Physiologic responses to cognitive challenge during pregnancy: effects of task and repeat testing.

Physiological responses to stress during pregnancy are believed to influence birth outcomes. Researchers have studied pregnant women in laboratory stressor paradigms to investigate these associations, yet normative data on cardiovascular and respiratory responses to laboratory challenge during pregnancy are not yet established. To begin to establish such normative data, this study examined the effects of task and repeat stressor exposure on reactivity in third-trimester pregnant women. Thirty-one healthy pregnant women (mean age=27 years; range 18-36) between the 33rd and 39th week of pregnancy, were instrumented for continuous electrocardiography, blood pressure (BP), and respiration data. Subjects rested quietly for a 5-min baseline and then performed both a mental arithmetic stressor and a Stroop color-word-matching task, each 5 min in length and each followed by a 5-min recovery period. The order of the tasks was counterbalanced. After each 5-min period, subjects rated the period on a 10-point stress scale. Averaged across task type and challenge period, systolic and diastolic BP and respiration rate increased significantly in response to cognitive challenge, but heart rate (HR) did not. When data were examined for task and period effects, the following results emerged: the Stroop task elicited significantly greater systolic BP and HR reactivity than the arithmetic task, yet subjects rated the arithmetic task as more stressful. Averaged across task type, subjects showed greater systolic BP reactivity during the second challenge period compared to the first. Finally, women's BP tended to drift upward and did not return to baseline during the first recovery period. These findings indicate that averaging data across tasks and periods can obscure the time course of response patterns that may be important in the study of associations between maternal stress and perinatal development, as well as in other research on reactivity to repeat stress exposure.     

Protective effect of interval exercise on psychophysiological stress reactivity in children

Two studies determined whether interval exercise reduces children's stress reactivity. For Experiment 1 children completed interval exercise ( n =14) or watched TV ( n =14) for 25 min. After 20 min rest children completed a speech task. Speech-induced diastolic blood pressure (DBP) reactivity was dampened in the exercise group ( p <.05). For Experiment 2 children ( n =22) completed interval exercise-speech and TV-speech conditions on separate days. Physical activity was assessed by accelerometry and aerobic fitness estimated by submaximal exercise. DBP, systolic BP, and heart rate (HR) reactivity to the speech stressor were dampened ( p <.05) after exercise compared to TV watching. Fitness was positively associated with HR reactivity. Interval exercise that mimics usual patterns of physically active play dampens cardiovascular reactivity to interpersonal stress.     

Three‐year stability of cardiovascular and autonomic nervous system responses to psychological stress

Chronically heightened physiological reactivity to or delayed recovery from stress may contribute to cardiovascular (CV) risk and mortality. Long‐term stability of physiological stress responses has received little attention. Our objectives were to evaluate the 3‐year stability of reactivity and recovery change scores across CV and autonomic parameters and assess whether sex and age moderate stability. A total of 134 healthy participants underwent two laboratory stress protocols, including four 5‐min interpersonal stressors, each followed by a 5‐min recovery period. Heart rate (HR), blood pressure (BP), and HR variability (high frequency, low frequency, very low frequency [VLF]) were obtained. Spearman rank correlations and linear regressions were performed. Significant correlations emerged for all physiological measures except diastolic BP and VLF recovery. No significant sex or age differences were found. Stress responses represent stable individual traits little affected by sex or age.     

The mindful attention and awareness scale is associated with lower levels of high-frequency heart rate variability in a laboratory context

Trait mindfulness has been associated with well-being. A key component of trait mindfulness is intentional attention and awareness which is most commonly measured by the Mindful Attention and Awareness Scale (MAAS). This study investigated the relationship between the MAAS and cardiovascular (HF-HRV, heart rate) reactivity to two laboratory stressors that evoked different patterns of change in heart rate (HR). One stressor (viewing a video of a surgery) evoked HR deceleration while the other stressor (mental arithmetic) evoked HR acceleration. Undergraduate students completed the MAAS and were then exposed to the two stressors while ECG (electrocardiography) was recorded. Findings support the reliability of the stressors to induce expected differential cardiovascular responses and explicate the role of parasympathetic activation. Further, a main effect for MAAS was observed indicating that across laboratory conditions, persons scoring higher on the MAAS had lower HF-HRV relative to persons scoring lower on the MAAS. These findings suggest that higher levels of intentional attention and awareness in a laboratory context might promote parasympathetic withdrawal because these participants were more vigilant, experienced higher cognitive load, and detected more threat cues. Implications for the MAAS and cardiovascular responses to stress are discussed.     

