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Kanbay M, Tanriover C, Copur S, Peltek IB, Mutlu A, Mallamaci F, Zoccali C. Social isolation and loneliness: Undervalued risk factors for disease states and mortality. Eur J Clin Invest 2023; 53:e14032. [PMID: 37218451 DOI: 10.1111/eci.14032] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/07/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023]
Abstract
Social isolation and loneliness are two common but undervalued conditions associated with a poor quality of life, decreased overall health and mortality. In this review, we aim to discuss the health consequences of social isolation and loneliness. We first provide the potential causes of these two conditions. Then, we explain the pathophysiological processes underlying the effects of social isolation and loneliness in disease states. Afterwards, we explain the important associations between these conditions and different non-communicable diseases, as well as the impact of social isolation and loneliness on health-related behaviours. Finally, we discuss the current and novel potential management strategies for these conditions. Healthcare professionals who attend to socially isolated and/or lonely patients should be fully competent in these conditions and assess their patients thoroughly to detect and properly understand the effects of isolation and loneliness. Patients should be offered education and treatment alternatives through shared decision-making. Future studies are needed to understand the underlying mechanisms better and to improve the treatment strategies for both social isolation and loneliness.
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Affiliation(s)
- Mehmet Kanbay
- Department of Medicine, Division of Nephrology, Koc University School of Medicine, Istanbul, Turkey
| | - Cem Tanriover
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sidar Copur
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ibrahim B Peltek
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Ali Mutlu
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Francesca Mallamaci
- Nephrology, Dialysis and Transplantation Unit Azienda Ospedaliera "Bianchi-Melacrino-Morelli" & CNR-IFC, Institute of Clinical Physiology, Research Unit of Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Carmine Zoccali
- Renal Research Institute, New York City, New York, USA
- Institute of Molecular Biology and Genetics (Biogem), Ariano Irpino, Italy and Associazione Ipertensione Nefrologia Trapianto Renal (IPNET), c/o Nefrologia, Grande Ospedale Metropolitano, Reggio Calabria, Italy
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Bosle C, Brenner H, Fischer JE, Jarczok MN, Schöttker B, Perna L, Hoffmann K, Herr RM. The association between supportive social ties and autonomic nervous system function—differences between family ties and friendship ties in a cohort of older adults. Eur J Ageing 2021; 19:263-276. [PMID: 35663910 PMCID: PMC9156582 DOI: 10.1007/s10433-021-00638-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2021] [Indexed: 11/26/2022] Open
Abstract
AbstractSupportive family and friendship ties can serve different functions and thus might show different associations with an individual’s health. Particularly, older adults might show varying health benefits of different types of supportive ties depending on their marital and retirement status. Our aim is to analyze relationships between different types of supportive social ties and autonomic nervous system (ANS) function, a physiological indicator of health that can help to establish the biological plausibility of the association—measured by heart rate variability (HRV). We present cross-sectional linear regression analyses of a German cohort of community-dwelling older adults (2008–2010; n = 1,548; mean age = 68.7 years). Our findings indicate that supportive friendship ties show significant positive associations (i.e., higher HRV) in individuals that are either not married or above retirement age. Supportive family ties show significant positive associations in individuals below retirement age. Significant results vanish or are reduced after accounting for behavioral/physical and psychological/cognitive indicators. We conclude that programs supporting the development or maintenance of friendship ties might be especially beneficial in unmarried older adults and adults above retirement age.
