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.     

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.     

Ethnic differences in cardiovascular responses to laboratory stress: A comparison between asian and white americans

Compared to other ethnic groups, Asian Americans show significantly lower rates of cardiovascular disease (CVD). We tested the hypothesis that Asian Americans would show reduced cardiovascular responses to laboratory stressors than Caucasians. Forty-three Asians (18 men, 25 women) and 77 Caucasians (36 men, 41 women) with a mean age of 24 years (SD = 3.93) participated in a stress reactivity protocol consisting of four tasks (speech, serial subtraction, mirror tracing, handgrip) while heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured. Asian Americans demonstrated overall lower reactivity across tasks for SBP F(1,117 = 7.48, p < .01) and a trend toward lower HR response F(1,117 = 3.18, p < .10). A significant ethnicity by task interaction was observed for HR reactivity F(3,351 = 2.94, p < .05) such that Caucasians showed greater responses for the subtraction task.     

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.     

The Availability of Social Support Reduces Cardiovascular Reactivity to Acute Psychological Stress

The influence of the availability of social support on cardiovascular reactivity to acute psychological stress was examined. Twenty-eight men and twenty-one women performed a speech task either in a support availability or no support availability condition while measures of systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were assessed. Consistent with past research, the speech stressor was associated with significant increases in SBP, DBP, and HR. More important, the availability of social support moderated cardiovascular reactivity to the acute stressor: individuals in the support availability condition were characterized by lower SBP and DBP reactivity to the acute stressor compared to individuals in the no support availability condition. These data suggest that simply having potential access to support is sufficient to foster adaptation to stress in the absence of enacted support.     

Four-Year Stability of Cardiovascular Reactivity to Psychological Stress

The 4-year stability of cardiovascular responses to laboratory psychological stress (mental arithmetic) was examined in 75 adults. The stability coefficients were .76 for heart rate (HR) change and .81 for absolute HR, .66 for systolic blood pressure (SBP) change and .52 for absolute SBP, .16 for diastolic blood pressure (DBP) change and .27 for absolute DBP. Males had greater SBP and DBP reactivity than females in the first session, but this reactivity decreased by the 4-year follow-up session (which was not the case for women).     

Behaviour of the carotid wall in menopausal women with and without arterial hypertension

OBJECTIVE: A study was conducted on the carotid vascular wall to evaluate its behaviour in postmenopausal women suffering from arterial hypertension compared to normotensive postmenopausal women. METHOD: Intima-media thickness(IMT) of carotid artery was determined by ecoduplex scanner in 182 postmenopausal women (age range 40-60 years) divided in four age classes (40-45, 46-50, 51-55, 55-60 years). Ninety-one women presented normal arterial blood pressure (SBP 136.6+/-11.7 and DBP 82.3+/-8.9 mmHg) and 91 were hypertensive (SBP 172.6+/-11.7 and DBP 97.4+/-6.6 mmHg). RESULTS: The normotensive women presented the following IMT values: 1.19+/-0.21 mm (40-45 years), 1.21+/-0.25 mm (46-50 years), 1.25+/-0.20 mm (51-55 years), 1.25+/-0.20 mm (55-60 years). IMT values in hypertensive women were: 1.75+/-0.25 mm (40-45 years), 1.77+/-0.30 mm (45-50 years), 1.91+/-0.28 mm (51-55 years), 2.02+/-0.33 mm (55-60 years). ANOVA test was performed in both groups of women and did not show any significant difference in the four age classes of normotensive women. On the other hand it revealed a statistical significance between 40-45 and 46-50-year-old hypertensive classes (P<0.001) and between 51-55 and 55-60-year-old hypertensive clases (P<0.02). CONCLUSIONS: There was a correlation between age and IMT in the arterial hypertensives, especially in two older classes, and between the duration of menopause and IMT values. The results indicated that carotid wall thickening was constantly higher in hypertensive women compared with normotensive ones.     

