Blood pressure, ethnicity, and psychosocial resources

Research on psychosocial factors and cardiovascular disease has shown that psychosocial resources (including social supports and coping styles) help to protect individuals from the risk associated with psychosocial stressors. Some evidence indicates that this protective effect may extend to standard risk factors as well. This latter hypothesis was examined in greater detail in a study conducted in Brazil, in which it was found that psychosocial resources modified black-white differences in blood pressure. Highest mean blood pressures were observed among mixed race and black Brazilians who had low psychosocial resources; Afro-Brazilians with high psychosocial resources had lower blood pressures than white Brazilians. Implications of these results for the mechanisms linking ethnicity, psychosocial factors, and blood pressure are discussed.     

Cumulative psychosocial stress,coping resources,and preterm birth

Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n?=?3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR?=?1.73; 95 % CI?=?1.07, 2.81), but not for early preterm birth (OR?=?2.44; 95 % CI?=?0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at <37 weeks gestation for women with low levels of social support (OR?=?2.09; 95 % CI?=?1.07, 4.07) or optimism (OR?=?1.87; 95 % CI?=?1.04, 3.37). Our analyses suggest that early vulnerability combined with current anxiety symptoms in pregnancy confers risk for preterm birth. Coping resources may mitigate the effect of cumulative psychosocial stress on the risk for early delivery.     

Blood pressure and lifestyle on Saba,Netherlands Antilles

During the 20th century, infectious disease morbidity and mortality generally waned whereas chronic degenerative diseases posed a growing burden at the global level. The population on Saba, Netherlands Antilles has recently experienced such an epidemiologic transition, and hypertension was reported to be extraordinarily high, although no prevalences have been reported and relationships with lifestyle factors associated with rapid modernization have not been explored. In this study, a medical and demographic questionnaires, as well as body composition and blood pressure measures were collected from 278 Saban men and women aged 18–91 years. When age and sex adjusted, 48% of the population was hypertensive. Age, BMI, and Afro‐Caribbean descent were all associated with higher blood pressures. In a second phase, 124 individuals of the 278 were invited to receive a longer questionnaire on individual exposure to modernizing influences such as travel and education. Higher blood pressure was associated with having lived in fewer different places in the past; those who stayed only on Saba or Statia had higher blood pressures than those who had also lived in more modernized areas. However, this was no longer statistically significant after adjustment for age and BMI. Lifestyle incongruity was positively associated with higher blood pressure in that those with more discord between material wealth and income were more likely to be hypertensive, and this remained statistically significant after adjustment for age and adiposity. In summary, hypertension is highly prevalent on Saba and tended to be associated with greater age, adiposity, Afro‐Caribbean ancestry, and lifestyle incongruity. Am. J. Hum. Biol., 2009. © 2009 Wiley‐Liss, Inc.     

Blood pressure analysis

SUMMARY  Arterial blood pressure is influenced by sleep-related breathing disorders. As cardiovascular consequences can be diagnosed by an accurate recording and analysis of blood pressure, new recording methodologies and an approach to analysis are presented here. Invasive continuous blood pressure recording is the common reference for all methodologies. As blood pressure varies rapidly in parallel with sleep-related breathing disorders it is indispensible to record blood pressure continuously. To introduce non-invasive methodology the Finapres system was used during sleep studies; a validation study showed severe limitations. This study was followed by the validation of an improved system called Portapres, which is portable, has two finger cuffs and a hydrostatic height compensation.
Analysis of continuous blood pressure in patients with sleep apnoea is carried out to detect mechanisms which influence the cardiovascular risk. Spectrum analysis of systolic blood pressure showed two different major oscillations present in patients with obstructive sleep apnoea. One oscillation (<0.06 Hz) occurs in parallel with each apnoeic episode and the other oscillation (0.2-0.4 Hz) occurs in parallel with the obstructive efforts during each apnoea and in parallel with respiration during periods of snoring. These two oscillations were so specific that the use of non-invasive continuous blood pressure recording allowed an estimation of the extent of underlying breathing disorders, and assessment of cardiovascular risk in a patient with obstructive apnoea in terms of hypertension and on the basis of ambulatory monitoring.     

Blood pressure and myotonic dystrophy

The blood pressures of 79 consecutive patients with myotonic dystrophy have been shown to be significantly lower than those of a control series. Reanalysis of previously published data on a group of 17 myotonic dystrophy patients shows a similar result. The possibility that relative hypotension may confer a selective genetic advantage on asymptomatic gene carriers in the community is considered. It is suggested that, since patients with minimal clinical evidence of disease are also hypotensive, measurement of blood pressure may be useful as an adjunct to other methods of preclinical diagnosis of myotonic dystrophy.     

The impact of psychosocial stressors on postpartum weight retention

Excessive gestational weight gain and postpartum weight retention are implicated in future morbidity in women. To understand whether psychosocial stressors contribute to weight retention, we used data collected in a cohort of postpartum women and analyzed measures of stress, depression, social support, and health-related quality of life. Depressive symptoms at delivery and worse health-related quality of life and lower stress at 3 months postpartum were associated with 3-month weight retention. Interventions targeting depression and improving quality of life may further reduce weight retained.     

