101
|
Smith TW. Does the interpersonally sensitive disposition advance research on personality and health? Comment on Marin and Miller (2013). Psychol Bull 2014; 139:985-90. [PMID: 24016232 DOI: 10.1037/a0033993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Marin and Miller (2013) have proposed the interpersonally sensitive disposition as an integrative model of personality characteristics affecting physical health. The model has considerable heuristic value and applied potential, and the related research is discussed with thoughtful attention to long-standing challenges and limitations in research on personality and health. However, their conclusions about the association of interpersonal sensitivity and subsequent health may be premature and overstated. The agenda for future research they propose is valuable, and in addition to the important epidemiologic and psychobiologic studies they describe, the essential research on the measurement of interpersonal sensitivity and its association with other personality and social-environmental risk factors will be best advanced through application of concepts and methods in current personality science and related interpersonal approaches.
Collapse
|
102
|
MacKenzie J, Smith TW, Uchino B, White PH, Light KC, Grewen KM. Depressive Symptoms, Anger/Hostility, and Relationship Quality in Young Couples. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2014. [DOI: 10.1521/jscp.2014.33.4.380] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
103
|
Uchino BN, Smith TW, Berg CA. Spousal relationship quality and cardiovascular risk: dyadic perceptions of relationship ambivalence are associated with coronary-artery calcification. Psychol Sci 2014; 25:1037-42. [PMID: 24501110 PMCID: PMC3984367 DOI: 10.1177/0956797613520015] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The quality of spousal relationships has been related to physical-health outcomes. However, most studies have focused on relationship positivity or negativity in isolation, despite the fact that many close relationships are characterized by both positive and negative aspects (i.e., ambivalence). In addition, most work has not accounted for the reciprocal nature of close-relationship processes that can have an impact on health. Using a sample of 136 older married couples, we tested whether actor-partner models of relationships that were either primarily positive or ambivalent (i.e., perceived as having both helpful and upsetting aspects) predicted measures of coronary-artery calcification. Results revealed an Actor × Partner interaction whereby coronary-artery calcification scores were highest for individuals who both viewed and were viewed by their spouse as ambivalent. These data are discussed in light of the importance of considering both positive and negative aspects of relationship quality and modeling the interdependence of close relationships.
Collapse
|
104
|
Caska CM, Smith TW, Renshaw KD, Allen SN, Uchino BN, Birmingham W, Carlisle M. Posttraumatic stress disorder and responses to couple conflict: Implications for cardiovascular risk. Health Psychol 2014; 33:1273-80. [DOI: 10.1037/hea0000133] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
105
|
Cribbet MR, Carlisle M, Cawthon RM, Uchino BN, Williams PG, Smith TW, Gunn HE, Light KC. Cellular aging and restorative processes: subjective sleep quality and duration moderate the association between age and telomere length in a sample of middle-aged and older adults. Sleep 2014; 37:65-70. [PMID: 24470696 DOI: 10.5665/sleep.3308] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
STUDY OBJECTIVES To examine whether subjective sleep quality and sleep duration moderate the association between age and telomere length (TL). DESIGN Participants completed a demographic and sleep quality questionnaire, followed by a blood draw. SETTING Social Neuroscience Laboratory. PARTICIPANTS One hundred fifty-four middle-aged to older adults (age 45-77 y) participated. Participants were excluded if they were on immunosuppressive treatment and/or had a disease with a clear immunologic (e.g., cancer) component. INTERVENTIONS N/A. MEASUREMENTS AND RESULTS Subjective sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI) and TL was determined using peripheral blood mononuclear cells (PBMCs). There was a significant first-order negative association between age and TL. Age was also negatively associated with the self-reported sleep quality item and sleep duration component of the PSQI. A significant age × self-reported sleep quality interaction revealed that age was more strongly related to TL among poor sleepers, and that good sleep quality attenuated the association between age and TL. Moreover, adequate subjective sleep duration among older adults (i.e. greater than 7 h per night) was associated with TL comparable to that in middle-aged adults, whereas sleep duration was unrelated to TL for the middle-aged adults in our study. CONCLUSIONS The current study provides evidence for an association between sleep quality, sleep duration, and cellular aging. Among older adults, better subjective sleep quality was associated with the extent of cellular aging, suggesting that sleep duration and sleep quality may be added to a growing list of modifiable behaviors associated with the adverse effects of aging.
