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Tyra AT, Young DA, Ginty AT. Emotion regulation tendencies and cardiovascular responses to repeated acute psychological stress. Int J Psychophysiol 2023; 194:112261. [PMID: 37914039 DOI: 10.1016/j.ijpsycho.2023.112261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/16/2023] [Accepted: 10/27/2023] [Indexed: 11/03/2023]
Abstract
Poor emotion regulation has been associated with cardiovascular disease (CVD) through maladaptive cardiovascular responses to psychological stress. However, there has been scant research examining the relationship between emotion regulation and habituation of cardiovascular responses to recurrent stress, which may be more directly applicable to the experience of stress in everyday life. The aims of the current study were to examine the associations between emotion regulation tendencies and cardiovascular stress reactivity, as well as habituation of cardiovascular reactivity across repeated stressors. A sample of 453 participants (mean (SD) age = 19.5 (1.3) years; 62 % women) completed a repeated stress paradigm, which consisted of two 10-minute baselines and two identical 4-minute stress tasks, separated by a 10-minute recovery period. Heart rate (HR) was measured continuously; systolic/diastolic blood pressures (SBP/DBP) were measured every 2 min. At the end of the visit, participants completed the Emotion Regulation Questionnaire (ERQ) and Difficulties in Emotion Regulation Scale (DERS). Results indicate that impulse control difficulties when distressed (a DERS subscale) were significantly associated with blunted SBP, DBP, and HR reactivity to both stressors, as well as impaired HR habituation across the stressors. None of the ERQ subscales (cognitive reappraisal, expressive suppression) were found to be associated with cardiovascular stress reactivity or habituation. The outcomes of this study demonstrate a potential underlying physiological pathway through which impulse control difficulties when distressed may contribute to CVD risk. This study also reveals the importance of extending traditional cardiovascular stress reactivity protocols to include multiple exposures of the same stress task.
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Affiliation(s)
- Alexandra T Tyra
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
| | - Danielle A Young
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Annie T Ginty
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
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2
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Myburgh-Jacobsz CE, Malan L, von Känel R, Steyn HS, Malan NT. Stress-induced cardiac troponin T, S100B and estradiol responses in defensive copers: The SABPA study. Int J Psychophysiol 2022; 177:159-170. [DOI: 10.1016/j.ijpsycho.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
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3
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Magán I, Jurado-Barba R, Casado L, Barnum H, Jeon A, Hernandez AV, Bueno H. Efficacy of psychological interventions on clinical outcomes of coronary artery disease: Systematic review and meta-analysis. J Psychosom Res 2022; 153:110710. [PMID: 34999380 DOI: 10.1016/j.jpsychores.2021.110710] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 12/18/2021] [Accepted: 12/18/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Psychological factors influence clinical outcomes in patients with coronary artery disease (CAD). Therefore, psychological interventions (PIs) may have beneficial effects in these patients. We evaluated the efficacy of PIs based on cognitive-behavioral therapy (CBT) and positive psychology therapy (PPT) on clinical and laboratory outcomes in CAD. METHODS Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2020 were systematically reviewed and analyzed. Primary outcomes were all-cause mortality, cardiovascular mortality, any cardiovascular event, myocardial infarction (MI), stroke, coronary revascularization, angina, and readmission. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as risk ratios (RR) or standardized mean difference (SMD) with 95% confidence intervals (CIs). RESULTS Twenty-five trials were included (n = 8119); 22 evaluating the effects of multi-component CBT (n = 7909), and three PPT (n = 210). Thirteen RCTs were at high risk of bias due to limitations in randomization or blinding. Compared with control groups any cardiovascular event (RR 0.82; 0.70 to 0.97; 5 studies), MI (RR 0.72; 0.52 to 0.98; 9 studies), and angina duration and intensity (SMD -0.64; -0.98 to -0.30; 4 studies; and -0.64; -1.17 to -0.11; 2 trials) were significantly reduced with PIs at the end of follow-up. PIs had no effect on other primary outcomes, laboratory or anthropometrical results and presented a moderate to high heterogeneity. CONCLUSIONS CBT- and PPT-based PIs reduce the risk of cardiovascular events, MI and angina in patients with CAD. Future research should assess the individual role of CBT and PPT in CAD populations.
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Affiliation(s)
- Inés Magán
- Department of Psychology, Facultad de Salud, Universidad Camilo José Cela, Madrid, Spain.
| | - Rosa Jurado-Barba
- Department of Psychology, Facultad de Salud, Universidad Camilo José Cela, Madrid, Spain; Instituto de Investigación Biomédica del Hospital 12 de Octubre (Imas12), Madrid, Spain
| | - Laura Casado
- Department of Psychology, Facultad de Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Haley Barnum
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Anne Jeon
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Adrian V Hernandez
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA; Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima, Peru
| | - Héctor Bueno
- Instituto de Investigación Biomédica del Hospital 12 de Octubre (Imas12), Madrid, Spain; Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain; Multidisciplinary Translational Cardiovascular Research Group, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
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Association between distinct coping styles and heart rate variability changes to an acute psychosocial stress task. Sci Rep 2021; 11:24025. [PMID: 34911998 PMCID: PMC8674249 DOI: 10.1038/s41598-021-03386-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 12/02/2021] [Indexed: 12/22/2022] Open
Abstract
Modern life comprises a myriad of stressful situations, ranging from life-threatening ones to others not so deadly, all of which activate a physiologic stress response. Engaging in healthy ways to cope can prevent us from wearing out our physiological systems. Heart rate variability (HRV) is often used as an index of emotion regulation response. Hence, our goal is to investigate whether the habitual use of coping strategies is related to a distinct pattern of HRV changes when the individual is exposed to a moderate psychosocial stressor. In this study, 60 female participants performed a psychosocial stress task-oral speech preparation-while ECG signals were collected during the whole experimental procedure. Heart rate (HR), HRV parameters (SDNN, RMSSD, LF, HF) and coping strategies (Brief COPE) were registered. Participants were divided into two groups (low and high groups) as a function of their scores on the maladaptive and adaptive coping strategies of the Brief COPE. As expected, the task alone induced increases in heart rate and reductions in HRV parameters. Additionally, the analyses revealed a different pattern of HRV (SDNN, RMSSD, LF and HF) changes in response to the stressor, with participants using less maladaptive strategies being able to maintain the HRV at baseline levels when confronting the stressor, while those using more maladaptive strategies reducing HRV during the task. These results show a different pattern of HRV changes as a function of the coping style, suggesting a possible autonomic advantage, namely, the maintenance of HRV, in individuals who use maladaptive coping strategies less frequently.
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Magán I, Casado L, Jurado-Barba R, Barnum H, Redondo MM, Hernandez AV, Bueno H. Efficacy of psychological interventions on psychological outcomes in coronary artery disease: systematic review and meta-analysis. Psychol Med 2021; 51:1846-1860. [PMID: 32249725 DOI: 10.1017/s0033291720000598] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The benefits of cognitive-behavioral treatment (CBT) and positive psychology therapy (PPT) in patients with cardiovascular disease are still not well defined. We assessed the efficacy of CBT and PPT on psychological outcomes in coronary artery disease (CAD) patients. METHODS Randomized controlled trials evaluating CBT or PPT in CAD patients published until May 2018 were systematically analyzed. Primary outcomes were depression, stress, anxiety, anger, happiness, and vital satisfaction. Random effects meta-analyses using the inverse variance method were performed. Effects were expressed as standardized mean difference (SMD) or mean differences (MD) with their 95% confidence intervals (CIs); risk of bias was assessed with the Cochrane tool. RESULTS Nineteen trials were included (n = 1956); sixteen evaluated CBT (n = 1732), and three PPT (n = 224). Compared with control groups, depressive symptoms (13 trials; SMD -0.80; 95% CI -1.33 to -0.26), and anxiety (11 trials; SMD -1.26; 95% CI -2.11 to -0.41) improved after the PI, and depression (6 trials; SMD -2.08; 95% CI -3.22 to -0.94), anxiety (5 trials; SMD -1.33; 95% CI -2.38 to -0.29), and stress (3 trials; SMD -3.72; 95% CI -5.91 to -1.52) improved at the end of follow-up. Vital satisfaction was significantly increased at follow-up (MD 1.30, 0.27, 2.33). Non-significant effects on secondary outcomes were found. Subgroup analyses were consistent with overall analyses. CONCLUSION CBT and PPT improve several psychological outcomes in CAD patients. Depression and anxiety improved immediately after the intervention while stress and vital satisfaction improve in the mid-term. Future research should assess the individual role of CBT and PPT in CAD populations.