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Affiliation(s)
- Catherin Bosle
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Joachim E. Fischer
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Marc N. Jarczok
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, Ulm, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Laura Perna
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Kristina Hoffmann
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Raphael M. Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany
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Han SC, Baucom B, Timmons AC, Margolin G. A Systematic Review of Respiratory Sinus Arrhythmia in Romantic Relationships. FAMILY PROCESS 2021; 60:441-456. [PMID: 33724463 PMCID: PMC8406683 DOI: 10.1111/famp.12644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Respiratory sinus arrhythmia (RSA), an index of the parasympathetic nervous system, has recently gained attention as a physiological component of regulatory processes, social connectedness, and health. Within the context of romantic relationships, studies have operationalized and conceptualized RSA in disparate ways, obscuring a clear pattern of findings. This systematic review synthesizes the rapidly developing literature and clarifies the role of RSA in romantic relationships. We evaluate support for three conceptual hypotheses: (1) resting baseline RSA is associated with better quality relationships; (2) phasic RSA is reflective of changes in threat and connection during couple interactions; and (3) physiological linkage in RSA between romantic partners relates to positive or negative relationship functioning depending on the nature of the linkage (e.g., in-phase vs. antiphase). We identified 26 empirical studies that tested associations between RSA and an index of romantic relationships (i.e., relationship satisfaction). Our findings show that higher RSA is not uniformly "good" for relationships. Higher resting baseline RSA was contemporaneously associated with better quality relationships, yet higher baseline RSA was also unexpectedly associated with relationship violence. Short-term decreases in RSA were found during relationship conflict, though the opposite-phasic increases in RSA during positive romantic partner interactions-was not found due to mixed empirical support. As expected, evidence for RSA linkage was found, though the connection between linkage and relationship functioning depends on the context in which it was measured. We discuss methodological limitations and directions for future research.
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Quadt L, Esposito G, Critchley HD, Garfinkel SN. Brain-body interactions underlying the association of loneliness with mental and physical health. Neurosci Biobehav Rev 2020; 116:283-300. [DOI: 10.1016/j.neubiorev.2020.06.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/31/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022]
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Li H, Xia N. The role of oxidative stress in cardiovascular disease caused by social isolation and loneliness. Redox Biol 2020; 37:101585. [PMID: 32709420 PMCID: PMC7767744 DOI: 10.1016/j.redox.2020.101585] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023] Open
Abstract
Loneliness and social isolation are common sources of chronic stress in modern society. Epidemiological studies have demonstrated that loneliness and social isolation increase mortality risk as much as smoking or alcohol consumption and more than physical inactivity or obesity. Loneliness in human is associated with higher blood pressure whereas enhanced atherosclerosis is observed in animal models of social isolation. Loneliness and social isolation lead to activation of the hypothalamic-pituitary-adrenocortical (HPA) axis, enhanced sympathetic nerve activity, impaired parasympathetic function and a proinflammatory immune response. These mechanisms have been implicated in the development of cardiovascular disease conferred by social isolation although a causal relationship has not been established so far. There is evidence that oxidative stress is likely to be a key molecular mechanism linking chronic psychosocial stress to cardiovascular disease. NADPH oxidase-mediated oxidative stress in the hypothalamus has been shown to be required for social isolation-induced HPA axis activation in socially isolated rats. Oxidative stress in the rostral ventrolateral medulla is also a key regulator of sympathetic nerve activity. In the vasculature, oxidative stress increases vascular tone and promote atherogenesis through multiple mechanisms. Thus, preventing oxidative stress may represent a therapeutic strategy to reduce the detrimental effects of social stress on health.
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Affiliation(s)
- Huige Li
- Department of Pharmacology, Johannes Gutenberg University Medical Center, 55131, Mainz, Germany.
| | - Ning Xia
- Department of Pharmacology, Johannes Gutenberg University Medical Center, 55131, Mainz, Germany.
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Laborde S, Mosley E, Mertgen A. A unifying conceptual framework of factors associated to cardiac vagal control. Heliyon 2018; 4:e01002. [PMID: 30623126 PMCID: PMC6313821 DOI: 10.1016/j.heliyon.2018.e01002] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/20/2018] [Accepted: 11/29/2018] [Indexed: 11/30/2022] Open
Abstract
Cardiac vagal control (CVC) reflects the activity of the vagus nerve regulating cardiac functioning. CVC can be inferred via heart rate variability measurement, and it has been positively associated to a broad range of cognitive, emotional, social, and health outcomes. It could then be considered as an indicator for effective self-regulation, and given this role, one should understand the factors increasing and decreasing CVC. The aim of this paper is to review the broad range of factors influencing CVC, and to provide a unifying conceptual framework to integrate comprehensively those factors. The structure of the unifying conceptual framework is based on the theory of ecological rationality, while its functional aspects are based on the neurovisceral integration model. The structure of this framework distinguishes two broad areas of associations: person and environment, as this reflects adequately the role played by CVC regarding adaptation. The added value of this framework lies at different levels: theoretically, it allows integrating findings from a variety of scientific disciplines and refining the predictions of the neurovisceral integration model; methodologically, it helps identifying factors that increase and decrease CVC; and lastly at the applied level, it can play an important role for society regarding health policies and for the individual to empower one's flourishing.
