Low forced expiratory volume is associated with blunted cardiac reactions to acute psychological stress in a community sample of middle-aged men and women

It has been argued recently that blunted cardiovascular reactions to acute psychological stress have adverse behavioural and health corollaries that reflect dysregulation of the neural systems that support motivation. We examined the association between cardiovascular reactions to a standard stress task, the paced auditory serial arithmetic rest, and forced expiratory volume in one second, an effort, hence motivation, dependent assessment of lung function measured by spirometry. Low forced expiratory volume, expressed as a ratio to height squared was associated with blunted heart rate, but not blood pressure, stress reactivity, r = .17, p < .001. The association survived adjustment for smoking, a range of anthropometric and sociodemographic covariates, resting heart rate and stress task performance, β = .11, p = .005. As such, our results provide support for the hypothesis that blunted stress reactivity may be a peripheral marker of a dysfunction in the brain systems that support motivated behaviour.     

Type D personality and cardiovascular reactivity to acute stress: The mediating effects of social support and negative social relationships

Type D personality has been consistently associated with adverse cardiovascular health with atypical cardiovascular reactions to psychological stress one potential underlying mechanism. As Type D individuals have been noted to report lower social support and greater perceptions of negativity in social interactions, this study examined if the association between Type D personality and cardiovascular reactivity was mediated by these social relationships. A sample of 195 undergraduate students (138 female) participated in this observational study, where they completed measures assessing Type D personality (DS14), social support, and perceptions of negative social relationships (National Institute of Health social relationship scales), before undergoing a traditional cardiovascular reactivity protocol. Systolic and diastolic blood pressure (SBP; DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR) were monitored throughout. ANCOVAs and regressions indicated that Type D personality was associated with lower cardiovascular reactivity to a mental arithmetic stressor. Furthermore, mediation analyses (process macro) indicated that the relationship between Type D personality and cardiovascular reactivity was mediated via increased perceptions of negative social relationships, as well as lower levels of social support. Apart from a significant association between Type D personality and increased HR reactivity, all results failed to withstand adjustment for the individual effects of negative affect (NA) and social inhibition (SI) in controlled analyses. Overall, these findings suggest that the predictive utility of Type D personality on cardiovascular reactivity above and beyond the individual effects of NA and SI is limited, and may vary depending on the cardiovascular parameter of focus.     

Diminished heart rate reactivity to acute psychological stress is associated with enhanced carotid intima‐media thickness through adverse health behaviors

Recent evidence demonstrates that individuals with low heart rate (HR) reactions to acute psychological stress are more likely to be obese or smokers. Smoking and obesity are established risk factors for increased carotid intima‐media thickness (IMT). The aim of this study was to examine the potential pathways linking intima‐media thickness, smoking, body mass index (BMI), and HR stress reactivity. A total of 552 participants, 47.6% male, M (SD) age = 58.3 (0.94) years, were exposed to three psychological stress tasks (Stroop, mirror drawing, and speech) preceded by a resting baseline period; HR was recorded throughout. HR reactivity was calculated as the average response across the three tasks minus average baseline HR. Smoking status, BMI, and IMT were determined by trained personnel. Controlling for important covariates (e.g., socioeconomic status), structural equation modeling revealed that BMI and smoking mediated the negative relationship between HR reactivity and IMT. The hypothesized model demonstrated a good overall fit to the data, χ²(8) = 0.692, p = .403; CFI = 1.00; TLI = 1.00 SRMR = .01; RMSEA < .001 (90% CI < 0.01–0.11). HR reactivity was negatively related to BMI (β = ?.16) and smoking (β = ?.18), and these in turn were positively associated with IMT (BMI: β = .10; smoking: β = .17). Diminished HR stress reactivity appears to be a marker for enlarged IMT and appears to be exerting its impact through already established risks. Future research should examine this relationship longitudinally and aim to intervene early.     

