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Arcidiacono DM, Machia LV, Lefferts WK, Wolf DA, Heffernan KS. Social isolation and subclinical vascular pathways to cerebrovascular disease. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2023; 68:14-31. [PMID: 36825786 PMCID: PMC10275295 DOI: 10.1080/19485565.2023.2182274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Social isolation and lack of social support are risk factors for cardiovascular and cerebrovascular disease (CVD). This study explored the relationship between measures of social support and subclinical measures of CVD risk. 58 healthy adults ages 18 to 85 years participated in this study. The Berkman-Syme Social Network Inventory (SNI) was used to assess social isolation, with higher scores signifying less isolation. Social support was defined using the 12-Item Interpersonal Support Evaluation List (ISEL-12) with a higher score signifying higher social support. Subclinical CVD measures included carotid-femoral pulse wave velocity (cfPWV), carotid beta-stiffness index, and middle cerebral artery (MCA) pulsatility index. Path analysis models for both the SNI and ISEL appraisal domain predicting cfPWV and cerebrovascular pulsatility fit the data well. Path analyses showed significant direct paths from the SNI (β = -.363, t = -2.91) and ISEL appraisal domain (β = -.264, t = -2.05) to cfPWV. From cfPWV, both models revealed significant direct paths to carotid stiffness (β = .488, t = 4.18) to carotid pulse pressure (β = .311, t = 2.45) to MCA pulsatility (β = .527, t = 4.64). Social isolation and appraisal of social support are related to unfavorably higher aortic stiffness, with subsequent detrimental effects on cerebrovascular hemodynamic pulsatility.
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Affiliation(s)
| | - Laura V. Machia
- Department of Psychology and the Syracuse University, Syracuse New York
| | - Wesley K. Lefferts
- Department of Exercise Science, Syracuse University, Syracuse New York
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | - Douglas A. Wolf
- Department of The Aging Studies Institute and the Center for Aging and Policy Studies, Syracuse University, Syracuse New York
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Uchino BN, Baucom BRW, Landvatter J, de Grey RGK, Tacana T, Flores M, Ruiz JM. Perceived social support and ambulatory blood pressure during daily life: a meta-analysis. J Behav Med 2022; 45:509-517. [PMID: 35034219 PMCID: PMC9283536 DOI: 10.1007/s10865-021-00273-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 12/11/2021] [Indexed: 11/27/2022]
Abstract
Perceived social support has been linked to lower rates of morbidity and mortality. However, more information is needed on the biological mechanisms potentially responsible for such links. The main aim of this paper was to conduct a meta-analytic review of the association between perceived social support and awake ambulatory blood pressure (ABP) which is linked to cardiovascular morbidity and mortality. The review identified 12 studies with a total of 3254 participants. The omnibus meta-analysis showed that higher perceived social support was not significantly related to lower ABP (Zr = -0.052, [ -0.11, 0.01]). In addition, there was evidence of significant bias across several indicators. Future research will be needed to explore the boundary conditions linking social support to ABP and its implications for theoretical models and intervention development.
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Affiliation(s)
- Bert N Uchino
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA.
| | - Brian R W Baucom
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Joshua Landvatter
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Robert G Kent de Grey
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Tracey Tacana
- Department of Psychology and Health Psychology Program, University of Utah, Salt Lake City, UT, 84112, USA
| | - Melissa Flores
- Department of Psychology, University of Arizona, Tucson, AZ, 85721, USA
| | - John M Ruiz
- Department of Psychology, University of Arizona, Tucson, AZ, 85721, USA
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Landvatter JD, Uchino BN, Smith TW, Bosch JA. Partner's Perceived Social Support Influences Their Spouse's Inflammation: An Actor-Partner Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020799. [PMID: 35055620 PMCID: PMC8776087 DOI: 10.3390/ijerph19020799] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 02/04/2023]
Abstract
Social support has been linked to lower cardiovascular morbidity and mortality. However, most studies have examined perceived support as an intrapersonal construct. A dyadic approach to social support highlights how interdependence between individuals within relationships, including partner perceptions and interactions, can influence one's health. This study's overall purpose was to test actor-partner models linking perceived social support to inflammation. Ninety-four cisgender married couples completed perceived support measures and had their blood drawn for CRP and IL-6 to produce an overall inflammatory index. The primary results indicate that only a partner's level of perceived support was related to lower inflammation in their spouse. Our sample size, although moderate for inflammatory studies, was probably not large enough to detect actor influences. These data highlight the importance of taking a dyadic perspective on modeling perceived support and its potential mechanism.