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Affiliation(s)
- Inés Magán
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Laura Casado
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Rosa Jurado-Barba
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
- Instituto de Investigación Biomédica del Hospital 12 de Octubre (Imas12), Madrid, Spain
| | - Haley Barnum
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Marta M Redondo
- Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Adrian V Hernandez
- Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT, USA
- Vicerrectorado de Investigacion, Universidad San Ignacio de Loyola (USIL), Lima, Peru
| | - Héctor Bueno
- Instituto de Investigación Biomédica del Hospital 12 de Octubre (Imas12), Madrid, Spain
- Department of Cardiology, Hospital Universitario 12 de Octubre, Madrid, Spain
- Multidisciplinary Translational Cardiovascular Research Group, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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Hu Y, Wang Z, Lü W. Conscientiousness and perceived physical symptoms: Mediating effect of life events stress and moderating role of resting respiratory sinus arrhythmia. J Health Psychol 2021; 27:1819-1832. [PMID: 33878900 DOI: 10.1177/13591053211008225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated the possible psychophysiological links between conscientiousness and perceived physical symptoms by examining the mediating role of life events stress and the moderating role of resting respiratory sinus arrhythmia (RSA). Participants participated in the collection of questionnaire data and physiological data (N = 396). Results showed life events stress mediated the association between conscientiousness and perceived physical symptoms, and the indirect effect was only significant among individuals with lower resting RSA. Findings indicate that low resting RSA as a risk-amplifying physiological marker may magnify the relationship that low conscientiousness affects physical symptoms by increasing life events stress.
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Affiliation(s)
- Yaqi Hu
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Zhenhong Wang
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Wei Lü
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, Shaanxi, China
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Frequency and perceptions of life stress are associated with reduced cardiovascular stress-response adaptation. Int J Psychophysiol 2020; 157:51-60. [DOI: 10.1016/j.ijpsycho.2020.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/17/2020] [Accepted: 08/23/2020] [Indexed: 12/27/2022]
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Glover LM, Cain‐Shields LR, Spruill TM, O'Brien EC, Barber S, Loehr L, Sims M. Goal-Striving Stress and Incident Cardiovascular Disease in Blacks: The Jackson Heart Study. J Am Heart Assoc 2020; 9:e015707. [PMID: 32342735 PMCID: PMC7428553 DOI: 10.1161/jaha.119.015707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/04/2020] [Indexed: 12/12/2022]
Abstract
Background Goal-striving stress (GSS), the stress from striving for goals, is associated with poor health. Less is known about its association with cardiovascular disease (CVD). Methods and Results We used data from the JHS (Jackson Heart Study), a study of CVD among blacks (21-95 years old) from 2000 to 2015. Participants free of CVD at baseline (2000-2004) were included in this analysis (n=4648). GSS was examined in categories (low, moderate, high) and in SD units. Incident CVD was defined as fatal or nonfatal stroke, coronary heart disease (CHD), and/or heart failure. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident CVD by levels of GSS, adjusting for demographics, socioeconomic status, health behaviors, risk factors, and perceived stress. The distribution of GSS categories was as follows: 40.77% low, 33.97% moderate, and 25.26% high. Over an average of 12 years, there were 140 incident stroke events, 164 CHD events, and 194 heart failure events. After full adjustment, high (versus low) GSS was associated with a lower risk of stroke (HR, 0.38; 95% CI, 0.17-0.83) and a higher risk of CHD (HR, 1.91; 95% CI, 1.10-3.33) among women. A 1-standard deviation unit increase in GSS was associated with a 31% increased risk of CHD (HR, 1.31; 95% CI, 1.10-1.56) among women. Conclusions Higher GSS may be a risk factor for developing CHD among women; however, it appears to be protective of stroke among women. These analyses should be replicated in other samples of black individuals.
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Affiliation(s)
| | | | - Tanya M. Spruill
- Department of Population HealthNYU Grossman School of MedicineNew YorkNY
| | | | - Sharrelle Barber
- Epidemiology and BiostatisticsDornsife School of Public HealthDrexel UniversityPhiladelphiaPA
| | - Laura Loehr
- Department of EpidemiologyUniversity of North Carolina at Chapel HillNC
| | - Mario Sims
- Department of MedicineUniversity of Mississippi Medical CenterJacksonMS
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Chronic depression symptoms desensitize renin activity to protect against volume-loading hypertension in Blacks: The SABPA study. Physiol Behav 2018; 194:474-480. [DOI: 10.1016/j.physbeh.2018.06.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/26/2018] [Accepted: 06/26/2018] [Indexed: 01/24/2023]
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Lai JCL, Leung MOY, Lee DYH, Lam YW, Berning K. Loneliness and Diurnal Salivary Cortisol in Emerging Adults. Int J Mol Sci 2018; 19:ijms19071944. [PMID: 29970811 PMCID: PMC6073375 DOI: 10.3390/ijms19071944] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/11/2018] [Accepted: 07/02/2018] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine the relationship between trait loneliness and diurnal rhythms of salivary cortisol. Fifty-One Chinese undergraduates provided six saliva samples on a weekday at immediately, 0.5, 3, 6, and 12 h after waking, and at bedtime. Saliva collection times were monitored using electronic devices (MEMS TrackCaps). Participants were also administered a questionnaire consisting of scales measuring, trait loneliness, depression, and demographics. Relationships between loneliness and the cortisol awakening response (CAR), diurnal slope (DS), and area under the curve with respect to ground (AUCG) were examined using multiple regression analyses. Results showed that a higher loneliness score was associated with an attenuated CAR, a large AUCG, and a steeper DS, with the effects of compliance, waking time, and depression being controlled. As a blunted CAR and a higher diurnal cortisol level have been shown to be associated with poorer health in prior studies, increased attention to the mechanisms translating loneliness into disease endpoints via elevated cortisol is warranted.
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Affiliation(s)
- Julian Chuk Ling Lai
- Psychophysiology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China.
| | - Monique On Yee Leung
- Psychophysiology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China.
| | - Daryl Yu Heng Lee
- Psychophysiology Laboratory, Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China.
| | - Yun Wah Lam
- Department of Chemistry, City University of Hong Kong, Hong Kong, China.
| | - Karsten Berning
- Department of Chemistry, City University of Hong Kong, Hong Kong, China.
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Myburgh CE, Malan L, Wentzel A, Scheepers JDW, Malan NT. Coping and Cardiac Troponin T - A Risk for Hypertension and Sub-Clinical ECG Left Ventricular Hypertrophy: The SABPA Study. Heart Lung Circ 2018; 28:908-916. [PMID: 29895484 DOI: 10.1016/j.hlc.2018.05.101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/16/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Defensive coping (DefS) was associated with cardiovascular disease (CVD) susceptibility in Blacks. Whether coping strategies will associate with sub-clinical left ventricular hypertrophy (electrocardiographic-left ventricular hypertrophy [ECG-LVH] or Cornell product), cardiomyocyte injury and blood pressure (BP), is unclear. Therefore, we assessed relationships between ECG-LVH, cardiac troponin T (cTnT) and 24-hour BP in bi-ethnic groups when habitually utilising a certain coping style, and these groups when having a stress-related cTnT cut-point of 4.2ng/L. METHODS A target population study included a Black (n=190) and White (n=204) teachers' gender cohort (20-65years) from South Africa. The Coping Strategy Indicator determined DefS, social support and avoidance coping scores. Fasting blood samples, 10-lead ECG, 24-hour BP and ECG data were obtained. RESULTS Interaction effects showed no gender, social support and avoidance coping differences. Stratification of groups was done for ethnicity and DefS. Blacks sought more social support, used less avoidance coping and presented with higher CVD susceptibility. Hypertension prevalence and ECG-LVH levels in DefS Blacks (63%) were higher compared to DefS Whites (40%). Multivariate regression analyses showed positive associations between Cornell product, cTnT and BP [p≤0.05] in DefS Blacks only. Their 24-hour systolic blood pressure (SBP) was associated with time-domain depressed heart-rate-variability and prolonged ST-segment-depression especially when applying an established stress-related cTnT ≥ 4.2ng/L cut-point. CONCLUSIONS Defensive coping facilitated autonomic hyperactivity, myocardial injury and subsequent compensatory BP elevations as possible homeostatic reflexes to alleviate myocardial perfusion deficits. The resulting pressure overload increased sub-clinical wall remodelling and ischaemic heart disease risk in Blacks utilising habitual defensiveness. We therefore recommend regular ECG and high sensitivity cTnT screening in asymptomatic patients with emotional stress susceptibility. Longitudinal evidence is needed to confirm causality and progression of cardiomyopathy risk.
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Affiliation(s)
| | - Leoné Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa.
| | - Annemarie Wentzel
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
| | - Jacobus De Wet Scheepers
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
| | - Nicolaas Theodor Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
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Covassin N, Greene EL, Singh P, Somers VK. Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep. Curr Hypertens Rep 2018; 20:57. [PMID: 29884924 DOI: 10.1007/s11906-018-0855-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Sleep deficiency has been proposed as a potential contributor to racial disparities in cardiovascular health. We present contemporary evidence on the unequal burden of insufficient sleep in Blacks/African-Americans and the repercussions for disparate risk of hypertension. RECENT FINDINGS The prevalence of insufficient sleep is high and rising and has been recognized as an important cardiovascular risk factor. Presumably due to a constellation of environmental, psychosocial, and individual determinants, these risks appear exacerbated in Blacks/African-Americans, who are more likely to experience short sleep than other ethnic/racial groups. Population-based data suggest that the risk of hypertension associated with sleep deficiency is greater in those of African ancestry. However, there is a paucity of experimental evidence linking short sleep duration to blood pressure levels in African-Americans. Blacks/African-Americans may be more vulnerable to sleep deficiency and to its hypertensive effects. Future research is needed to unequivocally establish causality and determine the mechanism underlying the postulated racial inequalities in sleep adequacy and consequent cardiovascular risk.