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Affiliation(s)
- Sylvain Laborde
- German Sport University Cologne, Institute of Psychology, Department of Performance Psychology, Germany.,Normandie Université Caen, UFR STAPS, EA 4260, Germany
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Abstract
SIGNIFICANCE Social and demographic changes have led to an increased prevalence of loneliness and social isolation in modern society. Recent Advances: Population-based studies have demonstrated that both objective social isolation and the perception of social isolation (loneliness) are correlated with a higher risk of mortality and that both are clearly risk factors for cardiovascular disease (CVD). Lonely individuals have increased peripheral vascular resistance and elevated blood pressure. Socially isolated animals develop more atherosclerosis than those housed in groups. CRITICAL ISSUES Molecular mechanisms responsible for the increased cardiovascular risk are poorly understood. In recent reports, loneliness and social stress were associated with activation of the hypothalamic-pituitary-adrenocortical axis and the sympathetic nervous system. Repeated and chronic social stress leads to glucocorticoid resistance, enhanced myelopoiesis, upregulated proinflammatory gene expression, and oxidative stress. However, the causal role of these mechanisms in the development of loneliness-associated CVD remains unclear. FUTURE DIRECTIONS Elucidation of the molecular mechanisms of how CVD is induced by loneliness and social isolation requires additional studies. Understanding of the pathomechanisms is essential for the development of therapeutic strategies to prevent the detrimental effects of social stress on health. Antioxid. Redox Signal. 28, 837-851.
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Affiliation(s)
- Ning Xia
- 1 Department of Pharmacology, Johannes Gutenberg University Medical Center , Mainz, Germany
| | - Huige Li
- 1 Department of Pharmacology, Johannes Gutenberg University Medical Center , Mainz, Germany .,2 Center for Translational Vascular Biology (CTVB), Johannes Gutenberg University Medical Center , Mainz, Germany .,3 German Center for Cardiovascular Research (DZHK) , Partner Site Rhine-Main, Mainz, Germany
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Sarlon J, Plaszczyk S, Engel S, Oertel-Knöchel V. Electrophysiological parameters as biomarkers for psychiatry: Intra-individual variability and influencing factors. Int J Psychophysiol 2017; 123:42-47. [PMID: 29155050 DOI: 10.1016/j.ijpsycho.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 10/21/2017] [Accepted: 11/15/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Jan Sarlon
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; Psychiatric Hospital, Oberbergkliniken, Oberberg 1, 78132 Hornberg, Germany.
| | - Simone Plaszczyk
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
| | - Sinah Engel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany; Department of Neurology, University of Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Viola Oertel-Knöchel
- Laboratory for Neuroimaging, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Goethe University, Heinrich-Hoffmann-Str. 10, 60528 Frankfurt am Main, Germany
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Doucerain MM, Deschênes SS, Aubé K, Ryder AG, Gouin JP. Respiratory Sinus Arrhythmia Is Prospectively Associated With Early Trajectories of Acculturation Among New International Students. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2016. [DOI: 10.1177/0022022115624015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Respiratory sinus arrhythmia (RSA) is a marker of parasympathetic activity hypothesized to index a neurophysiological system supporting social engagement behaviors. Following migration, people must navigate and adapt to a new sociocultural environment. Whether RSA affects this psychological acculturation process is unknown. This longitudinal study investigated whether resting RSA on arrival in the receiving country was related to changes in cultural orientations toward both mainstream and heritage cultural groups during the first 5 months following migration. Sixty new international students provided information on their cultural orientations toward the mainstream and heritage cultural groups shortly after arrival in the new country and 2 and 5 months after the first assessment. Results indicated that both heritage and mainstream orientations increased linearly over time. Furthermore, greater resting RSA at baseline was prospectively associated with larger increases in positive orientation toward the mainstream culture but not the heritage culture, over and above individual differences in extraversion, depression, and anxiety. These data provide longitudinal evidence that higher RSA promotes an approach-oriented stance toward a novel cultural environment.