Collapse
|
106
|
Joyce AT, Gandra SR, Fox KM, Smith TW, Pill MW. National and regional dose escalation and cost of tumor necrosis factor blocker therapy in biologic-naïve rheumatoid arthritis patients in US health plans. J Med Econ 2014; 17:1-10. [PMID: 24131136 DOI: 10.3111/13696998.2013.856314] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study examined the proportion and magnitude of dose escalation nationally and regionally among rheumatoid arthritis (RA) patients treated with TNF-blockers and estimated the costs of TNF-blocker therapy. METHODS This retrospective cohort study used claims data from US commercially-insured adult RA patients who initiated adalimumab, etanercept, or infliximab therapy between 2005-2009. Biologic-naïve patients enrolled in the health plan for ≥6 months before and ≥12 months after therapy initiation were followed for 12 months. Dose escalation was assessed using three methods: (1) average weekly dose > recommended label dose, (2) average ending dispensed dose > maintenance dose, and (3) average dose after maintenance dose > maintenance dose. Annual cost of therapy included costs for mean dose and drug administration fees. RESULTS Overall, 1420 etanercept, 874 adalimumab, and 454 infliximab patients were included. A significantly lower proportion of etanercept-treated patients had dose escalation using the average weekly dose (3.9% vs 21.4% adalimumab and 69.6% infliximab; p < 0.0001), average ending dispensed dose (1.1% vs 10.6% adalimumab and 63.0% infliximab; p < 0.0001), and average dose after maintenance dose methods (2.8% vs 15.7% adalimumab and 69.6% infliximab; p < 0.0001). Regional dose escalation rates and magnitudes of escalation were directionally consistent with national rates. Etanercept had the lowest cost per treated RA patient ($19,690) compared to adalimumab ($23,020) and infliximab ($24,030). LIMITATIONS Exclusion of patients not on continuous TNF-blocker therapy limits the generalizability; however, ∼50% of patients were persistent on therapy for 12 months. The study population comprised RA patients in commercial health plans, thus the results may not be generalizable to Medicare or uninsured populations. CONCLUSIONS In this retrospective study, etanercept patients had the lowest proportions and magnitudes of dose escalation across all methods compared to adalimumab and infliximab patients nationally and regionally. Mean annual cost was lowest for etanercept-treated patients.
Collapse
|
107
|
Bowen KS, Uchino BN, Birmingham W, Carlisle M, Smith TW, Light KC. The stress-buffering effects of functional social support on ambulatory blood pressure. Health Psychol 2013; 33:1440-3. [PMID: 24245843 DOI: 10.1037/hea0000005] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Social support is a reliable predictor of cardiovascular health. According to the buffering hypothesis, stress is 1 mechanism by which support is able to affect physiological processes. However, most of the experimental evidence for the hypothesis comes from laboratory studies. Ambulatory blood pressure (ABP) protocols examine participants in their natural environment, where they are more likely to encounter personally relevant real-world stressors. Furthermore, prior work shows that examining support by its specific functional components reveals additional independent links to health. METHODS The current study aimed to examine the stress-buffering effects of functional social support on ABP. One hundred eighty-eight participants completed a 1-day ABP assessment along with measures of functional social support and both global perceived stress and momentary stress at time of reading. RESULTS RESULTS indicated main effects for both stress measures. Global support, emotional, tangible, and informational support only moderated the effects of momentary stress, but not global stress, in predicting ABP. Informational support was the most consistent stress-buffering predictor of ABP, predicting both ambulatory systolic and diastolic blood pressure. CONCLUSIONS The predicted values in ABP for informational support achieved health-relevant differences, emphasizing the value of examining functional support beyond global support alone.
