Coronary-Prone Behavior Pattern and Cardiovascular Response

Two studies were carried out examining the relationship between coronary-prone behavior pattern and cardiovascular responses to an experimental stressor. Among 52 subjects of the Type A (coronary-prone) and Type B (non-coronary-prone) behavior patterns in Study I, Type A males showed greater elevations of systolic blood pressure than Type B males on exposure to a difficult cognitive task; no reliable differences were found for Type A and B females. Due to a conceptual similarity of the coronary-prone behavior pattern and the personality dimension of Internal External locus of control, 48 male subjects in Study II were selected with respect to four subject groups: Type A-Internals, Type A-Externals, Type B-Internals, and Type B-Externals. Again, Type As showed a more pronounced systolic response than subjects of the Type B pattern, though diastolic blood pressure and heart rate responses did not vary by coronary-prone behavior pattern. While locus of control-Internals tended to show greater task-related systolic elevations than Externals, this effect was not significant. Self-reports of anxiety increased during the period of the task, but revealed no differences among Type A and B subjects of either study. It was concluded that for male subjects the Type A-Type B dimension constitutes a salient variable of individual differences mediating the systolic pressor response.     

Effects of Task Incentive on Cardiovascular Response in Type A and Type B Individuals

An experiment was conducted to investigate the interaction of task incentive and the Type A behavior pattern in determining psychomotor performance and psychophysiological responses during a verbal problem solving task. Twenty-four Type A and 17 Type B subjects as determined by the structured interview were randomly assigned to a Monetary Incentive condition or a Non-incentive Control condition. Results indicated that the presence or absence of explicit incentives affected task performance for Type As but not for Type Bs. Type As gave more responses more quickly when offered monetary reward. In contrast, the effects of incentive on cardiovascular responses were observed in Type B subjects but not Type As. Type As showed increased systolic blood pressure and heart rate and skeletal muscle vasodilatation in both conditions, while Type Bs showed increased heart rate and systolic blood pressure only when incentives were offered. Type Bs in the Control condition did not change significantly from baseline and actually tended to respond with a deceleration of heart rate and skeletal muscle vasoconstriction. The results are discussed in terms of the need to consider both the interaction of Type A with the nature of the task and the pattern of cardiovascular responses in future studies of psychophysiologic differences between Type A and Type B individuals.     

Task Difficulty, Type A Behavior Pattern, and Cardiovascular Response

Forty-one young male subjects performed either an easy or moderately difficult arithmetic task with the opportunity to earn a monetary incentive if they did well. Cardiovascular (heart rate, systolic and diastolic blood pressure) and subjective responses were assessed immediately prior to and 5 min following task performance. Results indicated greater systolic (SBP) responses during the Pre-task period for subjects expecting to perform the difficult task. Behavior pattern classifications based on the Jenkins Activity Survey revealed Higher Pre-task heart rate (HR) elevations among Type As compared to Bs in the Difficult task condition, and greater Pre-task SBP responses in As compared to Bs irrespective of task difficulty. There also was some evidence of an association between SBP reactivity and scores on the Thurstone Activity scale. Change-scores reflecting SBP and HR reactivity were correlated in the Pre-task period of the Difficult but not the Easy condition. Predictions regarding the impact of motivational arousal upon goal attractiveness were not supported, possibly for methodological reasons.     

Cardiovascular and Electrodermal Response Patterns in Heart Rate Reactive Individuals During Psychological Stress

The goal of this research was to examine the cardiovascular and electrodermal response patterns of heart rate reactive and nonreactive individuals to psychological stress. Sixty males were tested while resting, listening to tones, identifying tone patterns, and performing mental arithmetic. Dependent variables were blood pressure, heart rate (HR), and skin conductance responses. Based on the change in HR from baseline to the first minute of mental arithmetic, two extreme reactivity groups of 15 subjects each were formed. Results indicated that HR reactive subjects had higher systolic blood pressure and HR than nonreactives. Reactives showed greater HR lability during all the tasks and a phasic acceleration to tones, while nonreactives showed a deceleration. Finally, comparisons of skin conductance responses indicated that subjects who were nonreactive when measuring HR were more reactive when measuring skin conductance. The HR reactivity seen in these subjects has been linked to predisposition to psychosomatic illness, and the current findings are discussed in that light.     