Cardiovascular risks related to increased diastolic, systolic and pulse pressure. An epidemiologist's point of view.

Since the introduction of the sphygmomanometer at the beginning to the 20th century, the significance of diastolic (DBP), Systolic (DBP) and pulse pressure (PP) as hypertensive cardiovascular risk factors has been controversial. These historical controversies are reviewed. Initially, DBP was thought to be the best measure of risk, but more recently both SBP and DBP, which ever is higher, are used in classifying hypertensive cardiovascular risk. There are problems with the present guidelines, in that SBP and DBP represent only two inflection points on the propagated pulse wave that is measured by cuff readings at the peripheral brachial artery. The heart is exposed to the central aortic pressure not to the brachial artery pressure. Moreover, both peripheral vascular resistance and large artery stiffness contribute to hypertensive cardiovascular risk. In middle-aged and elderly, elevated SBP is a better surrogate measurement of resistance than DBP, but SBP underestimates large artery stiffness. PP, the difference between peak SBP and end DBP, is the single best blood pressure surrogate for large artery stiffness. Epidemiological studies over the past decade point to SBP and DBP as the best cardiovascular risk markers for young subjects, whereas PP takes over as the more powerful risk marker for middle-aged and elderly subjects. These findings support the concept that cardiovascular events are more related to the pulsatile stress of large artery stiffness during systole than the steady-state stress of small vessel resistance during diastole. Therefore, at similar elevations of SBP, subjects with isolated systolic hypertension are at greater risk for cardiovascular events than those with combined systolic/diastolic hypertension.     

Smoking cessation and cardiovascular reactivity to stress

Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) reactivity to mental arithmetic and deep knee bends were monitored in a sample of smokers prior to and 6 months following smoking cessation. There was no reduction in cardiovascular reactivity to either stressor following cessation. However, heightened pretreatment DBP and HR reactivity to mental arithmetic and SBP reactivity to deep knee bends were associated with relapse by the 6-month follow-up. Demographic and smoking history variables and pretreatment nicotine dependence were not associated with treatment outcome. Further exploration of cardiovascular reactivity to stress among smokers may elucidate the process of relapse.This research was supported by funds from the American Lung Association (Nassau-Suffolk County, NY), the American Heart Association (Suffolk County), the Veteran's Administration, NIH Grants HL3142903, HL3426103, HL4036801, and CA 50108-02, Biomedical Research Support Grants RR0706721 and RR0536927, and Sigma Xi.     

Pain catastrophizing,physiological indexes,and chronic pain severity: tests of mediation and moderation models

Catastrophizing about pain is related to elevated pain severity and poor adjustment among chronic pain patients, but few physiological mechanisms by which pain catastrophizing maintains and exacerbates pain have been explored. We hypothesized that resting levels of lower paraspinal muscle tension and/or lower paraspinal and cardiovascular reactivity to emotional arousal may: (a) mediate links between pain catastrophizing and chronic pain intensity; (b) moderate these links such that only patients described by certain combinations of pain catastrophizing and physiological indexes would report pronounced chronic pain. Chronic low back pain patients (N = 97) participated in anger recall and sadness recall interviews while lower paraspinal and trapezius EMG and systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were recorded. Mediation models were not supported. However, pain catastrophizing significantly interacted with resting lower paraspinal muscle tension to predict pain severity such that high catastrophizers with high resting lower paraspinal tension reported the greatest pain. Pain catastrophizing also interacted with SBP, DBP and HR reactivity to affect pain such that high catastrophizers who showed low cardiovascular reactivity to the interviews reported the greatest pain. Results support a multi-variable profile approach to identifying pain catastrophizers at greatest risk for pain severity by virtue of resting muscle tension and cardiovascular stress function.     