Collapse
|
108
|
Jordan KD, Masters KS, Hooker SA, Ruiz JM, Smith TW. An Interpersonal Approach to Religiousness and Spirituality: Implications for Health and Well-Being. J Pers 2013; 82:418-31. [DOI: 10.1111/jopy.12072] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
109
|
Smith TW, Baron CE, Grove JL. Personality, Emotional Adjustment, and Cardiovascular Risk: Marriage as a Mechanism. J Pers 2013; 82:502-14. [DOI: 10.1111/jopy.12074] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
110
|
Memon NB, Briceno DF, Torres-Russotto D, Chen J, Smith TW. Speech-induced atrial tachycardia: an unusual presentation of supraventricular tachycardia. J Cardiovasc Electrophysiol 2013; 24:1412-5. [PMID: 24180527 DOI: 10.1111/jce.12278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 08/22/2013] [Accepted: 08/26/2013] [Indexed: 11/26/2022]
Abstract
A 63-year-old male radio announcer was admitted with a narrow complex, long RP tachycardia. While in the awake state, the patient spoke in his radio voice, initiating and maintaining the tachycardia. Three-dimensional electroanatomic mapping during electrophysiology study localized the tachycardia to the ostium of the right superior pulmonary vein. After single radiofrequency energy application, no further arrhythmias were inducible with speech. At more than 1 year of follow-up, the patient had no recurrences and continues to work as a radio announcer.
Collapse
|
111
|
Fansler DR, Smith TW. Rotors: Linking VF and VT? Heart Rhythm 2013; 10:1917-8. [PMID: 23969071 DOI: 10.1016/j.hrthm.2013.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Indexed: 11/16/2022]
|
112
|
Uchino BN, Smith TW, Carlisle M, Birmingham WC, Light KC. The quality of spouses' social networks contributes to each other's cardiovascular risk. PLoS One 2013; 8:e71881. [PMID: 23990999 PMCID: PMC3749188 DOI: 10.1371/journal.pone.0071881] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 07/04/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Although the quality of one's own social relationships has been related to cardiovascular morbidity and mortality, whether a partner's social network quality can similarly influence one's cardiovascular risk is unknown. In this study we tested whether the quality of a partner's social networks influenced one's own ambulatory blood pressure (ABP). METHODS The quality of 94 couples' social networks was determined using a comprehensive model of relationships that separates out social ties that are sources of positivity(supportive), negativity (aversive), and both positivity and negativity (ambivalent). We then utilized statistical models (actor-partner analyses) that allowed us to separate out the links between one's own social network quality on ABP (actor influences), a partner's social network quality on ABP (partner influences), and a couple's network quality combined on ABP (actor X partner interactions). RESULTS Independent of one's own relationship quality, results showed that an individual's ABP was lower if their spouse had more supportive ties, and higher if a spouse had more aversive and ambivalent ties. In addition, couples' networks in combination were associated with higher ABP but only if both had a low number of supportive ties, or a high number of aversive or ambivalent ties. CONCLUSIONS These data suggest that the social ties of those we have close relationships with may influence our cardiovascular risk and opens new opportunities to capitalize on untapped social resources or to mitigate hidden sources of social strain.
Collapse
|
113
|
Bowen KS, Birmingham W, Uchino BN, Carlisle M, Smith TW, Light KC. Specific dimensions of perceived support and ambulatory blood pressure: which support functions appear most beneficial and for whom? Int J Psychophysiol 2013; 88:317-24. [PMID: 22465206 PMCID: PMC3432297 DOI: 10.1016/j.ijpsycho.2012.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 02/20/2012] [Accepted: 03/20/2012] [Indexed: 01/28/2023]
Abstract
Perceived support has been related to lower cardiovascular morbidity and mortality. However, little is known about the specific functional components of support responsible for such links. We tested if emotional, informational, tangible, and belonging support predicted ambulatory blood pressure (ABP) and interpersonal interactions (e.g., responsiveness), and if such links were moderated by gender. In this study, 94 married couples underwent 12 h of ABP monitoring during daily life which included a night at home with their spouse. They completed a short-form of the interpersonal support evaluation list that provides information on total (global) support, as well as specific dimensions of support. Results revealed that global support scores did not predict ABP during daily life. However, separating out distinct support components revealed that emotional support was a significant predictor of lower ambulatory systolic and diastolic blood pressure, primarily for women. Finally, emotional support predicted greater partner responsiveness and self-disclosure, along with less perceived partner negativity although these results were not moderated by gender. These data are discussed in terms of the importance of considering specific support components and the contextual processes that might influence such links.