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Hosseini Z, Safari A, Khan NA, Veenstra G, Conklin AI. Gender Differences in the Role of Social Support for Hypertension Prevention in Canada: A Population-Based Cross-Sectional Study of the Canadian Longitudinal Study on Aging Cohort. CJC Open 2021; 3:S62-S70. [PMID: 34993435 PMCID: PMC8712674 DOI: 10.1016/j.cjco.2021.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/12/2021] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The relationship between social support and hypertension is poorly understood in women and men. We investigated whether multiple measures of social support are linked to blood pressure levels differentially by gender. METHODS Cross-sectional study of 28,779 middle-age and older-age adults (45-85 years) in the baseline Canadian Longitudinal Study on Aging comprehensive cohort. Stratified multivariable regression models estimated the role and relative contribution of 4 types of support to blood pressure in women and men. RESULTS The highest levels of perceived availability of informational, tangible, emotional, and belonging support were significantly associated with the lowest mean level of systolic blood pressure (SBP) but not diastolic blood pressure, independent of known confounders and other support types. However, associations were small, and their directions were more consistent in women. The lowest levels of informational support, relative to the highest, were associated with higher odds of hypertension in women (odds ratio [OR] = 1.20 [95% confidence interval {CI}: 1.06, 1.36]), more so than in men (OR = 1.16 [95% CI: 1.03, 1.32]). The lowest levels of emotional support were similarly associated with the odds of hypertension (OR = 1.08 [95% CI: 1.00, 1.17] in women and OR = 1.08 [95% CI: 1.00, 1.15] in men), relative to the highest. Larger differences in mean SBP in women, compared with men, were seen for informational support (2.43 and 1.18 mm Hg, respectively) and emotional support (1.60 and 0.74 mm Hg, respectively). Findings were unaltered by sensitivity analyses. CONCLUSIONS Informational and emotional support were inversely associated with SBP, more so in women than men. Further longitudinal investigation is warranted, as results suggest that specific supports may help prevent hypertension and lower cardiovascular risk, especially in women.
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Affiliation(s)
- Zeinab Hosseini
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Abdollah Safari
- Data, Analytics, Statistics and Informatics (DASI), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nadia A. Khan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Gerry Veenstra
- Department of Sociology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Annalijn I. Conklin
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences (CHÉOS), St. Paul’s Hospital, Vancouver, British Columbia, Canada
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Otto AK, Soriano EC, Birmingham WC, Vadaparampil ST, Heyman RE, Ellington L, Reblin M. Impact of Relationship and Communication Variables on Ambulatory Blood Pressure in Advanced Cancer Caregivers. Ann Behav Med 2021; 56:405-413. [PMID: 34244701 DOI: 10.1093/abm/kaab057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Cancer impacts both patients and their family caregivers. Evidence suggests that caregiving stress, including the strain of taking on a new role, can elevate the risk of numerous health conditions, including high blood pressure (BP). However, the caregiver's psychosocial experiences, including their interpersonal relationship with the patient, may buffer some of the negative physiological consequences of caregiving. PURPOSE To examine the influence of psychosocial contextual variables on caregiver ambulatory BP. METHODS Participants were 81 spouse-caregivers of patients with advanced gastrointestinal or thoracic cancer. For an entire day at home with the patient, caregivers wore an ambulatory BP monitor that took readings at random intervals. Immediately after each BP reading, caregivers reported on physical circumstances (e.g., posture, activity) and psychosocial experiences since the last BP measurement, including affect, caregiver and patient disclosure, and role perceptions (i.e., feeling more like a spouse vs. caregiver). Multilevel modeling was used to examine concurrent and lagged effects of psychosocial variables on systolic and diastolic BP, controlling for momentary posture, activity, negative affect, and time. RESULTS Feeling more like a caregiver (vs. spouse) was associated with lower systolic BP at the same time point. Patient disclosure to the caregiver since the previous BP reading was associated with higher diastolic BP. No lagged effects were statistically significant. CONCLUSIONS Caregivers' psychosocial experiences can have immediate physiological effects. Future research should examine possible cognitive and behavioral mechanisms of these effects, as well as longer-term effects of caregiver role perceptions and patient disclosure on caregiver psychological and physical health.
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Affiliation(s)
- Amy K Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Emily C Soriano
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | | | - Susan T Vadaparampil
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Richard E Heyman
- Family Translational Research Group, New York University, New York, NY, USA
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.,College of Medicine, University of Vermont, Burlington, VT, USA
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Xi X, Lu Q, Lu M, Xu A, Hu H, Ung COL. Evaluation of the association between presenteeism and perceived availability of social support among hospital doctors in Zhejiang, China. BMC Health Serv Res 2020; 20:609. [PMID: 32616033 PMCID: PMC7331165 DOI: 10.1186/s12913-020-05438-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022] Open
Abstract
Background This study investigated the association between presenteeism and the perceived availability of social support among hospital doctors in China. Methods A questionnaire was administered by doctors randomly selected from 13 hospital in Hangzhou China using stratified sampling. Logit model was used for data analysis. Results The overall response rate was 88.16%. Among hospital doctors, for each unit increase of the perceived availability of social support, the prevalence of presenteeism was decreased by 8.3% (OR = 0.91, P = 0.000). In particular, if the doctors perceived availability of appraisal support, belonging support and tangible support as sufficient, the act of presenteeism was reduced by 20.2% (OR = 0.806, P = 0.000) 20.4% (OR = 0.803, P = 0.000) and 21.0% (OR = 0.799, P = 0.000) respectively with statistical differences. Conclusion In China, appraisal support, belonging support and tangible support, compared to other social support, had a stronger negative correlation with presenteeism among hospital doctors. The benefits of social support in alleviating doctors’ presenteeism warrant further investigation.