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Affiliation(s)
- Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Eddie L Greene
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Prachi Singh
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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Brewer LC, Redmond N, Slusser JP, Scott CG, Chamberlain AM, Djousse L, Patten CA, Roger VL, Sims M. Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life's Simple 7 in Blacks of the Jackson Heart Study. J Am Heart Assoc 2018; 7:JAHA.118.008855. [PMID: 29871857 PMCID: PMC6015384 DOI: 10.1161/jaha.118.008855] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Ideal cardiovascular health metrics (defined by the American Heart Association Life's Simple 7 [LS7]) are suboptimal among blacks, which results in high risk of cardiovascular disease. We examined the association of multiple stressors with LS7 components among blacks. Methods and Results Using a community‐based cohort of blacks (N=4383), we examined associations of chronic stress, minor stressors, major life events, and a cumulative stress score with LS7 components (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting plasma glucose) and an LS7 composite score. Multivariable logistic regression assessed the odds of achieving intermediate/ideal levels of cardiovascular health adjusted for demographic, socioeconomic, behavioral, and biomedical factors. The LS7 components with the lowest percentages of intermediate/ideal cardiovascular health levels were diet (39%), body mass index (47%), and physical activity (51%). Higher chronic, minor, and cumulative stress scores were associated with decreased odds (odds ratio [OR]) of achieving intermediate/ideal levels for smoking (OR [95% confidence interval], 0.80 [0.73–0.88], 0.84 [0.75–0.94], and 0.81 [0.74–0.90], respectively). Participants with more major life events had decreased odds of achieving intermediate/ideal levels for smoking (OR, 0.84; 95% confidence interval, 0.76–0.92) and fasting plasma glucose (OR, 0.90; 95% confidence interval, 0.82–0.98). Those with higher scores for minor stressors and major life events were less likely to achieve intermediate or ideal LS7 composite scores (OR [95% confidence interval], 0.89 [0.81–0.97] and 0.91 [0.84–0.98], respectively). Conclusions Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall cardiovascular health (LS7 composite score), specific behaviors (smoking), and biological factors (fasting plasma glucose).
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Affiliation(s)
| | - Nicole Redmond
- National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, MD
| | - Joshua P Slusser
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Luc Djousse
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Veronique L Roger
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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14
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Versey HS, Tan M. Work-family spillover and metabolic syndrome indicators: Findings from a national sample. J Health Psychol 2018; 25:1771-1783. [PMID: 29575934 DOI: 10.1177/1359105318764014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
This study examines the link between negative work-family spillover and metabolic risk factors over a 9-year period. Data from two waves of the Midlife in the United States Survey were used to explore relationships between negative work-family spillover and four indicators of metabolic syndrome-blood pressure, triglycerides, body mass index, and glucose levels. In a sample of full-time working men and women (N = 630), increased negative spillover at baseline significantly predicted higher body mass index nearly a decade later, with a marginally significant effect for triglyceride levels. Increases in spillover also body mass index and glucose levels at follow-up. This study extends research tying work-life spillover to health and suggests that further investigation is needed to fully understand the long-term effects of work stress.
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15
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Okhomina VI, Glover L, Taylor H, Sims M. Dimensions of and Responses to Perceived Discrimination and Subclinical Disease Among African-Americans in the Jackson Heart Study. J Racial Ethn Health Disparities 2018; 5:1084-1092. [PMID: 29313298 DOI: 10.1007/s40615-017-0457-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/21/2017] [Accepted: 12/26/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although discrimination among African Americans (AAs) has been linked to various health outcomes, few studies have examined associations of multiple measures of discrimination with prevalent subclinical disease in a large sample of AAs. OBJECTIVES To examine the associations of measures of discrimination and coping responses to discrimination with prevalent subclinical disease among AAs in the Jackson Heart Study (JHS); and whether this association is modified by sex. METHODS We examined the associations of everyday, lifetime, and burden of lifetime discrimination with carotid intima-media thickness (cIMT), and left ventricular hypertrophy (LVH) among 3029 AAs in the JHS. Prevalence ratios (PR 95% confidence interval-CI) and odds ratios (OR 95% CI) were estimated for above-median cIMT and LVH, respectfully, adjusting for demographic, behavioral, and clinical risk factors. RESULTS No significant associations were found between everyday and lifetime discrimination and median cIMT and LVH. Participants who reported high (vs. no) burden of lifetime discrimination had a 48% reduced odds of LVH (OR, 0.52; 95% CI, 0.29, 0.94) after full adjustment. There was evidence of effect modification by sex in the association of coping with everyday discrimination and LVH after full adjustment (p value for interaction < 0.01). Women who actively (vs. passively) coped with everyday discrimination had a greater odds of prevalent LVH (OR, 2.49; 95% CI, 1.39, 4.46). CONCLUSIONS This study suggests that the manner by which AA women cope with discriminatory events is associated with subclinical disease.
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Affiliation(s)
- Victoria I Okhomina
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - LáShauntá Glover
- Department of Medicine, University of Mississippi Medical Center, Jackson Heart Study, 350 W. Woodrow Wilson Drive, Jackson, MS, 39213, USA
| | - Herman Taylor
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson Heart Study, 350 W. Woodrow Wilson Drive, Jackson, MS, 39213, USA.
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Rueda MA. Depresión en la mujer. REVISTA COLOMBIANA DE CARDIOLOGÍA 2018. [DOI: 10.1016/j.rccar.2017.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Williams JAR, Ortiz SE. Examining public knowledge and preferences for adult preventive services coverage. PLoS One 2017; 12:e0189661. [PMID: 29261757 PMCID: PMC5738055 DOI: 10.1371/journal.pone.0189661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 11/29/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. Methods An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015–2017. A 17-item survey instrument was designed and used to evaluate respondents’ knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Results Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small—around one service less than those with liberal ideologies. Conclusions Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered.
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Affiliation(s)
- Jessica A R Williams
- Department of Health Management and Policy, University of Kansas School of Medicine, Kansas City, Kansas, United States of America
| | - Selena E Ortiz
- Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, United States of America
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Schutte AE, Botha S, Fourie CMT, Gafane-Matemane LF, Kruger R, Lammertyn L, Malan L, Mels CMC, Schutte R, Smith W, van Rooyen JM, Ware LJ, Huisman HW. Recent advances in understanding hypertension development in sub-Saharan Africa. J Hum Hypertens 2017; 31:491-500. [PMID: 28332510 DOI: 10.1038/jhh.2017.18] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/16/2017] [Accepted: 02/03/2017] [Indexed: 12/13/2022]
Abstract
Consistent reports indicate that hypertension is a particularly common finding in black populations. Hypertension occurs at younger ages and is often more severe in terms of blood pressure levels and organ damage than in whites, resulting in a higher incidence of cardiovascular disease and mortality. This review provides an outline of recent advances in the pathophysiological understanding of blood pressure elevation and the consequences thereof in black populations in Africa. This is set against the backdrop of populations undergoing demanding and rapid demographic transition, where infection with the human immunodeficiency virus predominates, and where under and over-nutrition coexist. Collectively, recent findings from Africa illustrate an increased lifetime risk to hypertension from foetal life onwards. From young ages black populations display early endothelial dysfunction, increased vascular tone and reactivity, microvascular structural adaptions as well as increased aortic stiffness resulting in elevated central and brachial blood pressures during the day and night, when compared to whites. Together with knowledge on the contributions of sympathetic activation and abnormal renal sodium handling, these pathophysiological adaptations result in subclinical and clinical organ damage at younger ages. This overall enhanced understanding on the determinants of blood pressure elevation in blacks encourages (a) novel approaches to assess and manage hypertension in Africa better, (b) further scientific discovery to develop more effective prevention and treatment strategies and
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Affiliation(s)
- A E Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - S Botha
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - C M T Fourie
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - L F Gafane-Matemane
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - R Kruger
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - L Lammertyn
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - L Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - C M C Mels
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - R Schutte
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa.,Department of Medicine and Healthcare Science, Anglia Ruskin University, Chelmsford, UK
| | - W Smith
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - J M van Rooyen
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - L J Ware
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - H W Huisman
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa.,South African Medical Research Council: Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
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Step On It! Workplace Cardiovascular Risk Assessment of New York City Yellow Taxi Drivers. J Immigr Minor Health 2017; 18:118-34. [PMID: 25680879 DOI: 10.1007/s10903-015-0170-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Multiple factors associated with taxi driving can increase the risk of cardiovascular disease (CVD) in taxi drivers. This paper describes the results of Step On It!, which assessed CVD risk factors among New York City taxi drivers at John F. Kennedy International Airport. Drivers completed an intake questionnaire and free screenings for blood pressure, glucose and body mass index (BMI). 466 drivers participated. 9 % had random plasma glucose values >200 mg/dl. 77 % had elevated BMIs. Immigrants who lived in the US for >10 years had 2.5 times the odds (CI 1.1-5.9) of having high blood pressure compared to newer immigrants. Abnormalities documented in this study were significant, especially for immigrants with greater duration of residence in the US, and underscore the potential for elevated CVD risk in this vulnerable population, and the need to address this risk through frameworks that utilize multiple levels of intervention.