Effect of meal content on heart rate variability and cardiovascular reactivity to mental stress

Little is known about transient effects of foods and nutrients on reactivity to mental stress. In a randomized crossover study of healthy adults (n=20), we measured heart rate variability (respiratory sinus arrhythmia), blood pressure, and other hemodynamic variables after three test meals varying in type and amount of fat. Measurements were collected at rest and during speech and cold pressor tasks. There were significant postmeal changes in resting diastolic blood pressure (-4%), cardiac output (+18%), total peripheral resistance (-17%), and interleukin-6 (-27%). Heart rate variability and hemodynamic reactivity to stress was not affected by meal content. We recommend that future studies control for time since last meal and continue to examine effects of meal content on heart rate variability.     

Blunted cardiac stress reactivity relates to neural hypoactivation

The present study compared neural activity in participants with blunted (N = 9) or exaggerated (N = 8) cardiac stress reactions. Neural activity was recorded with fMRI while participants performed a validated stress task and control task. Exaggerated reactors exhibited significant increases in heart rate from control to stress task, whereas blunted reactors had no change in heart rate. Blunted reactors also had reduced activation in the anterior midcingulate cortex and insula compared to exaggerated reactors during the stress condition, and a greater deactivation in the amygdala and posterior cingulate. The biological differences between groups in response to the stress task could not be explained by subjective measures of engagement, stressfulness, or difficulty. This study supports the notion that blunted peripheral physiological stress reactivity may be a marker of a corresponding under‐recruitment of brain systems during behavioral states requiring motivated action.     

Cardiovascular and cortisol reactions to acute psychological stress and cognitive ability in the Dutch Famine Birth Cohort Study

Given evidence linking blunted cardiovascular and cortisol reactions to acute stress and a range of adverse behavioral outcomes, the present study examined the associations between cardiovascular and cortisol reactivity and cognitive ability measured independently of the stress task exposure. Cognitive ability was assessed using the Alice Heim-4 test of general intelligence and two memory tasks in 724 men and women who were part of the Dutch Famine Birth Cohort Study. Blood pressure and heart rate, as well as cortisol reactivity, were measured to a battery of three standard acute stress tasks. Poorer cognitive ability was associated with lower cardiovascular reactions to stress and lower cortisol area under the curve. Our results are consistent with recent findings implicating low physiological stress reactivity in a range of adverse behavioral and health outcomes.     

Speaking from the heart: cardiovascular components of stress rating changes and the relative reactivity of physiological and psychological variables

The first part of the experiment compared the relative reactivity of various cardiovascular measurements and self-reported assessment of mental arithmetic, an active coping stress task. It was found that the self-reported stres rating was more responsive (student's t=9.4) than the physiological measurements. Among the cardiovascular indices, heart rate was the most responsive (student's t=6.5), followed by the interval between R-wave and the maximal systolic pressure (student's t=5.0). The second part of the study used a multiple regression to examine the cardiovascular components of change in stres rating following mental arithmetic. Both resting (psychophysiological trait varibles) and change under stress (psychophysiological state variables) were used to predict change in stress rating. Stress rating increase were associated with greater maximal systolic pressure rate of rise (finger dP/dt) at baseline and less heart rate increase during mental arithmetic, yielding a multiple r of 0.67. The dual autonomic nature of active coping stress response is discussed. The shortcomings of using a correlate of a correlate are noted.     

Aerobic exercise training and cardiovascular reactivity to psychological stress in sedentary young normotensive men and women

Forty-five (22 women) sedentary young (18-30 years old) nonsmoking normotensive volunteers engaged in either 6 weeks of aerobic training (AT), weight training (WT), or a no-treatment (NT) condition to determine whether AT lowers systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), and rate-pressure product (RPP) during rest, psychological stress, and recovery periods. Estimated VO(2)max increased for the AT (32.1+/-1.1 to 38.4+/-1.0 ml.kg(-1).min(-1)). A smaller increase for the WT (30.5+/-1.1 to 33.8+/-1.0) was likely due to increased leg strength, and VO(2)max did not change for the NT (32.5+/-1.1 to 32.9+/-1.0). Heart rate and RPP levels were lower during psychological stress and recovery after training for AT relative to the WT and NT. Overall SBP was also lower in the AT relative to the NT but not the WT. In conclusion, aerobic training lowered cardiovascular activity levels during psychological stress and recovery in healthy young adults, implying a protective role against age-related increases in coronary heart disease for individuals who adopt aerobic exercise early in life and maintain the behavior across the life span.     