Sibling Similarities in Cardiovascular Reactivity to Stress

To examine the similarities of nun-twin sibling pairs in cardiovascular reactivity to stress, in terms of both individual parameters such as heart rate and general cardiovascular reactivity, 36 young adult sibling pairs were recruited. Members of 12 same-sex male, 12 same-sex female, and 12 opposite-sex pairs participated in a 66-min experimental protocol consisting of alternating stress and relaxation periods. Pour stressors were employed: a challenging conceptual task, mental arithmetic, isometric bund-grip, and the cold pressor test. Repeated measurements of systolic and diastolic blood pressure (SBP. DBF), heart rate (HR), ear pulse transit time (EPTT), and digital blood volume pulse (DBVP) were obtained. Pair members exhibited significant similarities in resting SBP, DBP, and HR. A number of significant similarities in reactivity to stress were observed. To examine the specificity of familial influences on different aspects of cardiovascular response to stress, a number of canonical and cross-correlations were computed. The cardiovascular reactions of one sibling were used to predict those of his/her brother or sister. Several of the correlations attained significance. Most interestingly, familial influences on SBP, DBP, and DBVP reactivity to the cold pressor test appear to exhibit some degree of overlap, possibly reflecting more fundamental familial influences on alpha-adrenergic reactivity. Joint familial influences on behavioral and cardiovascular reactivity to stress are discussed.     

高频超声对OSAS患者颈动脉结构和顺应性的研究

目的应用高频超声对阻塞性睡眠呼吸暂停综合征(OSAS)患者颈动脉结构和顺应性变化进行研究,为OSAS的临床治疗效果提供依据。方法 40例OSAS患者(A组),均为男性,年龄21~55岁,平均年龄40.80岁;体质量指数(BMI)为(27.23±3.35)kg/m2。40例健康志愿者(B组),均无OSAS,均为男性,年龄22～57岁,平均年龄42.21岁;BMI为(25.71±2.31)kg/m2。用高频超声对A组患者和B组志愿者颈动脉进行二维超声检查,测量颈动脉内-中膜厚度(IMT)、收缩期内径(Ds)、舒张期内径(Dd),并测量肱动脉收缩压(SBP)、舒张压(DBP)和脉压(PP),计算颈动脉紧张度(AS)、扩张性(AD)和僵硬度(ASt),评价颈动脉顺应性。结果 A组IMT、SBP、DBP较B组增大,差异有统计学意义(P<0.05);PP、Ds、Dd两组间差异无统计学意义(P>0.05);A组颈动脉AS、AD较B组减小,ASt较对照组增大,差异有统计学意义(P<0.05)。结论高频超声能够反映颈动脉结构和功能变化,可为临床评价OSAS治疗效果提供颈动脉顺应性变化的监测数据,具有临床应用价值。     

Cardiovascular responses during effortful active coping and acute experience of anger in women

This study addresses the question of whether effortful active coping and anger provocation add in their effects on cardiovascular responses. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) responses of 64 female students were collected during an active versus nonactive coping task with and without provocation. After a baseline period, women did mental arithmetic (active coping) or read numbers aloud (nonactive coping). Half of each group was then additionally provoked. Ratings of the emotional states (Positive and Negative Affect Scale) indicate that provocation led to an increase in anger, but not in fear or negative or positive affect. Effortful active coping and provocation elevated cardiovascular activity. Although active coping enhanced all cardiovascular variables, provocation particularly affected HR and DBP. The effects of active coping and provocation on HR and DBP but not on SBP were additive and probably were produced by different physiological mechanisms.     

Harassment,hostility, and Type A as determinants of cardiovascular reactivity during competition

Anger/hostility and Type A behavior have been implicated in elevated cardiovascular reactivity and disease. In the present experiment systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were monitored during conditions of competition alone or in conjunction with goal blocking or harassment. Cardiovascular reactivity was examined as a function of conditions, Type A or B pattern, and various measures of anger/hostility. Harassment elicited significantly elevated SBP and HR changes relative to goal-blocking and control conditions. Type As reliably exceeded Type Bs in magnitude of SBP change during the harassment condition only. However, exploratory analyses correlating anger/hostility measures and cardiovascular reactivity indicated that only subjects scoring high on the Buss-Durkee Hostility Inventory showed significantly elevated SBP reactivity as a function of Type A behavior pattern, rated hostility during the A-B interview, or outward expression of anger assessed by the Framingham Anger-In vs Anger-Out Scale.This study was supported in part by National Heart, Lung and Blood Institute (NHLBI) Training Grant HL07426 to the University of Miami. We thank Professor T. Dembroski for his overall consultation during the study and for providing training in the administration and scoring of the Type A structured interview and components.     