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Hill LK, Hoggard LS, Richmond AS, Gray DL, Williams DP, Thayer JF. Examining the association between perceived discrimination and heart rate variability in African Americans. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:5-14. [PMID: 28045306 PMCID: PMC5755701 DOI: 10.1037/cdp0000076] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Previous research attempting to delineate the role of discrimination in racial/ethnic disparities in hypertension has focused largely on blood pressure, which is chiefly governed by the sympathetic branch of the autonomic nervous system. Consequently, few studies have considered the role of the parasympathetic branch and particularly its regulation of the heart via the vagus nerve. METHOD In the present cross-sectional study, we employed hierarchical linear regressions to examine associations between perceived ethnic discrimination and resting heart rate variability (HRV), an important biomarker of parasympathetic cardiac modulation and overall health, in a sample (N = 103) of young, healthy African American participants (58% female, Mage = 19.94 years, SD = 2.84). RESULTS After accounting for demographic factors and health status characteristics, lifetime discrimination emerged as an inverse predictor of HRV. When subdomains of discrimination were considered, discrimination attributable to threats or actual acts of aggression was also predictive of lower HRV. CONCLUSIONS Our findings suggest that a greater lifetime burden of discrimination and discriminatory harassment and/or assault is associated with lower resting HRV in African Americans. The implications of these findings are discussed in the context of past, present and emerging research emphasizing biological linkages between discrimination and health. (PsycINFO Database Record
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Affiliation(s)
- LaBarron K Hill
- Center for the Study of Aging and Human Development, Duke University Medical Center
| | - Lori S Hoggard
- Department of Psychology, University of North Carolina at Chapel Hill
| | | | - DeLeon L Gray
- Department of Educational Psychology, North Carolina State University
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Chadwick AE, Zoccola PM, Figueroa WS, Rabideau EM. Communication and Stress: Effects of Hope Evocation and Rumination Messages on Heart Rate, Anxiety, and Emotions After a Stressor. HEALTH COMMUNICATION 2016; 31:1447-1459. [PMID: 27054822 DOI: 10.1080/10410236.2015.1079759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
How we cope with the many stressors that we encounter throughout our lives has implications for our well-being. By affecting how individuals appraise stressful events, communication can prolong or ameliorate physiological and emotional responses to stress. This study investigated the short-term effects of hope-inducing and rumination-inducing messages on heart rate, state anxiety, and emotions after a standardized, social-evaluative stressor. Continuous heart rate was monitored for 127 college students (64 female, 63 male) throughout an experiment that included a performance stressor and messages designed to (a) cause feelings of hope, (b) evoke rumination, or (c) be a distraction (control). Heart rate varied by message, such that heart rate was lowest in the hope evocation condition. State anxiety was lower in the hope evocation and distraction control conditions than in the rumination condition. The rumination condition led to greater anger, greater guilt, and less happiness than did the other conditions. This study advances our knowledge about potential ways that communication messages can counter the psychological and biological effects of stressful life events. Overall, the study provides preliminary evidence that hope evocation messages may be a form of supportive communication and can ameliorate stress.
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Measuring hassles in adults with congenital heart disease. PROGRESS IN PEDIATRIC CARDIOLOGY 2016. [DOI: 10.1016/j.ppedcard.2016.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Dipeptidyl peptidase- IV inhibitor alogliptin improves stress-induced insulin resistance and prothrombotic state in a murine model. Psychoneuroendocrinology 2016; 73:186-195. [PMID: 27509090 DOI: 10.1016/j.psyneuen.2016.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/04/2016] [Accepted: 08/02/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Stress evokes lipolytic release of free fatty acid (FFA) and low-grade inflammation in visceral adipose tissue, mediated by increased adipokine secretion, and contributes to glucose metabolism disorder and prothrombotic state. We tested the hypothesis that alogliptin, a dipeptidyl peptidase-4 inhibitor, can ameliorate the biological effects of chronic stress in mice. METHOD AND RESULTS C57BL/6J mice were subjected to 2-week intermittent restraint stress and orally treated with vehicle or alogliptin (dose: 15 or 45mg/kg/day). Plasma levels of lipids, proinflammatory cytokines (monocyte chemoattractant protein-1, tumor necrosis factor-α, and interleukin-6), and 8-hydroxydeoxyguanosine were measured with enzyme-linked immunosorbent assay. Monocyte/macrophage accumulation in inguinal white adipose tissue (WAT) was examined by CD11b-positive cell count and mRNA expression of CD68 and F4/80 was examined by immunohistochemistry and RT-PCR, respectively. The mRNA levels of the above-mentioned proinflammatory cytokines, NADPH oxidase 4, adiponectin, and coagulation factors (plasminogen activation inhibitor-1 and tissue factor) in WAT were also assessed with RT-PCR. Glucose metabolism was assessed by glucose and insulin tolerance tests, plasma levels of DPP-4 activity, glucagon-like peptide-1, expression of DPP-4, insulin receptor substrate-1 and glucose transporter 4 in WAT and skeletal muscle. Alogliptin administration suppressed stress-induced FFA release, oxidative stress, adipose tissue inflammation, DPP-4 activation, and prothrombotic state in a dose-dependent manner, and improved insulin sensitivity in stressed mice. CONCLUSIONS The results indicate that alogliptin improves stress-induced prothrombotic state and insulin resistance; suggesting that alogliptin could have beneficial therapeutic effects against cardiovascular complications in diabetic patients under stress.
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Jansen van Vuren E, Malan L, Cockeran M, Scheepers JD, Oosthuizen W, Malan NT. Fibrosis and coronary perfusion - a cardiovascular disease risk in an African male cohort: The SABPA study. Clin Exp Hypertens 2016; 38:482-8. [PMID: 27380493 DOI: 10.3109/10641963.2016.1151524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Low-grade inflammation has been correlated with risk factors of cardiovascular diseases (CVD). Whether the pro-inflammatory and thrombotic ratio (fibrosis) may contribute to CVD is not known. We therefore aimed to assess whether Cornell Product left ventricular hypertrophy (LVH) is associated with fibrosis and coronary perfusion (silent ischemia) in a bi-ethnic male cohort from South Africa. A cross sectional study was conducted including 165 African and Caucasian men between the ages of 20-65. Fasting blood samples were obtained to measure fibrinogen, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor (TNF-α). Ambulatory blood pressure, ECG and 12 lead ECG measures were obtained to determine silent ischemic events (ST events) and LVH, respectively. Africans revealed more silent ischemia, higher 24 h blood pressure, inflammatory, coagulation as well as fibrosis levels than Caucasians. In a low-grade inflammatory state (CRP > 3 mg/l), Africans revealed higher fibrosis (p ≤ 0.01) values, but lower IL-6 and TNF-α values than Caucasians. Linear regression analyses in several models demonstrated positive associations between silent ischemia and fibrosis [Adj. R(2) 0.23; ß 0.35 (95% CI 0.13, 0.58), p ≤ 0.01]. In a low-grade inflammatory state (CRP>3mg/l), fibrinogen predicted AV-block in African men [OR 3.38 (95% CI 2.24, 4.53); p = 0.04]. Low-grade inflammation may induce AV-block through mechanisms involving fibrosis and ischemia to increase the burden on the heart in African men.
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Affiliation(s)
- Esmé Jansen van Vuren
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom Campus, South Africa
| | - Leoné Malan
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom Campus, South Africa
| | - Marike Cockeran
- b Medicine Usage in South Africa (MUSA) , North-West University , Potchefstroom Campus, South Africa
| | - Jacobus D Scheepers
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom Campus, South Africa
| | - Woudri Oosthuizen
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom Campus, South Africa
| | - Nicolaas T Malan
- a Hypertension in Africa Research Team (HART) , North-West University , Potchefstroom Campus, South Africa
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Hyperpulsatile pressure, systemic inflammation and cardiac stress are associated with cardiac wall remodeling in an African male cohort: the SABPA study. Hypertens Res 2016; 39:648-53. [PMID: 27169396 DOI: 10.1038/hr.2016.45] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/08/2016] [Accepted: 03/11/2016] [Indexed: 12/19/2022]
Abstract
Inflammation may contribute to an increase in cardiac wall stress through pathways related to cardiac remodeling. Cardiac remodeling is characterized by myocyte hypertrophy, myocyte death and modifications of the extracellular matrix. We sought to explore associations among cardiac remodeling, inflammation and myocardial cell injury in a bi-ethnic cohort of South African men and women. We included 165 men (76 African and 89 Caucasian) and 174 women (80 African and 94 Caucasian) between 20 and 65 years of age. Inflammatory markers used were C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-alpha (TNF-α), whereas troponin T (Trop T) and the N-terminal of pro B-type natriuretic peptide (NT-proBNP) were used as cardiac markers. The frequency of ischemic events (ST segment depression) and left ventricular strain (left ventricular hypertrophy: LVH) were monitored by a 24-h recording of ambulatory blood pressure (BP), ECG and 12-lead standard ECG. Hypertension diagnosed with ambulatory monitoring was more frequent in Africans (53.85 vs. 24.59%; P<0.001), as was the number of ischemic events (6±15 (1; 5) vs. 3±6 (0; 3)). Inflammatory markers (CRP, IL-6 and TNF-α) and the degree of LVH were all significantly higher in Africans (P<0.05). BP was associated (P<0.05) with Trop T in men across ethnic groups. In African men, cardiac stress (NT-proBNP) was associated with TNF-alpha (P<0.001), Trop T (P<0.001) and pulse pressure (P=0.048; adjusted R(2)=0.45). The susceptibility for cardiac wall remodeling appears to increase with hyperpulsatile pressure, low-grade systemic inflammation and ventricular stress, and may lead to the development of future cardiovascular events in African men.