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Affiliation(s)
| | | | - Karine Aubé
- Concordia University, Montreal, Quebec, Canada
| | - Andrew G. Ryder
- Concordia University, Montreal, Quebec, Canada
- Jewish General Hospital, Montreal, Quebec, Canada
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Social integration prospectively predicts changes in heart rate variability among individuals undergoing migration stress. Ann Behav Med 2015; 49:230-8. [PMID: 25212509 DOI: 10.1007/s12160-014-9650-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Poor social integration increases risk for poor health. The psychobiological pathways underlying this effect are not well-understood. PURPOSE This study utilized a migration stress model to prospectively investigate the impact of social integration on change in high-frequency heart rate variability (HF-HRV), a marker of autonomic functioning. METHODS Sixty new international students were recruited shortly after their arrival in the host country and assessed 2 and 5 months later. At each assessment period, participants provided information on social integration and loneliness and had their resting HF-HRV evaluated. RESULTS There was an overall decrease in HF-HRV over time. The magnitude of the within-person and between-person effects of social integration on HRV increased over time, such that greater social integration was associated with higher HF-HRV at later follow-ups. CONCLUSIONS These results suggest that altered autonomic functioning might represent a key pathway linking social integration to health outcomes.
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Lammintausta A, Airaksinen JKE, Immonen-Räihä P, Torppa J, Kesäniemi AY, Ketonen M, Koukkunen H, Kärjä-Koskenkari P, Lehto S, Salomaa V. Prognosis of acute coronary events is worse in patients living alone: the FINAMI myocardial infarction register. Eur J Prev Cardiol 2013; 21:989-96. [DOI: 10.1177/2047487313475893] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 01/07/2013] [Indexed: 01/21/2023]
Affiliation(s)
| | | | | | - Jorma Torppa
- National Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Heli Koukkunen
- University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Kuopio, Finland
| | | | | | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
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Maunder RG, Nolan RP, Hunter JJ, Lancee WJ, Steinhart AH, Greenberg GR. Relationship between social support and autonomic function during a stress protocol in ulcerative colitis patients in remission. Inflamm Bowel Dis 2012; 18:737-42. [PMID: 21688349 DOI: 10.1002/ibd.21794] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Accepted: 05/16/2011] [Indexed: 12/09/2022]
Abstract
BACKGROUND The relationship of psychological stress to relapse in ulcerative colitis (UC) is inconsistent. This may be due to a failure to identify patient characteristics, such as social support, which moderate the transduction of stress from the central nervous system to the immune system. In this study we tested the hypothesis that social support enhances parasympathetic modulation of heart rate in UC. METHODS An indirect measure of autonomic function (heart rate variability; HRV) was measured in 108 patients with UC in remission during a standard protocol involving periods of stress, paced breathing, and relaxation. Social support was measured with the Social Support Questionnaire. RESULTS After controlling for age, which is strongly related to HRV, both satisfaction with social support (F = 5.7, significance = 0.002) and its interaction with age (F = 7.8, significance <0.001) were associated with high-frequency HRV, which measures parasympathetic modulation of heart rate. Social support was associated with higher levels of high-frequency HRV at almost all points in the stress protocol. Neither age nor social support was associated with differences in the LF/HF ratio, which measures sympathetic modulation of heart rate. CONCLUSIONS Social support is related to parasympathetic activity in UC. Given previous evidence of an antiinflammatory role for the parasympathetic nervous system, this suggests that autonomic function could serve as a mediating link between social support and reduced inflammatory activity.