Parental Hypertension and Cardiovascular Response to Cognitive and Isometric Challenge

The purposes of this investigation were to contrast the cardiovascular responses of sons of hypertensive and normotensive parents to tasks involving cognitive and isometric challenge, and lo examine the relationship of individual differences in heart rate (HR) reactivity to baseline blood pressure (BP) measurements. Thirty-six male, undergraduate volunteers (18 with and 18 without a parental history of hypertension) were scheduled for two, 1-hr experimental sessions (Days I and II). On Day 1, HR and BP measurements were obtained while subjects performed each of three laboratory tasks: a difficult test in concept formation, serial subtraction, and a sustained handgrip at 30% of maximum voluntary contraction. Each task lasted 3 min and was preceded by a 3-min baseline interval. On Day II, subjects were instructed to relax quietly while baseline measures of HR and BP were recorded. Relative to sons of normotensive parents, offspring of hypertensives exhibited higher mean Systolic BPs during all task periods; no corresponding group differences were observed on either Day I or Day II baseline recordings. Unlike SBP, Diastolic BP measurements did not vary reliably by parental hypertensive/normotensive status. Although the mean HRs of sons of hypertensives were significantly higher than in offspring of normotensives, these differences obtained uniformly across both the baseline and task intervals. Among subjects identified as High HR reactors during the two cognitive tasks, sons of hypertensive parents exhibited Day II baseline SBPs about 9 mmHg higher than did subjects without a parental history of hypertension. Among subjects identified as Low HR reactors, baseline SBPs did not differ reliably between sons of hypertensive and normotensive parents.     

Difficulty and Instrumentality of Imminent Behavior as Determinants of Cardiovascular Response and Self-Reported Energy

College-aged male subjects were presented with an easy or moderately difficult memorization task and were told that they could earn either a very low or a very high chance of obtaining a modest prize if they did well. Cardiovascular (heart rate, systolic blood pressure, diastolic blood pressure) and subjective measures were taken during an interval immediately preceding the task performance period. Results indicated greater systolic blood pressure and self-perceived energy in the moderately difficult condition than in the easy condition only when the probability of attaining the prize (if subjects did well) was high. When the probability of goal attainment (given success) was low, systolic responses and self-reported energy levels were minimal in both task conditions. Predictions regarding the impact of energy levels upon goal attractiveness ratings were not supported, possibly for methodological reasons.     

Parental Hypertension and Cardiovascular Response to Stress in Healthy Young Adults

One indicator of elevated risk for subsequent development of essential hypertension is the presence of the disorder in either or both parents. Exaggerated cardiovascular responsivity to stress has also been suggested as a possible precursor to hypertension. This study examined the relationship between parental hypertension and the heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP) levels of 103 healthy college-age men, during two resting conditions and stressful cold pressor and reaction time tasks. Sons of hypertensive parents (N = 25) showed higher HR and SBP than sons of normotensive parents (N = 78) during both rest and stress, but these differences were greatest during the stressful reaction time (RT) task. No reliable differences in DBP were seen. A subsample of 45 subjects, including 14 with hypertensive parents, were also monitored during a second stress, the cold pressor test; only trends toward HR or BP differences related to parental hypertension were seen for this stress, although HR and SBP differences during the RT task were still significant (p<.05) even in this smaller group. Since the incidence of high blood pressure is known to be greater among the offspring of hypertensive parents, these findings suggest that cardiovascular responses to certain types of stress (e.g., active coping tasks) may help predict future risk of hypertension.     