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Scheepers JDW, Malan L, de Kock A, Malan NT, Cockeran M, von Känel R. Hypercoagulation and hyperkinetic blood pressure indicative of physiological loss-of-control despite behavioural control in Africans: The SABPA study. Blood Press 2016; 25:219-27. [PMID: 26806201 DOI: 10.3109/08037051.2015.1131432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES A dissociation between behavioural (in-control) and physiological parameters (indicating loss-of-control) is associated with cardiovascular risk in defensive coping (DefS) Africans. We evaluated relationships between DefS, sub-clinical atherosclerosis, low-grade inflammation and hypercoagulation in a bi-ethnic sex cohort. METHODS Black (Africans) and white Africans (Caucasians) (n = 375; aged 44.6 ± 9.7 years) were included. Ambulatory BP, vascular structure (left carotid cross-sectional wall area (L-CSWA) and plaque counts), and markers of coagulation and inflammation were quantified. Ethnicity/coping style interaction was revealed only in DefS participants. RESULTS A hypertensive state, less plaque, low-grade inflammation, and hypercoagulation were more prevalent in DefS Africans (27-84%) than DefS Caucasians (18-41%). Regression analyses demonstrated associations between L-CSWA and 24 hour systolic BP (R(2) = 0.38; β = 0.78; p < 0.05) in DefS African men but not in DefS African women or Caucasians. No associations between L-CSWA and coagulation markers were evident. CONCLUSION Novel findings revealed hypercoagulation, low-grade inflammation and hyperkinetic BP (physiological loss-of-control responses) in DefS African men. Coupled to a self-reported in-control DefS behavioural profile, this reflects dissociation between behaviour and physiology. It may explain changes in vascular structure, increasing cerebrovascular disease risk in a state of hyper-vigilant coping.
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Affiliation(s)
- Jacobus De Wet Scheepers
- a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa
| | - Leoné Malan
- a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;,b Medical Research Council: Research Unit for Hypertension and Cardiovascular Disease, North-West University , Potchefstroom , South Africa
| | - Andrea de Kock
- a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa
| | - Nicolaas Theodor Malan
- a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa
| | - Marike Cockeran
- c Medicine Usage in South Africa (MUSA), North-West University , Potchefstroom , South Africa
| | - Roland von Känel
- a Hypertension in Africa Research Team (HART), School for Physiology, Nutrition, and Consumer Science, North-West University , Potchefstroom , South Africa ;,d Department of Neurology , Inselspital, Bern University Hospital, and University of Bern , Switzerland ;,e Department of Psychosomatic Medicine , Clinic Barmelweid , Barmelweid , Switzerland
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Pimenta AM, Assunção AÁ. Estresse no trabalho e hipertensão arterial em profissionais de enfermagem da rede municipal de saúde de Belo Horizonte, Minas Gerais, Brasil. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2016. [DOI: 10.1590/2317-6369000113515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: analisar a associação entre estresse no trabalho e hipertensão arterial (HA). Método: estudo transversal com amostra probabilística de 273 profissionais de enfermagem da rede municipal de saúde de Belo Horizonte, Minas Gerais, Brasil, desenvolvido entre setembro de 2008 e janeiro de 2009. O estresse no trabalho foi mensurado com o modelo de demanda-controle e a hipertensão arterial por meio do autorrelato de diagnóstico médico da doença ou uso de medicação anti-hipertensiva. Razões de prevalência (RP) de HA e seus respectivos intervalos de confiança de 95% (IC 95%) foram ajustados pela técnica de regressão multivariada de Poisson. Resultados: dos profissionais estudados, 42,1% eram enfermeiros e 57,8%, técnicos ou auxiliares de enfermagem. A HA foi diagnosticada em 16,9%. Sexo feminino (RP = 0,56), avançar da idade (p de tendência linear < 0,001), renda familiar de 4 ou mais salários mínimos (RP = 0,39) e o estresse no trabalho (RP = 2,53) permaneceram independentemente associadas à HA após o ajuste multivariado dos dados. Conclusões: o estresse no trabalho está associado à HA em profissionais de enfermagem da rede municipal de saúde de Belo Horizonte. Este achado deve ser levado em consideração na formulação de políticas públicas que envolvem a promoção da saúde desses trabalhadores.
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Hsu YC, Tsai SF, Yu L, Chuang JI, Wu FS, Jen CJ, Kuo YM. Long-term moderate exercise accelerates the recovery of stress-evoked cardiovascular responses. Stress 2016; 19:125-32. [PMID: 26473638 DOI: 10.3109/10253890.2015.1108305] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Psychological stress is an important global health problem. It is well documented that stress increases the incidences of various cardiovascular disorders. Regular exercise is known to reduce resting blood pressure (BP) and heart rate (HR). This study was designed to clarify the effects of long-term exercise on stress-evoked cardiovascular responses and to emphasize post-stress recovery effects. Male Wistar rats underwent 8 weeks of moderate treadmill training, with cardiovascular responses, autonomic nervous system activities and local Fos reactivity changes in the cardiovascular regulation center were monitored before, during and after immobilization stress. A spectral analysis of cardiovascular parameters was used to examine autonomic nervous activities. We found that long-term exercise (i) lowered resting BP, HR and sympathetic activity, but increased resting parasympathetic activity and baroreflex sensitivity (BRS); (ii) accelerated post-stress recovery of stress-evoked cardiovascular and sympathetic responses along with increased BRS and (iii) accelerated post-stress recovery of stress-evoked neuron activations in the paraventricular nucleus, but delayed it in the nucleus of the tractus solitarius. We conclude that, in rats, long-term exercise accelerated recovery of stress-evoked cardiovascular responses differentially altering hypothalamic and medullar neuron activities.
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Affiliation(s)
- Yuan-Chang Hsu
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
| | - Sheng-Feng Tsai
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
| | - Lung Yu
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
- b Institute of Behavioral Medicine, National Cheng Kung University , Tainan , Taiwan
| | - Jih-Ing Chuang
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
- c Department of Physiology , National Cheng Kung University , Tainan , Taiwan , and
| | - Fong-Sen Wu
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
- c Department of Physiology , National Cheng Kung University , Tainan , Taiwan , and
| | - Chauying J Jen
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
- c Department of Physiology , National Cheng Kung University , Tainan , Taiwan , and
| | - Yu-Min Kuo
- a Institute of Basic Medical Sciences, National Cheng Kung University , Tainan , Taiwan
- d Department of Cell Biology and Anatomy , National Cheng Kung University , Tainan , Taiwan
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Terrill AL, Gjerde JM, Garofalo JP. Background Stress Inventory: Developing a Measure of Understudied Stress. Stress Health 2015; 31:290-8. [PMID: 26468688 DOI: 10.1002/smi.2554] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 09/25/2013] [Accepted: 10/23/2013] [Indexed: 01/10/2023]
Abstract
Background stress is an understudied source of stress that involves both ambient stress and daily hassles upon which new stressors are superimposed. To date, an accurate measure of the background stress construct has not been available. We developed the Background Stress Inventory, a 25-item self-report measure that asks respondents to indicate how distressed they have felt over the past month and the majority of the past year across five domains: financial, occupation, environment, health and social. Seven hundred seventy-two participants completed the paper-and-pencil measure; the sample was randomly split into two separate subsamples for analyses. Exploratory factor analysis suggested five factors corresponding to these domains, and confirmatory factor analysis showed acceptable global fit (X(2)(255) = 456.47, comparative fit index = 0.94, root mean square error of approximation = 0.045). Cronbach's alpha (0.89) indicated good internal reliability. Construct validity analyses showed significant positive relationships with measures of perceived stressfulness (r = 0.62) and daily hassles (0.41), p's < 0.01. Depressive symptoms (0.62) and basal blood pressure (0.21) were both significantly associated with background stress, p's < 0.01. The importance of the proposed measure is reflected in the limited research base on the impact of background stress. Systematic investigation of this measure will provide insight into this understudied form of chronic stress and its potential influence on both psychological and physical endpoints.