Collapse
|
114
|
Gillen EM, Hassmiller Lich K, Yeatts KB, Hernandez ML, Smith TW, Lewis MA. Social ecology of asthma: engaging stakeholders in integrating health behavior theories and practice-based evidence through systems mapping. HEALTH EDUCATION & BEHAVIOR 2013; 41:63-77. [PMID: 23709516 DOI: 10.1177/1090198113486804] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes a process for integrating health behavior and social science theories with practice-based insights using participatory systems thinking and diagramming methods largely inspired by system dynamics methods. This integration can help close the gap between research and practice in health education and health behavior by offering a systematic approach to bring together stakeholders across multiple domains. In this process we create a diagram using constructs from multiple health behavior theories at all levels of the social ecological framework as variables in causal loop diagrams. The goal of this process is to elucidate the reciprocal relationships between explanatory factors at various levels of the social ecological framework that render so many public health problems intractable. To illustrate, we detail a theory-based, replicable process for creating a qualitative diagram to enrich understanding of caregiver and provider behavior around adherence to pediatric asthma action plans. We describe how such diagramming can serve as the foundation for translating evidence into practice to address real-world challenges. Key insights gained include recognition of the complex, multilevel factors affecting whether, and how effectively, parents/caregivers and medical providers co-create an asthma action plan, and important "feedback" dynamics at play that can support or derail ongoing collaboration. Although this article applies this method to asthma action plan adherence in children, the method and resulting diagrams are applicable and adaptable to other health behaviors requiring continuous, daily action.
Collapse
|
115
|
Smith TW, Ruiz JM, Cundiff JM, Baron KG, Nealey-Moore JB. Optimism and Pessimism in Social Context: An Interpersonal Perspective on Resilience and Risk. JOURNAL OF RESEARCH IN PERSONALITY 2013; 47:553-562. [PMID: 27840458 DOI: 10.1016/j.jrp.2013.04.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Using the interpersonal perspective, we examined social correlates of dispositional optimism. In Study 1, optimism and pessimism were associated with warm-dominant and hostile-submissive interpersonal styles, respectively, across four samples, and had expected associations with social support and interpersonal stressors. In 300 married couples, Study 2 replicated these findings regarding interpersonal styles, using self-reports and spouse ratings. Optimism-pessimism also had significant actor and partner associations with marital quality. In Study 3 (120 couples), husbands' and wives' optimism predicted increases in their own marital adjustment over time, and husbands' optimism predicted increases in wives' marital adjustment. Thus, the interpersonal perspective is a useful integrative framework for examining social processes that could contribute to associations of optimism-pessimism with physical health and emotional adjustment.
Collapse
|
116
|
Uchino BN, Bosch JA, Smith TW, Carlisle M, Birmingham W, Bowen KS, Light KC, Heaney J, O'Hartaigh B. Relationships and cardiovascular risk: Perceived spousal ambivalence in specific relationship contexts and its links to inflammation. Health Psychol 2013; 32:1067-75. [DOI: 10.1037/a0033515] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
117
|
Uchino BN, Cawthon RM, Smith TW, Light KC, McKenzie J, Carlisle M, Gunn H, Birmingham W, Bowen K. Social relationships and health: is feeling positive, negative, or both (ambivalent) about your social ties related to telomeres? Health Psychol 2012; 31:789-96. [PMID: 22229928 PMCID: PMC3378918 DOI: 10.1037/a0026836] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The quality of one's personal relationships has been linked to morbidity and mortality across different diseases. As a result, it is important to examine more integrative mechanisms that might link relationships across diverse physical health outcomes. In this study, we examine associations between relationships and telomeres that predict general disease risk. These questions are pursued in the context of a more comprehensive model of relationships that highlights the importance of jointly considering positive and negative aspects of social ties. METHOD One hundred thirty-six individuals from a community sample (ages 48 to 77 years) completed the social relationships index, which allows a determination of relationships that differ in their positive and negative substrates (i.e., ambivalent, supportive, aversive, indifferent). Telomere length was determined from peripheral blood mononuclear cells via quantitative polymerase chain reaction. RESULTS Participants who had a higher number of ambivalent ties in their social networks evidenced shorter telomeres. These results were independent of other relationship types (e.g., supportive) and standard control variables (e.g., age, health behaviors, and medication use). Gender moderated the links between ambivalent ties and telomere length, with these associations seen primarily in women. Follow-up analyses revealed that the links between ambivalent ties and telomeres were primarily due to friendships, parents, and social acquaintances. CONCLUSION Consistent with epidemiological findings, these data highlight a novel and integrative biological mechanism by which social ties may affect health across diseases and further suggest the importance of incorporating positivity and negativity in the study of specific relationships and physical health.