The stability of cardiovascular reactivity: Effects of task-type and family history over a 3-year interval

Although there are now more than one-half dozen published studies examining the longitudinal stability of cardiovascular reactivity, methodological limitations leave several important issues unexplored. In this investigation, 126 disease-free participants completed a laboratory protocol containing physical (hand-grip), cognitive (mental arithmetic), and speech (anger recall interview) tasks at the beginning and end of a 3-year interval. In addition, we collected information regarding family history of hypertension. As expected, blood pressure and heart rate reactivity was statistically reproducible across the 3-year time interval, but coefficients were moderate at best (rs =.37 diastolic blood pressure [DBP], .25 systolic blood pressure [SBP], & .22 heart rate [HR]). In addition, participants with a positive family history of hypertension showed greater stability of systolic reactivity. We conclude that (a) the long-term reproducibility of reactivity is strongly affected by the number of measurements, and (b) family history and task-type may have modest effectson the reproducibility ofcardiovascular reactivity.     

Nicotine and acute stress: effects of nicotine versus nicotine withdrawal on stress-induced hemoconcentration and cardiovascular reactivity

This study was designed to assess the effects of nicotine and nicotine withdrawal on stress-induced hemoconcentration and cardiovascular reactivity during acute stress in smokers. Forty-six smokers (>or=10 cigarettes per day) were tested twice, once while wearing a 21 mg nicotine patch for 12h and once while wearing a placebo patch (nicotine withdrawal). Calculated plasma volume, hemoglobin, hematocrit, HR, SBP, DBP, cardiac output, stroke volume, and total peripheral resistance were assessed during a 10-min baseline period, 6-min Paced Auditory Serial-Addition Task (PASAT), and a 2-min cold pressor (CP). No differences between conditions were found for any of the hematological measurements. Participants demonstrated greater HR and SBP increases to the PASAT during the nicotine withdrawal condition. For CP, participants showed greater HR and DBP increases and SV decreases during the nicotine withdrawal condition. Data from affective state ratings indicated that participants reported more negative affect during the psychological challenges during nicotine withdrawal conditions. Negative affective state may further lead to enhanced cardiovascular reactivity. These results demonstrate that although nicotine and nicotine withdrawal significantly have differential effects on cardiovascular functioning, the same differential condition effects do not appear to exist for stress-induced hemoconcentration.     

Sociotropic cognition moderates stress-induced cardiovascular responsiveness in women through effects on total peripheral resistance, but not cardiac output.

Although cardiovascular disease (CVD) remains the leading cause of mortality in women, few studies have examined the role of psychosocial factors in its development. This study examined the moderating effects of sociotropic cognition (SC), a need for social acceptance and approval, on psychosocial stress-induced cardiovascular responsiveness (CVR) and affect reactivity in women. Sixty-eight normotensive, college-aged females were randomly assigned to a low or high social threat condition. Measures of systolic, diastolic and mean arterial blood pressures (SBP, DBP and MAP, respectively), heart rate (HR), cardiac output (CO), total peripheral resistance (TPR) and negative affect were collected during rest, and under conditions of high vs. low interpersonal threat. A two-step hierarchical regression analysis was performed to predict all response variables (BPs, HR, CO, TPR and affect). Increases in SBP, DBP, MAP, TPR and negative affect were greater in the high threat than low threat condition. Changes in SBP, MAP and TPR positively covaried with SC under conditions of high interpersonal threat, but showed no significant covariation in the low threat condition. The data suggest that an excessive need for social acceptance may contribute to rises in BP through an increase in TPR, but not CO under conditions of high social threat.     