Type A Behavior and Psychophysiological Responses in Adult Women

The purpose of this study was to assess both coronary-prone behavior and physiological responses to stress in adult women. Forty-one women, aged 25–55, were tested; half were professional or executive-level employed women, the remainder were housewives. Based on the Jenkins Activity Survey, the working women scored as strong Type A's; the housewife group contained both A's and B's. The heart rate, blood pressure and skin conductance responses were compared for these groups while they rested, performed math problems, and attempted to solve visual puzzles. Type A women showed higher heart rates and larger increases in systolic and diastolic blood pressure; Type B women showed larger phasic heart rate decelerations. Employment was not a prerequisite for increased cardiovascular responsivity in Type A's; however, the unemployed Type A's indicated a desire to work. Given the similarities between employment status, Type A behavior and physiological responses in these working women as compared to men, their risk for coronary heart disease may also be similar.     

Cardiovascular Effects of Mental Arithmetic in Type A and Type B Females

The cardiovascular responsivity of women demonstrating the Type A coronary-prone behavior pattern was investigated by presenting female Type A and Type B subjects with a challenging mental arithmetic task. Female subjects responded to the task with elevations in heart rate, blood pressure, and forearm blood flow, but did not show the active vasodilatation in the forearm vasculature seen in males in an earlier study. Type A females as a group were not hyperresponsive compared to Type B. However, measures of Type A behavior interacted with family history of hypertension such that, in the subgroup with a positive family history, the Type A behavior pattern was associated with larger cardiovascular responses. The results suggest that sex differences could be present in the expression of the cardiovascular concomitants of Type A behavior. Both gender and family history of cardiovascular disease may represent additional dimensions in the understanding of the pathological mechanisms linking Type A behavior and coronary disease.     

Cooperative Dyadic Interactions, Perceived Control, and Task Difficulty in Type A and Type B Individuals: A Cardiovascular Study

Eighty Type A and SO Type B young male subjects (assessed by both the Bortner and Thurstone Scales) cooperated on either a difficult or simple reaction time task, with either the same or opposite behavior type partner. Only the first member of each dyad was given control of responding A-A, B-B, A-B, B-A). Dyads performed with equal efficiency on the simple task, but when the task became more difficult to master a remarkable pattern of behavioral activity emerged. Deleterious or efficient task performance was largely influenced by the behavioral style of the two individuals within the dyad, and more importantly, by their control positions (which member had response control). Cardiovascular responses were monitored throughout the task and 10 min following task performance. During the task, increases in heart rate, and systolic and diastolic blood pressure were observed for all groups regardless of task difficulty and control positions, although the magnitude of cardiovascular reactivity was greatest for Type As during the difficult task, especially if they lacked control of responding or were cooperating with the same type partner. Following the difficult task, Type As demonstrated greater magnitude and more prolonged cardiovascular reactivity, compared with Type Bs. The findings are briefly discussed within the context of the work environment.     

Effects of Behavioral Control and Type A Behavior on Cardiovascular Responses

The purpose of this study was twofold: (a) to examine the relationship between degree of behavioral control and cardiovascular changes in 60 adult males performing an anagram solution task, and (b) to assess the interaction between behavioral control and type of subject (A vs. B). Three conditions were used, differing from each other in the percentage of solvable anagrams (100, 50, and 30%). Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before, during, and after the anagram task. In all conditions, during-task SBP, DBP, and HR were significantly elevated above baseline. Blood pressure (BP) elevations appeared to be curvilinearly related to degree of behavioral control, i.e., more elevated in the 50% than in the 100% and 30% conditions. HR changes did not differ among conditions. Concerning the Type A behavior pattern, the results revealed significantly greater BP elevations for Type A than for Type B subjects, especially in the 50% condition, thereby confirming that the physiologic correlates of Type A behavior are predominantly evoked in challenging circumstances. Findings were discussed in the light of results of cardiovascular and endocrinological research. Consideration was given to the possible role of disengagement in the 30% condition and to differences in the pattern of responding between As and Bs.     