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Barreto-Osorio RV, Campos MS, Carrillo-González GM, Coral-Ibarra R, Chaparro-Díaz L, Duran Parra M, Rosales-Jiménez R, Tamara-Ortiz V. Entrevista Percepción de Carga del Cuidado de Zarit: pruebas psicométricas para Colombia. AQUICHAN 2015. [DOI: 10.5294/aqui.2015.15.3.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: determinar la validez y confiabilidad de la Entrevista de Percepción de Carga del Cuidado de Zarit, versión de 22 ítems en español, con cuidadores familiares de personas con enfermedades crónicas en Colombia. Materiales y métodos: estudio metodológico de corte transversal, con 652 cuidadores familiares de personas con enfermedades crónicas, residentes en las cinco regiones de Colombia, con el fin de establecer la validez de constructo, con un análisis factorial y la confiabilidad a través de la consistencia interna determinando el alfa de Cronbach. Resultado: respecto a la validez de constructo, el estudio reporta a partir de la asociación libre de la rotación Varimax la carga total, y en sus dimensiones que incluyen carga interpersonal, impacto del cuidado, y las competencias y expectativas sobre el cuidado. Las cargas factoriales corresponden a los ítems planteados para medir cada una de las dimensiones propuestas. Conclusión: el instrumento Entrevista de Percepción de Carga del Cuidado de Zarit, versión de 22 ítems en español, es una herramienta de fácil aplicación y comprensión en población colombiana de diferente nivel educativo, socioeconómico y cultural; además, mostró ser válido y confiable para evaluar la carga del cuidado en cuidadores familiares de personas con enfermedad crónica.
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Cascio WE. Life Style. Atherosclerosis 2015. [DOI: 10.1002/9781118828533.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Woody A, Smolak EL, Rabideau EM, Figueroa WS, Zoccola PM. Trait rumination moderates the effect of mentation type on heart rate responses to stressor recall. Stress 2015; 18:554-60. [PMID: 26119263 DOI: 10.3109/10253890.2015.1055726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Ruminative thought about stressors has been linked to extended post-stressor cardiovascular activation, which in turn predicts negative long-term health outcomes. Past work indicates that the nature of thought (mental imagery or verbal thought) may shape cardiovascular responses. Some evidence suggests that individuals with rumination tendencies may be especially vulnerable to stress-related cardiovascular activation, although it is unclear to what extent type of thought (imagery or verbal thought) influences this relationship. This study included a laboratory stressor followed by a stressor recall task in which mentation type was manipulated. Healthy undergraduate students (N = 138; 47% female) underwent a speech stressor and then were randomly assigned to complete a stressor recall task using either mental imagery or verbal-linguistic mentation. Heart rate (HR) and blood pressure (BP) were measured throughout. Self-report trait rumination was measured at baseline. Results indicated that trait rumination and mentation type interacted to predict HR. Individuals with high trait rumination scores had significantly greater increases in HR during the verbal-linguistic conditions compared to the mental imagery conditions. There were no mentation type differences in the low trait ruminators, no differences in BP and no main effects of trait rumination. Results suggest that mentation type may be a key in understanding the relationship between rumination and cardiovascular activation, especially for trait ruminators.
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Affiliation(s)
- Alex Woody
- a Department of Psychology , Ohio University , Athens , OH , USA
| | - Erin L Smolak
- a Department of Psychology , Ohio University , Athens , OH , USA
| | - Erin M Rabideau
- a Department of Psychology , Ohio University , Athens , OH , USA
| | | | - Peggy M Zoccola
- a Department of Psychology , Ohio University , Athens , OH , USA
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Hayashi M, Takeshita K, Uchida Y, Yamamoto K, Kikuchi R, Nakayama T, Nomura E, Cheng XW, Matsushita T, Nakamura S, Murohara T. Angiotensin II receptor blocker ameliorates stress-induced adipose tissue inflammation and insulin resistance. PLoS One 2014; 9:e116163. [PMID: 25551221 PMCID: PMC4281136 DOI: 10.1371/journal.pone.0116163] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 12/03/2014] [Indexed: 12/18/2022] Open
Abstract
A strong causal link exists between psychological stress and insulin resistance as well with hypertension. Meanwhile, stress-related responses play critical roles in glucose metabolism in hypertensive patients. As clinical trials suggest that angiotensin-receptor blocker delays the onset of diabetes in hypertensive patients, we investigated the effects of irbesartan on stress-induced adipose tissue inflammation and insulin resistance. C57BL/6J mice were subjected to 2-week intermittent restraint stress and orally treated with vehicle, 3 and 10 mg/kg/day irbesartan. The plasma concentrations of lipid and proinflammatory cytokines [Monocyte Chemoattractant Protein-1 (MCP-1), tumor necrosis factor-α, and interleukin-6] were assessed with enzyme-linked immunosorbent assay. Monocyte/macrophage accumulation in inguinal white adipose tissue (WAT) was observed with CD11b-positive cell counts and mRNA expressions of CD68 and F4/80 using immunohistochemistry and RT-PCR methods respectively. The mRNA levels of angiotensinogen, proinflammatory cytokines shown above, and adiponectin in WAT were also assessed with RT-PCR method. Glucose metabolism was assessed by glucose tolerance tests (GTTs) and insulin tolerance tests, and mRNA expression of insulin receptor substrate-1 (IRS-1) and glucose transporter 4 (GLUT4) in WAT. Restraint stress increased monocyte accumulation, plasma free fatty acids, expression of angiotensinogen and proinflammatory cytokines including MCP-1, and reduced adiponectin. Irbesartan reduced stress-induced monocyte accumulation in WAT in a dose dependent manner. Irbesartan treatment also suppressed induction of adipose angiotensinogen and proinflammatory cytokines in WAT and blood, and reversed changes in adiponectin expression. Notably, irbesartan suppressed stress-induced reduction in adipose tissue weight and free fatty acid release, and improved insulin tolerance with restoration of IRS-1 and GLUT4 mRNA expressions in WAT. The results indicate that irbesartan improves stress-induced adipose tissue inflammation and insulin resistance. Our results suggests that irbesartan treatment exerts additive benefits for glucose metabolism in hypertensive patients with mental stress.
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Affiliation(s)
- Motoharu Hayashi
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kyosuke Takeshita
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Clinical Laboratory, Nagoya University Hospital, Nagoya, Japan
- * E-mail:
| | - Yasuhiro Uchida
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koji Yamamoto
- Department of Blood Transfusion, Nagoya University Hospital, Nagoya, Japan
| | - Ryosuke Kikuchi
- Department of Clinical Laboratory, Nagoya University Hospital, Nagoya, Japan
| | - Takayuki Nakayama
- Department of Blood Transfusion, Aichi Medical University Hospital, Nagakute, Japan
| | - Emiko Nomura
- Department of Blood Transfusion, Nagoya University Hospital, Nagoya, Japan
| | - Xian Wu Cheng
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadashi Matsushita
- Department of Blood Transfusion, Nagoya University Hospital, Nagoya, Japan
| | - Shigeo Nakamura
- Department of Pathology, Nagoya University Hospital, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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McVicar A, Ravalier JM, Greenwood C. Biology of stress revisited: intracellular mechanisms and the conceptualization of stress. Stress Health 2014; 30:272-9. [PMID: 23868544 DOI: 10.1002/smi.2508] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 05/24/2013] [Accepted: 06/05/2013] [Indexed: 12/30/2022]
Abstract
Application of allostatic theory to stress during the 1990s refocused attention on internal responses to a perceived hazard, and the last 20 years has seen considerable developments in the biological contexts of stress. Evidence from neuroscience now suggests that secretion of the hormone cortisol is not only stimulated by the outcomes of cognitive transaction but it also feeds back and contributes positively to the cognitive adaptation that is a feature of stress resilience. More recently, the operative intracellular mechanisms are beginning to be understood and provide an insight into the regulation and maintenance of intracellular homeostasis that underpins adaptive change and vulnerability. The maintenance or appropriate modulation of intracellular homeostasis usually provides a buffering of potential adverse interactions. However, the capacity to do so is diminished during chronic stress leading to intracellular and subsequently systemic, homeostatic failure and hence maladaptation. This area of research seems far removed from cognitive theory, but placing intracellular homeostasis at the core of cognitive and biological responses supports the concept of stress as a genuinely psycho-biological phenomenon.