Heart rate and autonomic response to stress after experimental induction of worry versus relaxation in healthy,high-worry,and generalized anxiety disorder individuals

Generalized anxiety disorder (GAD) is the most commonly occurring anxiety disorder and has been related to cardiovascular morbidity such as cardiac ischemia, sudden cardiac death, and myocardial infarction. Both GAD and its cardinal symptom – worry – have been shown to promote muted physiological reactivity in response to laboratory and ecological stressors. Importantly, no study to date has examined the concurrent and relative contributions of trait and state worry within healthy controls, (non-clinical) high trait-worry controls, and GAD participants. The present study examined heart rate (HR), respiratory sinus arrhythmia (RSA), and salivary alpha-amylase (sAA) responses to laboratory stress during and following the experimental induction of worry versus relaxation in healthy controls (n = 42), high trait worriers (n = 33) and participants with GAD (n = 76). All groups exhibited increased HR and decreased RSA in response to the stressor, with no differences by condition. Baseline sAA significantly moderated HR and RSA reactivity, such that higher sAA predicted greater increases in HR and decreases in RSA. There was a significant group by baseline sAA interaction such that in GAD, higher baseline sAA predicted decreased change in sAA during stress, whereas higher baseline sAA predicted greater sAA change in healthy controls. High-worry controls fell non-significantly between these groups. The present study provides additional evidence for the effect of worry on diminished HR stress response and points to possible suppression of adrenergic sympathetic stress responses in GAD.     

The effect of acute aerobic exercise on stress related blood pressure responses: a systematic review and meta-analysis

The beneficial impact of regular exercise on cardiovascular health is partly mediated by psychobiological mechanisms. However, the effect of acute exercise on psychobiological responses is unclear. Thus, we performed a systematic review of randomised controlled trials (RCTs) that examined the effect of acute aerobic exercise on blood pressure (BP) responses (the change from baseline to stress) to psychosocial laboratory tasks. Fifteen RCTs met inclusion criteria of which ten demonstrated significant reductions in post-exercise stress related BP responses compared with control (mean effect sizes for systolic and diastolic BP, 0.38 and 0.40). Studies involving greater exercise doses tended to show larger effects, with the minimum dose to show a significant effect being 30 min at 50% VO2max. No other moderators emerged from the examination of participant characteristics, research designs and stressor characteristics. In conclusion, an acute bout of aerobic exercise appears to have a significant impact on the BP response to a psychosocial stressor.     

The psychobiology of hostility: Possible endogenous opioid mechanisms

This study examined the role of endogenous opioids in the relation between hostility and cardiovascular stress responsiveness. Forty-six men completed the Cook-Medley Hostility Scale and experienced a laboratory pain stressor once under opioid blockade and once under placebo. Hostility scores were significantly related to the magnitude of change in cardiovascular reactivity/recovery resulting from opioid blockade. Low scorers on the Cynicism subscale displayed increases in heart rate (HR) reactivity under blockade relative to placebo, with reactivity decreases noted in high scorers. Low Hostile Affect scores were similarly associated with impaired diastolic blood pressure recovery under opioid blockade. HR recovery results were somewhat different, with high scorers on Aggressive Responding and the total Cook-Medley displaying improved HR recovery under opioid blockade, with no change noted in low scorers. These data provide preliminary support for the hypothesis that low hostile individuals rely on endogenous opioids for buffering cardiovascular stress responsiveness, but high hostiles do not.     

Cardiovascular activity during mental stress following vigorous exercise in sportsmen and inactive men

Thirty-six competitive sportsmen and 36 inactive men participated in a two-session experiment. Session 1 involved exercise to exhaustion so as to assess maximal oxygen consumption (V?o_{2 max}. In Session 2, both groups were randomized into three experimental conditions: 20 min of exercise at high intensity (70%V?o_{2 max}) or moderate intensity (50% V˙o_{2 max}) or a light exercise control. Following 30 min of recovery, all subjects performed mental arithmetic and public speech tasks in a counterbalanced order. Cardiovascular, electrodermal, respiratory, and subjective variables were recorded. Sportsmen had higher V˙o_{2 max}, lower body fat, and lower resting heart rate (HR) than inactive men. A postexercise hypotensive response was observed among subjects in the 70% and 50% V˙o_{2 max} conditions, accompanied by baroreceptor reflex inhibition in the 70% condition. Systolic pressure was lower during mental arithmetic and during recovery from the speech task in the high-intensity than in the control group. Diastolic pressure was lower following mental arithmetic in the high-intensity group. No differences in HR reactivity, electrodermal, or respiratory parameters were observed, but baroreceptor reflex sensitivity was inhibited during mental arithmetic. The results are discussed in relation to previous reports of suppressed cardiovascular reactivity to mental stress tests following vigorous exercise and the role of stress-related processes in the antihypertensive response to physical training.     