Stability of individual differences in cardiovascular reactivity: A thirteen month follow-up

This study concerns the stability of individual differences in cardiovascular reactivity among nineteen male subjects who had participated in a similar investigation thirteen months earlier. In the previous study (Year I), subjects were presented a frustrating task in concept formation to perform at each of two experimental sessions, scheduled one week apart, and recordings of heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) obtained during periods of rest and task performance on each occasion of testing. Under the current procedure (Year II), subjects were exposed to the same experimental stressor as on year I, as well as a second cognitive task involving a difficult problem in “mental arithmetic”; HR, SBP and DBP were again recorded both at rest and while subjects performed the instructed tasks. Measures of task-related cardiovascular arousal across the two years of observation revealed reproducible individual differences with respect to the magnitude of subjects' HR and SBP, but not DBP, reactivity. Although individual differences in HR and SBP responses correlated positively, neither HR nor SBP reactivity covaried reliably with DBP changes. It was suggested that concomitant response differences in HR and SBP, as observed under these experimental conditions, may reflect an underlying dimension of individual differences in beta-adrenergic reactivity.     

Stability of individual differences in cardiovascular reactivity

Examining the stability of individual differences in cardiovascular reactivity, 42 male subjects were presented a difficult cognitive task to perform at each of two experimental sessions, scheduled 1 week apart, and recordings of hear rate and systolic and diastolic blood pressure obtained during periods of rest and task performance on each occasion of testing. Measures of task-related arousal (reactivity) across the two experimental sessions revealed substantial and reliable individual differences on all three response variables, as evidenced by (1) subsets of subjects representing clearly differentiated groups of Reactors and NonReactors on each measure and (2) correlation of reactivity scores of all subjects between the first and second sessions. While individual differences in systolic blood pressure and heart rate reactivity correlated positively, magnitude of systolic and diastolic blood pressure responses did not covary reliably among subjects. It was concluded that the present data demonstrate consistency, or reproducibility, of idiosyncratic cardiovascular reactivity and suggested that the variability of relationships among response measures may reflect more basic dimensions of individual differences involving neuroregulatory mechanisms underlying cardiovascular adjustments.     

Effect of Harassment and Competition Upon Cardiovascular and Plasma Catecholamine Responses in Type A and Type B Individuals

Two experiments examined the relationship between Type A behavior and cardiovascular and plasma catecholamine responses to experimental competition and harassment. Experiment I showed that, in 44 male adults, the presence of a hostile opponent caused no significant differences in the responses of Type B's. In A's, by contrast, hostility elicited greater increases in systolic blood pressure, heart rate and plasma epinephrine during competition. Behavior pattern A appears selectively predisposed to enhanced reaction to hostile interactions, but competition alone does not distinguish between individuals with A and B behavior patterns. Experiment II, with 20 cases, was carried out to determine whether or not the absence of A-B differences in the presence of a nonhostile competitor could be explained by Type B's reactivity to the challenge of competition alone. The results were consistent with this interpretation. A's showed greater blood pressure and plasma epinephrine evaluations than B's when both types were confronted by the challenge of task performance. Consideration was given to the role of sympathetic activation in mediating the tendency of Type A individuals to develop coronary heart disease.     

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.     

Task Difficulty, Heart Rate Reactivity, and Cardiovascular Responses to an Appetitive Reaction Time Task

Cardiovascular responses of 72 young men were assessed during an appetitive reaction time task where winning money incentives was either easy, difficult, or impossible. The impossible condition led to reduced responses (e.g., longer pre-ejection period (PEP) and pulse transit time (PTT) and greater falls in systolic and diastolic pressures) as well as reports of trying less hard than the easy or the difficult condition. Regardless of task difficulty, subjects showing greater heart rate (HR) increases at task onset maintained higher HR levels than low HR reactors throughout the task. Overall, these high HR reactors also showed higher SBP and shorter PEP, PTT and left ventricular ejection time than low HR reactors, although these differences were less pronounced by the end of the task. Based on their responses to various standardized inventories, high and low HR reactors did not differ in behavioral traits such as Type A, suppressed hostility, or active coping as the preferred coping style. However, a subsample of subjects with extreme scores indicating suppressed hostility (N = 12) did show elevated HR and systolic pressure during both relaxation and the appetitive task.     