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Affiliation(s)
- Andrew McVicar
- Department of Allied Health and Medicine, Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, Essex, UK
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Refining and integrating schizophrenia pathophysiology – Relevance of the allostatic load concept. Neurosci Biobehav Rev 2014; 45:183-201. [DOI: 10.1016/j.neubiorev.2014.06.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 04/02/2014] [Accepted: 06/09/2014] [Indexed: 12/20/2022]
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Zoccola PM, Rabideau EM, Figueroa WS, Woody A. Cardiovascular and affective consequences of ruminating on a performance stressor depend on mode of thought. Stress Health 2014; 30:188-97. [PMID: 25100270 DOI: 10.1002/smi.2588] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 04/09/2014] [Accepted: 05/07/2014] [Indexed: 11/08/2022]
Abstract
Psychological detachment from work is important for facilitating recovery. This can be threatened by rumination, or thinking about the day's stressors. Rumination may lead to distress, fatigue and extended activation of stress-related systems, but findings are not unequivocal. Level of construal (abstract or concrete) and type of mentation (imagery or verbal thought) used during stressor-focused rumination may shape physiological and affective responses and impact recovery. This study tested whether blood pressure (BP) and anxiety responses to stressor-focused rumination differ by mentation type and construal level. Healthy undergraduates (n = 136) performed a speech stressor and then completed a rumination task in one of four randomly assigned conditions: concrete imagery, abstract imagery, concrete verbal thought or abstract verbal thought. Anxiety and continuous BP were assessed. Concrete rumination led to greater BP, whereas rumination with abstract construals led to lower BP. Furthermore, participants in the abstract conditions had greater increases in anxiety following stressor-focused rumination than in the concrete conditions. Results suggest that the immediate physiological and psychological consequences of stressor-focused rumination depend upon mode of thought.
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Nocturnal cardiac autonomic profile in young primary insomniacs and good sleepers. Int J Psychophysiol 2014; 93:332-9. [PMID: 24998642 DOI: 10.1016/j.ijpsycho.2014.06.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 06/24/2014] [Accepted: 06/26/2014] [Indexed: 01/08/2023]
Abstract
We investigated cardiac vagal and sympathetic activity in 13 young primary insomniacs (PI; 24.4±1.6years) and 14 good sleepers (GS; 23.3±2.5years) during nocturnal sleep. Pre-ejection period (PEP; inversely related to beta-adrenergic sympathetic activity), interval between consecutive R-waves (RR), and vagal-related indices of time- and frequency-domain heart rate variability were computed during pre-sleep wakefulness and undisturbed arousal-free sleep stages (N2, SWS, REM) as well as across the whole night irrespective of the presence of disruptive sleep events (e.g. sleep arousals/awakenings) and/or sleep stage transitions. Groups exhibited a similar vagal activity throughout each undisturbed sleep stage as well as considering the whole night, with a higher modulation during sleep compared to prior wakefulness. However, PEP was constantly shorter (higher sympathetic activity) during pre-sleep wakefulness and each sleep stage in PI compared to GS. Moreover, pre-sleep RR intervals were positively associated with sleep efficiency and negatively associated with wake after sleep onset in PI. Altogether our findings indicated a dysfunctional sympathetic activity but a normal parasympathetic modulation before and during sleep in young adults with insomnia.
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Smith AJ, Malan L, Uys AS, Malan NT, Harvey BH, Ziemssen T. Attenuated brain-derived neurotrophic factor and hypertrophic remodelling: the SABPA study. J Hum Hypertens 2014; 29:33-9. [PMID: 24898921 DOI: 10.1038/jhh.2014.39] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 03/25/2014] [Accepted: 04/02/2014] [Indexed: 11/09/2022]
Abstract
Brain-derived neurotrophic factor (BDNF) has been linked to neurological pathologies, but its role in cardiometabolic disturbances is limited. We aimed to assess the association between serum BDNF levels and structural endothelial dysfunction (ED) as determined by cross-sectional wall area (CSWA) and albumin/creatinine ratio (ACR) in black Africans. Ambulatory blood pressure (BP) and ultrasound CSWA values were obtained from 82 males and 90 females. Fasting blood and 8 h overnight urine samples were collected to determine serum BDNF and cardiometabolic risk markers, that is, glycated haemoglobin (HbA1c), lipids, inflammation and ACR. BDNF median split × gender interaction effects for structural ED justified stratification of BDNF into low and high (⩽/>1.37 ng ml(-1)) gender groups. BDNF values (0.86-1.98 ng ml(-1)) were substantially lower than reference ranges (6.97-42.6 ng ml(-1)) in the African gender cohort, independent of age and body mass index. No relationship was revealed between BDNF and renal function and was opposed by an inverse relationship between BDNF and CSWA (r=-0.17; P=0.03) in the African cohort. Linear regression analyses revealed a positive relationship between systolic BP and structural remodelling in the total cohort and low-BDNF gender groups. In the high-BDNF females, HbA1C was associated with structural remodelling. Attenuated or possible downregulated BDNF levels were associated with hypertrophic remodelling, and may be a compensatory mechanism for the higher BP in Africans. In addition, metabolic risk and hypertrophic remodelling in women with high BDNF underpin different underlying mechanisms for impaired neurotrophin homeostasis in men and women.
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Affiliation(s)
- A J Smith
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
| | - L Malan
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
| | - A S Uys
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
| | - N T Malan
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa
| | - B H Harvey
- Center of Excellence for Pharmaceutical Sciences, Division of Pharmacology, School for Pharmacy, North-West University, Potchefstroom, South Africa
| | - T Ziemssen
- Department of Neurology, Medical Faculty Carl Gustav Carus, Technische Universität, Dresden, Germany
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Wright L, Simpson W, Van Lieshout RJ, Steiner M. Depression and cardiovascular disease in women: is there a common immunological basis? A theoretical synthesis. Ther Adv Cardiovasc Dis 2014; 8:56-69. [DOI: 10.1177/1753944714521671] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Clinical studies have established an inherent comorbidity between depression and the development of cardiovascular disease (CVD). Furthermore, this comorbidity seems to be more amplified in women than in men. To further investigate this comorbidity, a thorough literature review was conducted on studies from 1992 to date. The PubMed database was accessed using the keywords: cardiovascular disease, inflammation, depression, and sex differences. Both human and animal studies were considered. This review takes the standpoint that depression and CVD are both inflammatory disorders, and that their co-occurrence may be related to how the hypothalamic–pituitary–adrenal axis, serotonergic transmission and circulation, and the renin–angiotensin–aldosterone system via angiotensin II are affected by the excess secretion of proinflammatory cytokines. More recently, preliminary research attributes this systemic inflammation to a global deficiency in CD4+CD25+FOXP3 regulatory T cells. 17-β estradiol and progesterone mediated modulation of cytokine secretion may partially explain the sex differences observed. These hormones and reproductive events associated with hormonal fluctuations are discussed in depth, including the analysis of perinatal models of depression and CVD, including preeclampsia. However, as evidenced by this review, there is a need for mechanistic research in humans to truly understand the nature and directionality of the relationship between depression and CVD.
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Affiliation(s)
- Lauren Wright
- MiNDS Neuroscience Program, McMaster University, Canada and Women’s Health Concerns Clinic, St Joseph’s Healthcare, Hamilton, ON, Canada
| | - William Simpson
- MiNDS Neuroscience Program, McMaster University, Canada and Women’s Health Concerns Clinic, St Joseph’s Healthcare, Hamilton, ON, Canada
| | - Ryan J. Van Lieshout
- MiNDS Neuroscience Program, McMaster University, Canada and Women’s Health Concerns Clinic, St Joseph’s Healthcare, and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Meir Steiner
- MiNDS Neuroscience Program, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada and Women’s Health Concerns Clinic, St Joseph’s Healthcare, 301 James Street South, Hamilton, ON, Canada L8P 3B6
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Szymczyk I, Wojtyna E, Lukas W, Kępa J, Pawlikowska T. How does gender influence the recognition of cardiovascular risk and adherence to self-care recommendations?: A study in Polish primary care. BMC FAMILY PRACTICE 2013; 14:165. [PMID: 24175983 PMCID: PMC3818445 DOI: 10.1186/1471-2296-14-165] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Accepted: 10/29/2013] [Indexed: 11/24/2022]
Abstract
Background Studies have shown a correlation between gender and an ability to change lifestyle to reduce the risk of disease. However, the results of these studies are ambiguous, especially where a healthy lifestyle is concerned. Additionally, health behaviors are strongly modified by culture and the environment. Psychological factors also substantially affect engagement with disease-related lifestyle interventions. This study aimed to examine whether there are differences between men and women in the frequency of health care behavior for the purpose of reducing cardiovascular risk (CVR), as well as cognitive appraisal of this type of risk. We also aimed to identify the psychological predictors of engaging in recommended behavior for reducing the risk of cardiovascular disease after providing information about this risk in men and women. Methods A total of 134 consecutive eligible patients in a family practice entered a longitudinal study. At initial consultation, the individual’s CVR and associated health burden was examined, and preventive measures were recommended by the physician. Self-care behavior, cognitive appraisal of risk, and coping styles were then assessed using psychological questionnaires. Six months after the initial data collection, the frequency of subjects’ self-care behavior was examined. Results We found an increase in health care behavior after providing information regarding the rate of CVR in both sexes; this increase was greater for women than for men. Women followed self-care guidelines more often than men, particularly for preventive measures and dietary advice. Women were more inclined to recognize their CVR as a challenge. Coping style, cognitive appraisal, age, level of health behaviors at baseline and CVR values accounted for 48% of the variance in adherence to self-care guidelines in women and it was 52% in men. In women, total risk of CVD values were most important, while in men, cognitive appraisal of harm/loss was most important. Conclusions Different predictors of acquisition of health behavior are encountered in men and women. Our results suggest that gender-adjusted motivation models influencing the recognition process need to be considered to optimize compliance in patients with CVR.