Collapse
|
118
|
Smith TW, Yun Z, Menter DG, McIntire LV, Nicolson GL. Computerized analysis of tumor cell interactions with extracellular matrix proteins, peptides, and endothelial cells under laminar flow. Biotechnol Bioeng 2012; 50:598-607. [PMID: 18627023 DOI: 10.1002/(sici)1097-0290(19960605)50:5<598::aid-bit15>3.0.co;2-f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Arrest and formation of stable adhesive interactions between circulating cells and the endothelium or exposed subendothelial matrix are important processes in many biological situations. We have developed a highly sensitive hydrodynamic assay that utilizes a parallel-plate flow chamber, video microscopy, and digital image processing to separate and measure the primary arrest and adhesion stabilization of flowing cells. Our data indicate that primary cell contact triggers secondary adhesion stabilization, and the secondary events are likely to be critical to metastasis formation. To study the relationship between tumor cell adhesion stabilization and organ-specific blood-borne metastasis, we investigated the adhesion stabilization of metastatic murine RAW117 large-cell lymphoma cells to the extracellular matrix proteins fibronectin and vitronectin, several Arg-Gly-Asp (RGD) containing peptides, and microvascular endothelial cells from the liver or lung. The highly liver metastatic RAW117-H10 subline showed the fastest stabilization to fibronectin, vitronectin, and RGD peptides. Poorly metastatic RAW117-P cells had stabilization times 3-10 times longer than for RAW117-H10 cells, while the lung- and liver-metastatic RAW117-L17 subline failed to stabilize at all. The adhesion stabilization of the RAW117-H10 cells to the extracellular matrix proteins and RGD peptides was inhibited by anti-beta(3) integrin monoclonal antibodies and RGD peptides. In contrast, the RAW117-L17 subline had the shortest stabilization time to unstimulated microvascular endothelial cells of the lung and hepatic sinusoids, followed by RAW117-H10 cells and RAW117-P cells. Monoclonal antibodies against the beta(3) integrin subunit and RGD peptides did not inhibit adhesion stabilization of RAW117-H10 cells to endothelial cells, suggesting that different metastatic variants of large-cell lymphoma cells use differing mechanisms to adhere to organ-specific endothelial cells.
Collapse
|
119
|
Benner JS, Smith TW, Petrilla AA, Klingman D, Goel S, Tang SSK, Wong ND. Estimated prevalence of uncontrolled hypertension and multiple cardiovascular risk factors and their associated risk of coronary heart disease in the United States. ACTA ACUST UNITED AC 2012; 2:44-53. [PMID: 20409884 DOI: 10.1016/j.jash.2007.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 07/03/2007] [Accepted: 07/10/2007] [Indexed: 01/26/2023]
Abstract
This study determined the prevalence of primary prevention patients aged 40 to 79 years with uncontrolled hypertension (HTN) and low/moderate cholesterol levels, and the clinical and economic consequences of their cardiovascular risk levels stratified by additional cardiovascular risk factors. Prevalence was estimated from the 1999 to 2002 National Health and Nutrition Examination Survey (NHANES) datasets. Framingham risk equations were used to calculate the 4-year risk of coronary heart disease (CHD). HTN and cholesterol levels were then statistically "controlled" to ideal levels and risks were recalculated. Prevalence of uncontrolled hypertension was 15.2 million cases (13.7%). Of those, 12.9 million (84.8%) had low/moderate cholesterol levels, and 2.2 million (16.7%) had >/=3 additional risk factors with no history of CHD. Nearly 200,000 coronary events are expected to occur within 4 years, incurring over $2.5 billion in direct medical costs. Statistical estimation suggests that 64% of 4-year risk was attributable to uncontrolled blood pressure and lipids. The large number and high cost of CHD events expected to occur within the next 4 years in primary prevention patients with uncontrolled hypertension and >/=3 additional risk factors justifies aggressive screening to ensure that these patients are identified and properly managed.