Physiological adaptation to recurrent social stress of extraversion

The present studies examined the influence of extraversion on physiological reactivity, recovery, and physiological habituation‐sensitization to repeated social stressors. In Study 1, subjective and physiological data were collected from 97 college students who were categorized as high (n = 51) and low (n = 46) on extraversion (NEO‐FFI) across five laboratory stages: baseline, stress 1, poststress 1, stress 2, and poststress 2. Results indicated high extraversion (HE) participants exhibited relative lesser heart rate (HR) reactivity and respiratory sinus arrhythmia (RSA) withdrawals to, and more complete HR and RSA recovery after the first social stress, and also exhibited relative lesser HR reactivity to the second social stress. When repeatedly exposed to a social stressor, HE participants showed pronounced systolic blood pressure (SBP) adaptation, low extraversion (LE) participants displayed diastolic blood pressure (DBP) sensitization. In Study 2, data were collected from another 78 participants (HE: n = 40, LE: n = 38) across the same laboratory stages with speech performance videotaped. After controlling for the speech styles, Study 2 found the same HR response and SBP/DBP adaptation pattern across extraversion groups to social stress as Study 1 but not RSA reactivity. These findings suggest extraverts exhibit more adaptive physiological reactivity to recurrent social stressors, which thus might benefit their health.     

Neuroendocrine and cardiovascular reactivity to stress in mid-aged and older women: long-term temporal consistency of individual differences

We report long-term temporal consistency of stress-related neuroendocrine and cardiovascular variables in mid-aged and older women who performed mental math and speech stress tasks two times approximately 1 year apart. Epinephrine, norepinephrine, ACTH, cortisol, cardiac preejection period (PEP), respiratory sinus arrhythmia, heart rate (HR), blood pressure, and respiration rate were measured at baseline, after or during stressors, and 30 min posttask. Although there were exceptions, year-to-year Spearman coefficients showed mostly moderate to high consistency (rs approximately equal to .5-.8) for baseline, stressor, and posttask values. For reactivity, HR and PEP were most consistent (rs approximately equal to .65); consistency for other variables was moderate to low (rs approximately equal to .1-.4). Means of most variables changed from year to year. Results support the use of baseline, stressor, and posttask values in longitudinal studies.     

Access to social support in life and in the laboratory: combined impact on cardiovascular reactivity to stress and state anxiety

Social support is associated with lower cardiovascular disease risk. We examined the effects of perceived network support and availability of functional support in the laboratory on blood pressure and heart rate (HR) reactivity to acute stress. When functional support was available, participants with low perceived network support had significantly lower HR reactivity than participants with high perceived network support (p = .04). Conversely, when functional support was not available, participants with low perceived network support had significantly higher HR reactivity (p = .05). Self-reported anxiety post-stressor was significantly higher when functional support was not mentioned (p = .03).     

An experimental test of blunting using sleep-restriction as an acute stressor in Type D and non-Type D women

Recent years have seen a growing interest in evidence indicating that a low, or blunted, cardiovascular response to stress may predict increased risk for a range of adverse health outcomes. Type D personality has been associated with poor health in cardiac patients, and more recently, has been associated with lower reactivity to laboratory stress in healthy individuals, underpinned by an increase in vascular responding. Previous findings have also demonstrated that partial sleep restriction is characterised by a robust vascular profile. However, despite the fact that a vascular response profile underpins both reactivity in sleep restricted adults and blunted reactivity in healthy Type D adults, limited empirical work has examined the correlates of sleep restriction and Type D. The present study sought to investigate if manipulation of sleep duration in healthy Type D and non-Type D individuals would alter cardiovascular reactivity to stress, and in particular whether such manipulation could elucidate the comparative nature of blunting. Seventy female university students completed a laboratory social stress task while undergoing continuous hemodynamic monitoring, after either a night of partial sleep restriction or a full night's rest. In both groups, Type D participants exhibited relatively low SBP stress responses, consistent with the view that at-risk groups show blunting in (some indices of) cardiovascular reactivity. For non-Type D participants, low SBP responses were observed only in participants who had undergone sleep restriction, suggesting that sleep-restriction served as an environmental stressor which precipitated in non-Type D persons a cardiovascular stress response resembling that ordinarily seen in Type D persons. This blunted response was associated with an increase in vascular responding. Thus, the findings suggest that blunting is characterised not only by reductions in some (frequently studied) cardiovascular parameters, but also by increases in others.     