A longitudinal investigation of the relationships among alcohol consumption, psychosocial factors, and blood pressure

Although a number of studies have demonstrated a link between alcohol intake and blood pressure, virtually no research has examined this relationship or the relevance of psychosocial variables in this context over time. This study utilized data from 416 subjects in the Air Traffic Controller Health Change Study to track these associations across five examinations over a 3-year period. Following obesity, alcohol consumption was consistently the second-best predictor of blood pressure. Alcohol intake rose among those subjects who developed sustained elevated blood pressure during the course of the study. Further, obesity became less important in predicting blood pressure at higher levels of alcohol intake. Factors predictive of alcohol use were also studied, and the suggestion is made that psychosocial variables may be linked primarily to alcohol use, which in turn combines with obesity to influence blood pressure levels.     

Culturally-sensitive weight loss program produces significant reduction in weight, blood pressure, and cholesterol in eight weeks

Dietary and behavioral needs of special populations are rarely considered in traditional weight loss programs. This study assessed the impact of culturally-sensitive modifications to the Duke University Rice Diet weight loss program for African-American dieters. The study was a randomized modified cross-over study in which volunteers received either early or delayed weight loss intervention. Final outcomes were measured at 8 weeks. At the onset of the study, there were 56 African American participants, however, only 44 (79%) completed the study. The eight-week intervention was a modified 1000-calorie/day version of the Rice Diet. Modifications to the program included decreased cost, culturally-sensitive recipes, addressing attitudes about exercise, and including family members in weight loss efforts. Average weight loss for subjects completing the program was 14.8 pounds (SD = 6.8 pounds). BMI decreased from 37.8 kg/m2 to 35.3 kg/m2 (p < 0.01). Total cholesterol levels decreased from 199.2 mg/dL to 185.4 mg/dL (p < 0.01); systolic and diastolic blood pressure decreased by 4.3 mmHg (p < 0.01) and 2.4 mmHg (p < 0.05), respectively. The control group showed no significant change in any outcome measures. We found that diet programs can be successfully tailored to incorporate the needs of African-Americans. Most importantly, these dietary program changes can lead to significant improvement in clinical parameters. Additional studies are necessary to determine the permanence of these short-term changes.     

The impact of the Russian transition on psychosocial resources and psychological distress

Studies suggest that the difficult transition of the Russian economy has led to decreased physical health among Russians. However, the impact of economic turmoil on Russians' psychological health has not been examined. We used Hobfoll's (1988; 1998) Conservation of Resources (COR) theory to examine how economic losses deteriorate personal and social resources (e.g., mastery and social support), and how these deteriorated resources, in turn, impact psychological well being. Participants were Russian women working in the retail (n = 99) and medical (n = 99) fields, two poorly paid sectors. Structural equation modeling indicated that economic loss negatively impacted mastery, but not social support. Women with greater mastery and social support resources, in turn, reported less psychological distress. Economic loss had both direct and indirect effects, through mastery, on women's psychological distress. Results supported COR theory and point to the importance of building and sustaining personal and social resources in the face of major economic stress. © 2003 Wiley Periodicals, Inc.     

Blood pressure, heart rate, and regional resistance in behavioral defense

Rats were instrumented with arterial catheters and directional pulsed Doppler flow probes for measurement of arterial blood pressure, heart rate, and blood flow in the renal, mesenteric, and hindquarter vascular beds. When tested as intruders in a resident-intruder aggression test, subjects responded to resident attack with species-characteristic defensive behavior and the “defense reaction” pattern of increased heart rate, renal resistance, and mesenteric resistance, and decreased hindquarter resistance. Blood pressure was variable, but sustained increases in blood pressure were rarely observed. The maintenance of blood pressure during species-specific defensive behavior can be contrasted with the sustained pressor responses observed in the centrally elicited defense reaction. The combination of pulsed Doppler technology and the residentintruder paradigm appears to be a promising method for investigating the mechanisms of cardiovascular adjustment to behavioral defense.     

Blood pressure publication guidelines

Blood pressure is one of the most commonly recorded functions in physiology and medicine, and it has become a major variable in recent psychophysiological and behavioral medicine research. Many methods have been developed for the measurement of blood pressure in clinical, laboratory, and natural settings. The broad objectives of this report are to summarize the most critical methodological issues in the measurement of blood pressure and to present principles and recommendations for the evaluation of blood pressure methods and findings in published studies.     

Assortative mating for relative weight: Genetic implications

Most work on the genetics of relative weight has not considered the role of assortative mating, i.e., mate selection based on similarity between mates. We investigated the extent to which engaged men and women in an archival longitudinal database were similar to each other in relative body weightprior to marriage and cohabitation. After controlling for age, a small but statistically significant mate correlation was found for relative weight (r=.13,p=.023), indicating some assortative mating. Furthermore, we examined whether mate similarity in relative weight prior to marriage predicts survival of the marriage. No significant effects were found. In sum, these results are consistent with those of other studies in suggesting that there is a small but significant intermate correlation for relative weight. However, they are unique in showing that these results cannot be explained on the basis of (a) cohabitation, (b) age similarity, or (c) selective survival of marriages between couples more similar in relative weight. The implications of these findings for heritability studies, linkage studies, and the estimation of shared environmental effects are discussed.