Collapse
|
120
|
Yamada KA, Smith TW. Photodynamic therapy: shining new light on limiting the collateral damage of ablation? Heart Rhythm 2012; 9:1510-1. [PMID: 22642984 DOI: 10.1016/j.hrthm.2012.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Indexed: 11/30/2022]
|
121
|
Smith TW, Uchino BN, MacKenzie J, Hicks AM, Campo RA, Reblin M, Grewen KM, Amico JA, Light KC. Effects of couple interactions and relationship quality on plasma oxytocin and cardiovascular reactivity: empirical findings and methodological considerations. Int J Psychophysiol 2012; 88:271-81. [PMID: 22543270 DOI: 10.1016/j.ijpsycho.2012.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 03/26/2012] [Accepted: 04/18/2012] [Indexed: 11/25/2022]
Abstract
Cardiovascular reactivity is a potential mechanism underlying associations of close relationship quality with cardiovascular disease. Two models describe oxytocin as another mechanism. The "calm and connect" model posits an association between positive relationship experiences and oxytocin levels and responses, whereas the "tend and befriend" model emphasizes the effects of negative relationship experiences in evoking oxytocin release. In this study of 180 younger couples, relationship quality had a small, marginally significant inverse association with plasma oxytocin levels, and neither positive nor negative couple interactions evoked change in plasma oxytocin. Negative couple interactions evoked significant cardiovascular reactivity, especially among women. Hence, in the largest study of these issues to date, there was little support for key tenets of the "calm and connect" model, and only very modest support for the "tend and befriend" model. However, findings were consistent with the view that CVR contributes to the effects of relationship difficulties on health.
Collapse
|
122
|
Glazer Baron K, Gunn HE, Czajkowski LA, Smith TW, Jones CR. Spousal involvement in CPAP: does pressure help? J Clin Sleep Med 2012; 8:147-53. [PMID: 22505859 DOI: 10.5664/jcsm.1766] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Continuous positive airway pressure (CPAP) improves sleep and quality of life for both patients with obstructive sleep apnea (OSA) and their spouses. However, few studies have investigated spousal involvement in treatment adherence. Aims of this observational study were to assess perceptions of spousal involvement and evaluate associations between involvement and adherence. METHODS Spousal involvement in CPAP adherence was assessed in 23 married male OSA patients after the first week of treatment. At 3 months, 16 participants completed a second assessment of spousal involvement. Types of involvement assessed included positive (e.g., encouraging), negative (e.g., blaming), collaboration (e.g., working together), and one-sided (e.g., asking). An interpersonal measure of supportive behaviors was also administered at 3 months to evaluate the interpersonal qualities of spousal involvement types. Objective CPAP adherence data were available for 14 participants. RESULTS Average frequency of spousal involvement ratings were low for each involvement type and only negative spousal involvement frequency decreased at 3 month follow-up (p = 0.003). Perceptions of collaborative spousal involvement were associated with higher CPAP adherence at 3 months (r = 0.75, p = 0.002). Positive, negative and one-sided involvement were not associated with adherence. Collaborative spousal involvement was associated with moderately warm and controlling interpersonal behaviors (affiliation, r = 0.55, p = 0.03, dominance r = 0.47, p = 0.07). CONCLUSIONS Patients reported low frequency but consistent and diverse perceptions of spousal involvement in CPAP over the first 3 months of treatment. Perceptions of collaborative spousal involvement were the only type associated with adherence and represent moderately warm and controlling interpersonal behavior. Interventions to increase spousal collaboration in CPAP may improve adherence.