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Affiliation(s)
- Xiaoyu Xi
- The Research Center of National Drug Policy& Ecosystem, China Pharmaceutical University, Nanjing, China
| | - Qianni Lu
- The Research Center of National Drug Policy& Ecosystem, China Pharmaceutical University, Nanjing, China
| | - Mengqing Lu
- The Research Center of National Drug Policy& Ecosystem, China Pharmaceutical University, Nanjing, China
| | - Ailin Xu
- The Research Center of National Drug Policy& Ecosystem, China Pharmaceutical University, Nanjing, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China.
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Creaven AM, Higgins NM, Ginty AT, Gallagher S. Social support, social participation, and cardiovascular reactivity to stress in the Midlife in the United States (MIDUS) study. Biol Psychol 2020; 155:107921. [PMID: 32598908 DOI: 10.1016/j.biopsycho.2020.107921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/21/2022]
Abstract
This study tested two hypotheses of associations between dimensions of social connectedness and cardiovascular reactivity to acute stress: (1) high social support predicts diminished cardiovascular responses to stress (i.e., the stress-buffering model of social support), and (2) diminished cardiovascular responses predict lower social participation, a form of motivated behaviour. Participants (N = 606) in the main Midlife in the United States study completed measures of social support and social participation and underwent psychophysiological stress testing. In unadjusted analyses, social support was positively, rather than inversely, associated with reactivity. Results withstood adjustment for several control variables, but not for depressive symptoms, which was associated with diminished reactivity. Further, diminished reactivity was associated with lower social participation, but not in fully adjusted models. No robust evidence was observed for either the stress-buffering model, or for an association between diminished reactivity and lower social participation. The implications for our understanding of links between social connectedness and cardiovascular reactivity are discussed.
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Affiliation(s)
- Ann-Marie Creaven
- Department of Psychology, Centre for Social Issues Research, & Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.
| | - Niamh M Higgins
- Department of Psychology, Mary Immaculate College, University of Limerick, South Circular Road, Limerick, Ireland.
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, TX, United States.
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, & Health Research Institute, University of Limerick, Castletroy, Limerick, Ireland.
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Abstract
OBJECTIVE Social support has been associated with greater nocturnal decline (dipping) in blood pressure (BP) in younger and middle-aged individuals. However, it is uncertain if aggregated measures of social support are related to ambulatory SBP in older adults, where high SBP is frequent and clinically challenging. METHODS We studied 1047 community-living individuals aged at least 60 years in Spain. Twenty-four-hour ambulatory BP was determined under standardized conditions. Social support was assessed with a seven-item questionnaire on marital status, cohabitation, frequency of contact with relatives, or with friends and neighbors, emotional support, instrumental support, and outdoor companionship. A social support score was built by summing the values of the items that were significantly associated with SBP variables, such that the higher the score, the better the support. RESULTS Participants' mean age was 71.7 years (50.8% men). Being married, cohabiting, and being accompanied when out of home were the support items significantly associated with SBP variables. After adjustment for sociodemographic (age, sex, education), behavioral (BMI, alcohol, tobacco, salt consumption, physical activity, Mediterranean diet score), and clinical variables [sleep quality, mental stress, comorbidity, BP medication, and ambulatory BP levels and heart rate (HR)], one additional point in the social support score built with the abovementioned three support variables, was associated with a decrease of 0.93 mmHg in night-time SBP (P = 0.039), totaling 2.8 mmHg decrease for a score of 3 vs. 0. The three-item social support score was also inversely associated with the night/day SBP ratio (β = -0.006, P = 0.010). CONCLUSION In older adults, social support is independently associated with lower nocturnal SBP and greater SBP dipping. Further research is needed in prospective studies to confirm these results.
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Changing work stressors and coping resources influence blood pressure and hypertension incidence in a large OHSPIW cohort. J Hum Hypertens 2016; 31:313-319. [DOI: 10.1038/jhh.2016.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/27/2016] [Accepted: 09/19/2016] [Indexed: 11/08/2022]
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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: 39] [Impact Index Per Article: 3.5] [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.
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Socioeconomic status and health: education and income are independent and joint predictors of ambulatory blood pressure. J Behav Med 2013; 38:9-16. [PMID: 23645146 DOI: 10.1007/s10865-013-9515-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 04/25/2013] [Indexed: 10/26/2022]
Abstract
Epidemiological research suggests that different indicators of socioeconomic status (SES) such as income and education may have independent and/or interactive effects on health outcomes. In this study, we examined both simple and more complex associations (i.e., interactions) between different indicators of SES and ambulatory blood pressure (ABP) during daily life. Our sample consisted of 94 married couples who completed a one-day ABP protocol. Both income and education were independently related to systolic blood pressure and only income was significantly related to diastolic blood pressure. There were also statistical interactions such that individuals with high levels of both income and education evidenced the lowest ABP. Gender moderated these findings. Three-way interactions revealed that, in general, women appear to benefit from either indicator of SES, whereas men appear to benefit more from income. The findings are consistent with epidemiological research and suggest one important physiological mechanism by which income and education may have independent and interactive effects on health.
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