Cardiovascular responses to a laboratory stressor in women: Assessing the role of body awareness

Body awareness (BA) is characterised by a general tendency towards awareness and recognition of normal, non-emotive bodily processes and physical sensations. BA considers one's sensitivity towards and belief in how well they can sense, predict, and describe their bodily functions and sensations. This study investigated the role of BA in haemodynamic and anxiety responses to a laboratory stressor. Women (n?=?40) completed assessments of BA and state/trait anxiety. Women with low BA displayed higher blood pressure (BP) and heart rate (HR) reactivity in response to the stressor than women with high BA. Delayed HR recovery poststressor was observed in women with low BA. BA was a significant predictor of haemodynamic reactivity over and above trait anxiety. BA effects on state anxiety were not observed. Thus, greater BA is associated with less haemodynamic stress reactivity in women lending further support for the development of BA interventions aimed at stress reduction.     

Effects of trait dominance on psychological and cardiovascular responses to social influence attempts: the role of gender and partner dominance.

This study investigated the influence of trait dominance on cardiovascular reactivity to and recovery from a dyadic interaction task requiring active social influence attempts. Thirty-six male and 36 female normotensive high-school students characterized as either high or low in trait dominance engaged in a mixed-gender discussion with a high or low dominant partner. Trait dominance substantially influenced cardiovascular reactivity to the interpersonal stressor. High dominant participants displayed higher increases in systolic blood pressure (SBP) and pulse pressure (PP), but lower diastolic elevations than low dominant participants. The difference in diastolic reactivity was particularly pronounced in females. Recovery from stress was influenced by level of partner dominance. Participants interacting with a dominant partner showed delayed diastolic recovery. The observed cardiovascular effects seem to reflect greater task engagement and efficient coping in dominant subjects. Group differences in cognitive task appraisals and affective experiences are consistent with this interpretation. Differences in psychological responding were not found to mediate the relation between trait dominance and cardiovascular responses, however.     

The Effects of Stress on Natural Killer Cell Activity in Healthy Men1

Several studies have shown that exposure to acute laboratory stressors produces an immediate change in immune function. We examined the effects of a mild laboratory stressor on natural killer (NK) cell cytotoxicity and on psychological and cardiovascular measures in 24 adult males. Subjects in the experimental condition worked on the Stroop task without interference for 30 min with blood samples drawn at baseline, 10, 20, and 30 min into the task, and 40 min after completing the task. The 30-min stressor produced increases in self-reported stress and tension, and in SBP, DBP, and HR. It was also associated with a decrease in NK cell cytotoxicity 40 min after the stressor. Results are discussed in relation to the effects of mild and intense stressors and future research implications.     

Effects of a 12-week endurance training program on the physiological response to psychosocial stress in men: a randomized controlled trial

The present study experimentally tested the cross-stressor adaptation hypothesis by examining whether endurance exercise training leads to reductions in the physiological stress response to a psychosocial stressor. We randomly assigned 149 healthy men to a 12-week exercise training, relaxation training, or a wait list control group. Before and after intervention we assessed the groups’ physical fitness (lactate testing) and compared their physiological stress responses to the Trier Social Stress Test for Groups in terms of salivary free cortisol, heart rate (HR) and heart rate variability (HRV); the final sample consisted of 96 subjects. As hypothesized, the exercise training significantly improved fitness and reduced stress reactivity in all three parameters; however, it only improved stress recovery in terms of HR. The relaxation program reduced only cortisol, but not HR or HRV reactivity; no changes emerged for the control group. The findings suggest that the cross-stressor adaptation hypothesis is valid for cardiovascular as well as endocrine stress reactivity.     

Cardiovascular reactivity in real life settings: Measurement, mechanisms and meaning