Collapse
|
123
|
Carlisle M, Uchino BN, Sanbonmatsu DM, Smith TW, Cribbet MR, Birmingham W, Light KC, Vaughn AA. Subliminal activation of social ties moderates cardiovascular reactivity during acute stress. Health Psychol 2012; 31:217-25. [PMID: 21842996 PMCID: PMC3241848 DOI: 10.1037/a0025187] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The quality of one's personal relationships has been reliably linked to important physical health outcomes, perhaps through the mechanism of physiological stress responses. Most studies of this mechanism have focused on whether more conscious interpersonal transactions influence cardiovascular reactivity. However, whether such relationships can be automatically activated in memory to influence physiological processes has not been determined. The primary aims of this study were to examine whether subliminal activation of relationships could influence health-relevant physiological processes and to examine this question in the context of a more general relationship model that incorporates both positive and negative dimensions. METHOD We randomly assigned participants to be subliminally primed with existing relationships that varied in their underlying positivity and negativity (i.e., indifferent, supportive, aversive, ambivalent). They then performed acute psychological stressors while cardiovascular and self-report measures were assessed. RESULTS Priming negative relationships was associated with greater threat, lower feelings of control, and higher diastolic blood pressure reactivity during stress. Moreover, priming relationships high in positivity and negativity (ambivalent ties) was associated with the highest heart rate reactivity and greatest respiratory sinus arrhythmia decreases during stress. Exploratory analyses during the priming task itself suggested that the effects of negative primes on biological measures were prevalent across tasks, whereas the links to ambivalent ties was specific to the subsequent stressor task. CONCLUSIONS These data highlight novel mechanisms by which social ties may impact cardiovascular health, and further suggest the importance of incorporating both positivity and negativity in the study of relationships and physical health.
Collapse
|
124
|
Jilcott SB, Whetstone LM, Wilkerson JR, Smith TW, Ammerman AS. A Community-Driven Approach to Identifying "Winnable" Policies Using the Centers for Disease Control and Prevention's Common Community Measures for Obesity Prevention. Prev Chronic Dis 2012. [DOI: 10.5888/pcd9.110195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
125
|
Smith TW, Birmingham W, Uchino BN. Evaluative threat and ambulatory blood pressure: cardiovascular effects of social stress in daily experience. Health Psychol 2012; 31:763-6. [PMID: 22251220 DOI: 10.1037/a0026947] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Physiological effects of social evaluation are central in models of psychosocial influences on physical health. Experimental manipulations of evaluative threat evoke substantial cardiovascular and neuroendocrine responses in laboratory studies, but only preliminary evidence is available regarding naturally occurring evaluative threats in daily life. In such nonexperimental ambulatory studies, it is essential to distinguish effects of evaluative threat from related constructs known to alter stress, such as ability perceptions and concerns about appearance. METHODS 94 married, working couples (mean age 29.2 years) completed a 1-day (8 a.m. to 10 p.m.) ambulatory blood pressure protocol with random interval-contingent measurements using a Suntech monitor and Palm Pilot-based measures of control variables and momentary experiences of social-evaluative threat, concerns about appearance, and perceived ability. RESULTS In hierarchical analyses for couples and multiple measurement occasions (Proc Mixed; SAS) and controlling individual differences (BMI, age, income) and potential confounds (e.g., posture, activity), higher reports of social-evaluative threat were associated with higher concurrent systolic (estimate = .87, SE = .34) and diastolic blood pressure (estimate = 1.06; SE = .26), both p < .02. Effects of social-evaluative threat remained significant when perceived ability and appearance concerns were controlled. CONCLUSIONS Naturally occurring social-evaluative threat during daily activity is associated with increased systolic and diastolic blood pressure. Given associations between ambulatory blood pressure and risk of cardiovascular disease, the findings support conceptual models of threats to the social self as a potentially important influence on physical health.
Collapse
|