Cardiac vagal activity during psychological stress varies with social functioning in older women

The polyvagal theory states that social behavior is linked to cardiac vagal control. This theory has been tested widely in infants and children, but less so in adults. Thus, we examined if resting or stress-related changes in high-frequency heart rate variability (HF-HRV; a presumed index of vagal control) varied with social functioning in 50 healthy women (mean age 68 years). After completing assessments of social functioning, women were exposed to laboratory stressors with concurrent psychophysiological monitoring. Although stressor-induced suppression of HF-HRV was common, women with less stressor-induced suppression of HF-HRV reported more positive social functioning. Resting HF-HRV was not related to social functioning. These findings are at apparent odds with the polyvagal theory; however, they complement prior work suggesting that emotional self-regulation could plausibly modulate cardiac vagal control in association with social functioning.     

Ethnic differences in cardiovascular-somatosensory interactions and in the central processing of noxious stimuli

Ethnic differences in central sensitization of pain processing and stress-relevant endogenous pain regulatory mechanisms were examined. Forty-four African Americans (AAs; 50% women) and 44 non-Hispanic Whites (nHWs; 50% women) matched for socioeconomic status, were tested for pain responses to the temporal summation of heat pulses and ischemic and cold pain. Resting and stress blood pressure (BP) and norepinephrine (NE) were assessed. AAs had heightened pain responses to all 3 pain tasks relative to nHWs. In nHWs, higher BP and NE were related to reduced pain. In AAs, there was no relationship between BP and pain, but higher NE was related to increased pain. This study provides evidence for ethnic differences in centrally mediated pain and extends prior research demonstrating ethnic differences in endogenous pain regulatory mechanisms. These results have implications for understanding biobehavioral factors contributing to ethnic disparities in clinical pain.     

The Relationship between the Type A Behavior Pattern and Physiological Responsivity: A Quantitative Review

Researchers have attempted to specify the process linking Type A behavior to coronary artery disease. Increased cardiovascular and neuroendocrine reactivity in Type A individuals has been proposed as the intervening mechanism. There have been several previous reviews of the research relating Type A behavior to physiological reactivity. The authors' conclusions have been equivocal; some assert that Type A persons are more reactive, whereas others find no evidence for such a conclusion. In this report, meta-analysis, an alternative to the traditional narrative review, was employed to provide a quantitative evaluation of the relationship between Type A behavior and physiological reactivity. Results indicated that: 1) Type As respond to cognitive and psychomotor stimulus situations with greater heart rate and systolic blood pressure responses, 2) this relationship is not evident in females, 3) the relationship is more evident for some cognitive tasks than for others, and 4) the strength of the relationship depends upon the instrument used to assess Type A behavior.     

Cardiovascular Responses to Effortful Active Coping: Implications for the Role of Stress in Hypertension Development

Recent contributions to the literature on stress and hypertension are discussed. The significance of effortful active coping in evoking sympathetically-mediated heart rate and blood pressure increases is supported by results of studies involving both aversive and appetitive task incentives. Young healthy males who are above-average in heart rate during coping tasks show consistently higher heart rates and systolic pressures during other stresses as well, but are indistinguishable from less reactive persons when relaxed. Studies involving beta-blockade indicate that these above-average cardiovascular increases are partly due to a greater beta-adrenergic response among the high heart rate reactors. In addition, the parents of these high heart rate reactors report a greater incidence of hypertension than parents of low reactors, suggesting that high cardiovascular responses during active coping stress may reflect a high degree of susceptibility to later hypertension.