Cardiovascular reactivity of patients with essential and renal hypertension in an emotion-triggering interview

Blood pressure reactivity to mental stress in hypertensives is much higher than in normotensives. The authors' aim in this study was to examine whether different cardiovascular responses can be induced by various stimuli in hypertensive subgroups. The authors matched 10 essential hypertensives (EHs), 10 renal hypertensives (RHs), and 10 normotensives (Ns) according to age and gender examined them during an emotion-stimulating interview, and measured blood pressure (BP) and heart rate (HR) during the phases of the interview. They observed differences in BP reactivity between EHs/RHs and Ns under some stimuli but not between EHs and RHs, as well as a marked difference in the product of systolic BP (SBP) and HR between both hypertensive groups in the anger/rage phase (p = .028) and the baseline 2 (p = .02). This shows a higher cardiovascular activation under mental stress and a lower recovery in EHs and more sensitivity to perturbation or higher central tension compared with RHs.     

Risk factor–gene interaction in carotid atherosclerosis: effect of gene polymorphisms of renin-angiotensin system

The risk factor–gene interaction in carotid atherosclerosis was investigated in 205 community-dwelling healthy subjects aged 50 years or more in Japan. The intima–media thickness (IMT) of the common carotid artery was evaluated by ultrasonography with a 7.5-MHz probe. Gene polymorphisms were determined for each subject with angiotensin-converting enzyme (ACE) insertion/deletion (I/D), angiotensinogen (AGT) M235T, angiotensin II type 1 receptor (AT1R) A1166C, and apolipoprotein E (apoE) genotypes. There was no genotype-specific difference in carotid IMT among any genes examined. Combinations of genotypes did not increase carotid IMT compared with subjects without these genotypes. In the total population, multiple regression analysis showed that age, systolic blood pressure (SBP), sex, and body mass index (BMI) were significantly associated with carotid IMT. However, the association between risk factors and IMT was genotype-specific. Age was significantly associated with IMT in ACE D carriers, but not in subjects with the ACE II genotype. Analysis of covariance adjusted with other risk factors showed that the age-dependent change in IMT was significantly different between subjects with the ACE II genotype and the ACE D carriers (F[1.196] = 4.97; P = 0.027). Similarly, the regression of IMT on SBP was significantly different between AGT TT and AGT MT + MM (F[1.196] = 7.20; P = 0.0079). The regression of IMT on BMI was also significantly different between apo E4 carriers and noncarriers (F[1.196] = 6.78; P = 0.0099). Furthermore, general linear model analysis with risk factors, genotype, and risk factor-genotype interactions revealed that the age^*ACE genotype interaction, the SBP^*AGT genotype interaction, and the BMI^*apoE genotype interaction were significantly associated with IMT. These findings further support the role of risk factor-gene interaction in carotid atherosclerosis. Received: January 5, 2001 / Accepted: February 5, 2001     

Cardiovascular Reactivity of Patients With Essential and Renal Hypertension in an Emotion-Triggering Interview

Blood pressure reactivity to mental stress in hypertensives is much higher than in normotensives. The authors' aim in this study was to examine whether different cardiovascular responses can be induced by various stimuli in hypertensive subgroups. The authors matched 10 essential hypertensives (EHs), 10 renal hypertensives (RHs), and 10 normotensives (Ns) according to age and gender, examined them during an emotion-stimulating interview, and measured blood pressure (BP) and heart rate (HR) during the phases of the interview. They observed differences in BP reactivity between EHs/RHs and Ns under some stimuli but not between EHs and RHs, as well as a marked difference in the product of systolic BP (SBP) and HR between both hypertensive groups in the anger/rage phase (p = .028) and the baseline 2 (p = .02). This shows a higher cardiovascular activation under mental stress and a lower recovery in EHs and more sensitivity to perturbation or higher central tension compared with RHs.