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Affiliation(s)
- R G Maunder
- Department of Psychiatry, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
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Stein KV, Rieder A, Dorner TE. East-West gradient in cardio-vascular mortality in Austria: how much can we explain by following the pattern of risk factors? Int J Health Geogr 2011; 10:59. [PMID: 22082341 PMCID: PMC3231809 DOI: 10.1186/1476-072x-10-59] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Accepted: 11/14/2011] [Indexed: 11/25/2022] Open
Abstract
Background Various studies show major regional differences in the prevalence of cardio-vascular disease morbidity and mortality, both in Europe and within European countries. In Austria, these differences are documented by an East-West gradient with declining morbidity and mortality rates when moving from the East to the West of the country. It was the aim of this study to analyse if, and to what extent, socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of this East-West gradient by conducting secondary analyses of an existing Austrian health dataset. Results The data were analysed using bivariate analyses, as well as univariate and multivariate logistic regression models. These analyses revealed significant East-West gradients for various risk factors, as well as socio-demographic and socio-economic health determinants. There was a gradual decrease of hypertension, diabetes mellitus, obesity, and psycho-social discomfort in both sexes, with the highest prevalences in those Austrian regions with the highest cardio-vascular mortality and a stepwise decrease to the regions with the lowest cardio-vascular mortality. Controlling for educational level significantly raised the odds for diabetes, hypertension and obesity. In the results of the multivariate analyses, factors that significantly and independently predicted diabetes mellitus were geographic location, psycho-social discomfort, lack of physical exercise, and age in both sexes. For women these factors additionally included a low educational level, lack of social support, and being born abroad. Conclusions Our study shows a clear gradual decline of cardio-vascular mortality and some of its risk factors from East to West in Austria. Concerning these risk factors, the geographic region and psycho-social discomfort showed the greatest association with diabetes mellitus, hypertension, and obesity. Hence, they contribute to the explanation of the variance in spatial cardio-vascular disease mortality. Yet, a large proportion of this variance remains unexplained. It would be of great importance to public health and preventive measures to take a closer look at spatial differences in cardio-vascular disease morbidity and mortality to better tailor programmes to the regional environments and settings. Our results also call for a greater importance of preventative measures for psycho-social discomfort and increase of social support.
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Affiliation(s)
- Katharina V Stein
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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Cardiac vagal control in nonmedicated depressed women and nondepressed controls: impact of depression status, lifetime trauma history, and respiratory factors. Psychosom Med 2011; 73:336-43. [PMID: 21364194 PMCID: PMC3090496 DOI: 10.1097/psy.0b013e318213925d] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of acute stress and relationship-focused imagery on cardiac vagal control, as indicated by levels of respiratory sinus arrhythmia (RSA), in depressed and nondepressed women. Impairment in cardiac parasympathetic (vagal) control may confer risk for cardiac mortality in depressed populations. METHODS Electrocardiogram and respiratory rate were evaluated in 15 nonmedicated depressed women and 15 matched controls during two laboratory conditions: 1) a relationship-focused imagery designed to elicit vagal activation; and 2) a speech stressor designed to evoke vagal withdrawal. RESULTS As expected, the relationship-focused imagery increased RSA (F(3,66) = 3.79, p = .02) and the speech stressor decreased RSA (F(3,66) = 4.36, p = .02) across women. Depressed women exhibited lower RSA during the relationship-focused imagery, and this effect remained after control for respiratory rate and trauma history (F(1,21) = 5.65, p = .027). Depressed women with a trauma history exhibited the lowest RSA during the stress condition (F(1,22) = 9.61, p = .05). However, after controlling for respiratory rate, Trauma History × Task Order (p = .02) but not Trauma History × Depression Group (p = .12) accounted for RSA variation during the stress condition. CONCLUSION Depression in women is associated with lower RSA, particularly when women reflect on a close love relationship, a context expected to elicit vagal activation and hence increase RSA. In contrast, depression-related variation in stressor-evoked vagal activity seems to covary with women's trauma history. Associations between vagal activity and depression are complex and should be considered in view of the experimental conditions under which vagal control is assessed, as well as physiological and behavioral factors that may affect vagal function.
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The mosaic of CVD risk factors – A study on 10,000 Pakistani cardiac
patients. Glob Heart 2011. [DOI: 10.1016/j.cvdpc.2010.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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