Cardiovascular Response to Interpersonal Provocation and Mental Arithmetic among High and Low Hostile Young Adult Males

Blood pressure responses of defensive hostile women when facing a real stress task

OBJECTIVE

This study investigated the importance of the combination of the hostility and defensiveness variables as psychosocial factors that predict the risk of cardiovascular dysfunction. We examined the impact of a stressful situation on blood pressure responses, using a continuous psychophysiological assessment approach.

DESIGN

We measured the evolution of these responses over three experimental phases (adaptation, task and recovery), also considering a minute-by-minute analysis within each phase.

MAIN OUTCOME MEASURES

We used the Cook-Medley Hostility Scale and the Social Desirability Questionnaire to form four groups (high hostility and high defensiveness, high hostility and low defensiveness, low hostility and high defensiveness, and low hostility and low defensiveness).

RESULTS

We expected the group of hostile defensive women to record higher activation (task phase: an academic exam) and slower habituation (recovery phase) compared to the other groups. The results confirmed our hypothesis, as the profile of the hostile defensive individuals was one of constant or sensitization during the task phase, while during the recovery phase those individuals underwent a slow recovery.

CONCLUSION

Therefore, it can be indicated that the low hostility and low defensive group is the most adaptive, as recorded very little activation in response, and rapid recovery.

Effect of orthostatic hypotension on sustained attention in patients with autonomic failure

INTRODUCTION

Orthostatic hypotension has been associated with impaired cognitive function, but cognitive function during orthostatic hypotension has hardly been studied. We studied the effect of orthostatic hypotension, induced by head-up tilt (HUT), on sustained attention in patients with autonomic failure.

METHODS

We studied the sustained attention to response task (SART) in the supine position and during HUT in 10 patients with autonomic failure and 10 age-matched and sex-matched controls. To avoid syncope, the tilting angle was tailored to patients to reach a stable systolic blood pressure below 100 mm Hg. Controls were all tilted at an angle of 60°. Cerebral blood flow velocity, blood pressure and heart rate were measured continuously.

RESULTS

In patients, systolic blood pressure was 61.4 mm Hg lower during HUT than in the supine position (p<0.001). Patients did not make more SART errors during HUT than in the supine position (-1.3 errors, p=0.3). Controls made 2.3 fewer errors during SART in the HUT position compared to the supine position (p=0.020). SART performance led to an increase in systolic blood pressure (+11.8 mm Hg, p=0.018) and diastolic blood pressure (+5.8 mm Hg, p=0.017) during SART in the HUT position, as well as to a trend towards increased cerebral blood flow velocity (+3.8 m/s, p=0.101).

DISCUSSION

Orthostatic hypotension in patients with autonomic failure was not associated with impaired sustained attention. This might partly be explained by the observation that SART performance led to a blood pressure increase. Moreover, the upright position was associated with better performance in controls and, to a lesser extent, also in patients.

Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors

AIMS

Estimated central systolic blood pressure (cSBP) and amplification (Brachial SBP-cSBP) are non-invasive measures potentially prognostic of cardiovascular (CV) disease. No worldwide, multiple-device reference values are available. We aimed to establish reference values for a worldwide general population standardizing between the different available methods of measurement. How these values were significantly altered by cardiovascular risk factors (CVRFs) was then investigated.

METHODS AND RESULTS

Existing data from population surveys and clinical trials were combined, whether published or not. Reference values of cSBP and amplification were calculated as percentiles for 'Normal' (no CVRFs) and 'Reference' (any CVRFs) populations. We included 45,436 subjects out of 82,930 that were gathered from 77 studies of 53 centres. Included subjects were apparently healthy, not treated for hypertension or dyslipidaemia, and free from overt CV disease and diabetes. Values of cSBP and amplification were stratified by brachial blood pressure categories and age decade in turn, both being stratified by sex. Amplification decreased with age and more so in males than in females. Sex was the most powerful factor associated with amplification with 6.6 mmHg (5.8-7.4) higher amplification in males than in females. Amplification was marginally but significantly influenced by CVRFs, with smoking and dyslipidaemia decreasing amplification, but increased with increasing levels of blood glucose.

CONCLUSION

Typical values of cSBP and amplification in a healthy population and a population free of traditional CVRFs are now available according to age, sex, and brachial BP, providing values included from different devices with a wide geographical representation. Amplification is significantly influenced by CVRFs, but differently in men and women.

Mental health outcomes in emerging adults exposed to childhood maltreatment: the moderating role of stress reactivity

Childhood maltreatment is an established risk factor for varying configurations of psychological problems in emerging adulthood. The current study tested associations between childhood maltreatment, cortisol reactivity, and current mental health symptoms in emerging adulthood. Eighty-eight participants (aged 18-22) completed measures of childhood maltreatment and current internalizing and externalizing symptoms and participated in a 10-min conflict role-play task. Salivary cortisol was sampled throughout the task, and a residualized change score between baseline and peak time points was computed to capture reactivity. Results from robust regression analyses indicated that cortisol reactivity moderated the association between childhood maltreatment and mental health symptoms as hypothesized. Childhood maltreatment was related to greater internalizing problems among participants with higher cortisol reactivity, whereas maltreatment was associated with greater externalizing problems among participants who exhibited lower cortisol reactivity. Results suggest that patterns of cortisol reactivity in emerging adulthood may help elucidate mental health outcomes associated with childhood maltreatment.

Hostile behavior links negative childhood family relationships to heart rate reactivity and recovery in young adulthood

Prior research has demonstrated that vulnerability to stress is influenced by early life experiences. This study evaluates the impact of negative childhood family relationships on cardiovascular stress reactivity in young adulthood. Participants (age 18-22) from families characterized by negative (n=39) or positive relationships (n=36) engaged in a role-play conflict task. Hostile/aggressive verbal behaviors during the task were observed, and blood pressure (BP) and heart rate (HR) responses were measured before, during, and after the task. Participants from negative families engaged in more hostile/aggressive verbal behavior during the task and showed attenuated HR reactivity. Hostile/aggressive verbal behavior predicted attenuated HR reactivity and recovery. Path analyses linked negative family relationships to more hostile verbal behavior during the task, and attenuated HR reactivity and recovery. These results support the development of hostile/aggressive behavior in social situations as a pathway linking childhood adversity to stress vulnerability across the lifespan.

The influence of forgiveness and apology on cardiovascular reactivity and recovery in response to mental stress

To investigate the relation between forgiveness and apology as they relate to cardiovascular reactivity and recovery, 29 men and 50 women were exposed to an interpersonal transgression (i.e., verbal harassment) while performing a serial subtraction task. Participants were categorized into high and low forgiveness groups based on scores on the forgiving personality scale. Following the task, approximately half of the participants received an apology from the experimenter for his/her comments during the task. Although no group differences in cardiovascular reactivity were observed during the serial subtraction task, persons high in forgiveness displayed more rapid diastolic and mean arterial blood pressure recovery than persons low in forgiveness. In response to the apology, participants displayed greater high frequency heart rate variability recovery compared to those who did not receive an apology. A significant apology x sex interaction was observed for diastolic blood pressure and mean arterial blood pressure. Women who received an apology exhibited faster recovery from the transgression than women who did not receive an apology. In contrast, men who received an apology exhibited delayed recovery from the transgression compared to men who did not receive an apology. These results indicate that there are potentially healthful benefits to forgiveness and apology, but the relation is influenced by situation and by sex.