Cardiovascular Reactivity to Psychological Stress in Healthy Children

Cardiovascular reactivity to stress has been implicated as a marker and/or mechanism in the development of cardiovascular disease. No normative data exist to classify children's reactivity to psychological stress. This investigation presents normative percentile data on the hemodynamic responses (heart rate and blood pressure) of 310 healthy, black or white, children between the ages of 6 and 18 years to the stress of a television video game. A series of three video games, played under three increasing levels of stress, elicited progressively higher values of blood pressure and heart rate. Both the child's race and gender, as well as the experimenter's race, significantly affected reactivity. Children demonstrated a wide range of interchild reactivity, thus allowing separation of individuals into high and low risk percentile groups.     

Prospective associations between cardiovascular reactions to acute psychological stress and change in physical disability in a large community sample

Exaggerated haemodynamic reactions to acute psychological stress have been implicated in cardiovascular disease outcomes, while lower reactions have been considered benign. This study examined, in a large cohort, the prospective associations between stress reactivity and physical disability. Blood pressure and pulse rate were measured at rest and in response to a stress task. Physical disability was assessed using the OPCS survey of disability at baseline and five years later. Heart rate reactivity was negatively associated with change in physical disability over time, such that those with lower heart rate reactivity were more likely to deteriorate over the following five years. These effects remained significant following adjustment for a number of confounding variables. These data give further support to the recent argument that for some health outcomes, lower or blunted cardiovascular stress reactivity is not necessarily protective.     

Sleep duration and cardiovascular responses to stress in undergraduate men

Short sleep has been related to incident cardiovascular disease, but physiological mechanisms accounting for this relationship are largely unknown. This study examines sleep duration and cardiovascular stress responses in 79 healthy, young men. Sleep duration was assessed by wrist actigraphy for seven nights. Participants then completed a series of laboratory stress tasks while heart rate and blood pressure were monitored. Shorter total sleep time was related to a greater reduction in high‐frequency heart rate variability during stress tasks, and to prolonged elevations in heart rate and diastolic pressure following tasks. Associations were independent of age, race, body mass index, caffeine intake, and smoking status. In sum, healthy young men with shorter actigraphy‐assessed sleep exhibit less cardiac vagal activity, and poorer heart rate and diastolic blood pressure recovery, upon encountering stressful stimuli, than those with longer sleep.     

Reproducibility of blood pressure and heart rate reactivity: A meta-analysis

Reproducibilities of blood pressure and heart rule (HR) reactivity reported in studies assessing responses to the same laboratory stressors across occasions were reviewed with meta-analytic techniques. Changes in HR had the greatest reproducibility (r =.555), followed by systolic blood pressure (SBP) (.407) and diastolic blood pressure (DBF) (.348), Both SBP and HR response reproducibility was higher at shorter lest-retest intervals, whereas DBP values varied unsystematically with length of test-retest interval Older samples exhibited higher SBP and DBP reproducibility to stressors. SBP and DBP reproducibilities were better for tasks that did not make speech demands. The reliability of reactivity assessment was higher when based on three or more measurements, On the basis of able evidence, the drop in stress reproducibility, as test-retest interval increases, places limits on the viability of BP reactivity as a strong marker or risk factor for coronary heart disease.     

Depressive symptoms and cardiovascular reactivity to laboratory behavioral stress

Although a growing literature associates depressive symptoms with cardiovascular disease (CVD), the mechanisms underlying this association have not been clearly determined. The cardiovascular reactivity (CVR) hypothesis suggests that chronically elevated CVR during psychological distress can confer disease risk via vascular alterations. This investigation is a quantitative review of studies that evaluated the association of depressive symptoms with CVR. Atotal of 60 hypotheses were tested: 21 tests involved systolic blood pressure (SBP), 21 involved diastolic blood pressure (DBP), and 18 involved heart rate (HR). The aggregate effect size for the relation between depressive symptoms and HR reactivity was moderate (d = 0.37); aggregate effect sizes were small for SBP reactivity (d = 0.13) and DBP reactivity (d = 0.17). Effect sizes involving SBP reactivity were homogenous, whereas effect sizes involving DBP and HR reactivity were higher for studies that examined participants with CVD. These findings provide partial support for the associations of depressive symptoms with CVR.