Cardiovascular reactivity to stress is most commonly studied in the laboratory. Laboratory stressors may have limited ecological validity due to the many constraints, operating in controlled environments. This paper will focus on paradigms that involve the measurement of cardiovascular reactions to stress in real life using ambulatory monitors. Probably the most commonly used paradigm in this field is to measure the response to a specific real life stressor, such as sitting an exam or public speaking. A more general approach has been to derive a measure of CV variability testing the hypothesis that more reactive participants will have more variable heart rate or blood pressure. Alternatively, self-reports of the participants’ perceived stress, emotion or demands may be linked to simultaneously collected ambulatory measures of cardiovascular parameters.This paper examines the following four questions: (1) What is the form and what are the determinants of stress-induced CV reactivity in real life? (2) What are the psychophysiological processes underlying heart rate and blood pressure reactivity in real life? (3) Does CV reactivity determined in the laboratory predict CV reactivity in real life? (4) Are ambulatory cardiovascular measures predictive of cardiovascular disease?It is concluded that the hemodynamic processes that underlie the blood pressure response can reliably be measured in real life and the psychophysiological relationships seen in the laboratory have been obtained in real life as well. Studies examining the effects of specific real life stressors show that responses obtained in real life are often larger than those obtained in the laboratory. Subjective ratings of stress, emotion and cognitive determinants of real life stress (e.g. demand, reward and control) also relate to real life CV responses. Surprisingly, ambulatory studies on real life cardiovascular reactivity to stress as a predictor of cardiovascular disease are rare. Measuring the CV response to stress in real life may provide a better measure of the stress-related process that are hypothesized to cause disease than is possible in the laboratory. In addressing these questions, below we review the studies that we believe are representative of the field. Therefore, this review is not comprehensive.     

Sex differences in the hemodynamic responses to mental stress: Effect of caffeine consumption

The effect of caffeine on stress responses was compared in 25 men and 22 women in a 2-week placebo-controlled, double-blind, randomized crossover trial. On each week, participants abstained from all dietary sources of caffeine before undergoing a 6-h laboratory protocol under placebo or caffeine exposure followed by a 30-min mental stressor with blood pressure (BP) and cardiovascular hemodynamic assessments. On the placebo session, men and women showed a significant BP increase to stress, although women had significant cardiac responses whereas men had vascular responses. Caffeine ingestion before stress caused both men and women to have enhanced hemodynamic responses to the stressor associated with an increase in cardiac index and a drop in the peripheral resistance index. Caffeine enhances the cardiovascular fight-or-flight response pattern to stress in men and women.     

The impact of physical proximity and attachment working models on cardiovascular reactivity: Comparing mental activation and romantic partner presence

Close relationships, especially high‐quality romantic relationships, are consistently associated with positive physical health outcomes. Attenuated cardiovascular reactivity is one physiological mechanism implicated in explaining these effects. Drawing on attachment and social baseline theories, this experimental study evaluated two potential affiliative cues as mechanisms through which romantic relationships may attenuate cardiovascular reactivity to a laboratory‐based stressor. Prior to a cold pressor task, 102 participants were randomly assigned to either have their partner physically present, call upon a mental representation of their partner, or think about their day during the stressor. Consistent with our preregistered hypotheses, participants in both the partner present and mental activation conditions had significantly lower blood pressure (BP) reactivity during the cold pressor task compared to control participants for both systolic (d = ?0.54) and diastolic BP (d = ?0.53), but no significant differences emerged for heart rate or heart rate variability. Although participants in the partner present and mental activation conditions had similar BP reactivity to the cold pressor task, those in the partner present condition reported significantly less pain as a result of the task. The difference in BP reactivity by condition was moderated—BP reactivity was greater for people with lower self‐reported relationship satisfaction. The results suggest that accessing the mental representation of a romantic partner and a partner’s presence each buffer against exaggerated acute stress responses to a similar degree.     

Cardiovascular effects of static and dynamic exercise

Summary The cardiovascular response to static exercise has often been quantified on the basis of a comparison between static handgrip and dynamic cycling exercise. It is then difficult to make precise comparisons because the physical units of work are not compatible. If the data from dynamic exercise can be used to predict the cardiovascular response to zero movement (static exercise) this would suggest that static exercise is not fundamentally different from dynamic exercise. Using leg extension exercise which lasted for 1 min, a set of weights was lifted repeatedly 50 times/min, through three different distances. On each occasion, the heart rate, systolic time intervals (STI) and systemic arterial blood pressure were monitored non-invasively. Regression analysis of heart rate (HR) or blood pressure (BP) against the distance moved by the weights was used to predict the heart rate or blood pressure that would be expected for static exercise. In addition the same responses were measured following 1 min of static exercise during which the weights were held up but not moved. Five subjects, trained in leg extension exercise, completed the four exercise sessions in a random order. A constant force was produced in each variant of the protocol and in the static exercise it amounted to 50% maximal voluntary contraction (MVC). The forces developed and the distance the weights were lifted were monitored. During this sustained static exercise at relatively low intensity the cardiovascular changes could be predicted from the responses induced by dynamic exercise. It is suggested that other factors are important in determining the cardiovascular response to exercise, not simply the mode.