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Affiliation(s)
| | - Ewa Wojtyna
- Institute of Psychology, University of Silesia in Katowice, ul, Grażyńskiego 53, 40-126 Katowice, Poland.
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Bogg T, Roberts BW. The case for conscientiousness: evidence and implications for a personality trait marker of health and longevity. Ann Behav Med 2013; 45:278-88. [PMID: 23225322 DOI: 10.1007/s12160-012-9454-6] [Citation(s) in RCA: 153] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Recent initiatives by major funding agencies have emphasized translational and personalized approaches (e.g., genetic testing) to health research and health management. While such directives are appropriate, and will likely produce tangible health benefits, we seek to highlight a confluence of several lines of research showing relations between the personality dimension of conscientiousness and a variety of health-related outcomes. METHODS Using a modified health process model, we review the compelling evidence linking conscientiousness to health and disease processes, including longevity, diseases, morbidity-related risk factors, health-related psychophysiological mechanisms, health-related behaviors, and social environmental factors related to health. CONCLUSION We argue the accumulated evidence supports greater integration of conscientiousness into public health, epidemiological, and medical research, with the ultimate aim of understanding how facilitating more optimal trait standing might foster better health.
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Affiliation(s)
- Tim Bogg
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Detroit, MI 48202, USA.
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Effects of acute and chronic stress on the L-arginine nitric oxide pathway in black and white South Africans: the sympathetic activity and ambulatory blood pressure in Africans study. Psychosom Med 2013; 75:751-8. [PMID: 23960161 DOI: 10.1097/psy.0b013e3182a3e465] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study investigated the impact of stress on effectors of the L-arginine/nitric oxide (NO) system including the endogenous inhibitor asymmetric dimethylarginine (ADMA). METHODS Black (n = 168) and white (n = 206) South African teachers were exposed to a mental and a physical stressor for 1 minute, respectively. Serum samples for determination of l-arginine, NO metabolites, ADMA, and symmetric dimethylarginine (SDMA) were obtained at rest and during stress exposure. Perception of task stressfulness was assessed on a 7-point Likert scale, and psychological distress was estimated by the General Health Questionnaire. RESULTS Black South Africans exhibited higher resting levels of NO metabolites (adjusted mean [standard error of the mean] = 11.3 [1.3] versus 3.9 [1.1] μmol/l, p < .001) but lower circulating ADMA (0.62 [0.02] versus 0.70 [0.02] μmol/l, p = .004) and SDMA (0.41 [0.01] versus 0.53 [0.01] μmol/l, p < .001) than did white South Africans. Ethnicity-by-psychological distress interaction was observed for resting levels of ADMA (p = .002), SDMA (p = .038), and L-arginine (p = .048). Ethnic differences in responses to experimental stress were evident for NO metabolites (blacks versus whites: 5.94 [1.55] versus -0.74 [1.25] μmol/l, p = .004) and SDMA (blacks versus whites: -0.02 [0.01] versus 0.02 [0.01] μmol/l, p = .004). Ethnicity-by-psychological distress interaction for stress responses was found for l-arginine/ADMA ratio (p = .027). CONCLUSIONS The l-arginine/NO system is affected by psychosocial distress with higher susceptibility in black South Africans. This interaction may contribute to the higher cardiovascular disease risk in black South Africans.
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Harvey BH, Hamer M, Louw R, van der Westhuizen FH, Malan L. Metabolic and glutathione redox markers associated with brain-derived neurotrophic factor in depressed african men and women: evidence for counterregulation? Neuropsychobiology 2013; 67:33-40. [PMID: 23221974 DOI: 10.1159/000343501] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 09/10/2012] [Indexed: 01/09/2023]
Abstract
BACKGROUND Major depression is associated with evidence for metabolic and redox imbalance and also with reports of lower serum levels of brain-derived neurotrophic factor (BDNF). However, the relationship between these factors has not been well studied. METHODS We studied the contribution of physiological risk factors to cardiometabolic health in 200 adult male and female black Africans, aged between 36 and 52 years, presenting with (n = 89) and without (n = 111) symptoms of depression. Specifically the association between serum BDNF and markers of basal metabolic and redox status in depressed versus nondepressed individuals were analyzed. RESULTS BDNF and markers of redox and metabolic status were not associated with the symptoms of depression. Waist circumference, a metabolic risk factor, was positively associated with BDNF and accounts for 49% of the variance in BDNF in depressed men. Reduced and oxidized glutathione were positively and negatively correlated with BDNF in depressed women, respectively, with glutathione redox status accounting for 36-42% of the variance in BDNF. CONCLUSION Selected metabolic and redox factors explained gender-specific variances in serum BDNF levels in depressed African men and women. Our findings suggest that changes in redox and metabolic status may represent counterregulation by BDNF or alternatively that BDNF may mediate undesirable redox and metabolic changes that are associated with the development of a mood disorder.
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Affiliation(s)
- Brian H Harvey
- Unit for Drug Research and Development, Division of Pharmacology, School for Pharmacy, North-West University, Potchefstroom, South Africa.
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de Zambotti M, Covassin N, Sarlo M, De Min Tona G, Trinder J, Stegagno L. Nighttime cardiac sympathetic hyper-activation in young primary insomniacs. Clin Auton Res 2012; 23:49-56. [PMID: 22975984 DOI: 10.1007/s10286-012-0178-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 08/27/2012] [Indexed: 11/27/2022]
Abstract
PURPOSE A growing literature supports the association between insomnia and cardiovascular risk. Since only few studies have provided empirical evidence of hyper-activation of the cardiovascular system in insomniacs, the aim of the present study was to analyze cardiac autonomic responses in primary insomnia. METHODS Impedance cardiography and heart rate variability (HRV) measures were assessed in 9 insomniacs and 9 good sleepers during a night of polysomnographic recording. RESULTS Insomniacs were found to be characterized by a constant sympathetic hyper-activation which was maintained all night, as suggested by a faster pre-ejection period (PEP) compared to good sleepers. In addition, only insomniacs showed a strong reduction in heart rate in the transition from wake to sleep. Both groups exhibited a reduction in cardiac output and sympathovagal balance, i.e., reductions in low-frequency/high-frequency ratio and increases in high-frequency normalized units of HRV, across the night. In addition, in our sample, a high physiological sympathetic activation (fast PEP) at night was found to be directly associated with low quality of sleep. CONCLUSIONS These preliminary findings suggest that a constant cardiac sympathetic hyper-activation throughout the night is a main feature of primary insomnia. Our evidences support the association between insomnia and increased risk for cardiovascular diseases.
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Affiliation(s)
- M de Zambotti
- Department of General Psychology, University of Padova,Padua, Italy.
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Facilitated defensive coping, silent ischaemia and ECG left-ventricular hypertrophy: the SABPA study. J Hypertens 2012; 30:543-50. [PMID: 22245987 DOI: 10.1097/hjh.0b013e32834fcf82] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Defensive active coping responses (being-in-control, acceptance of the stressor as reality) have been associated with vascular hyper-responsiveness in urban Africans. However, the association between active coping responses, blood pressure (BP), and ECG-derived left-ventricular hypertrophy (LVH) responses is unknown. OBJECTIVES AND METHODS Associations between BP, silent ischaemia and ECG Cornell product LVH were assessed in 161 African and Caucasian men with active coping responses identified by the Amirkhan Coping Strategy Indicator. BP, ECG and silent ischaemia data were obtained from 24-h ambulatory monitoring. Beat-to-beat BP was continuously recorded during stress testing and fasting resting blood samples obtained for biochemical analyses. RESULTS Enhanced ß-adrenergic central cardiac responses were evident in active coping Caucasians as opposed to a predomination of α-adrenergic vascular responses in active coping Africans. Active coping African men displayed higher 24-h BP and prevalence of silent ischaemia events compared to the Caucasian men. Regression analyses revealed that α-adrenergic responses were associated with silent ischaemic events, adjusted R 0.21 [ß 1.07, 95% confidence interval (CI) 0.29-1.85] and that ischaemic events predicted LVH in active coping Africans (adjusted R 0.12, ß 0.35, 95% CI 0.11-0.59). Receiver-operated characteristic (ROC) analyses indicated a defensive pathway cut point of 16 in Africans as opposed to 32 in Caucasians predicting silent ischaemia with sensitivity/specificity 100/96%. CONCLUSIONS A defensive pathway revealed disturbed vascular function showing dissociation between behavioural and physiological ß-adrenergic active coping responses in Africans. Vascular responsiveness facilitated silent ischaemia events and structural LVH changes which potentially explain the increased risk for incident ischaemic stroke in black Africans.
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Malan L, Hamer M, Reimann M, Huisman H, Van Rooyen J, Schutte A, Schutte R, Potgieter J, Wissing M, Steyn F, Seedat Y, Malan N. Defensive coping, urbanization, and neuroendocrine function in Black Africans: The THUSA study. Psychophysiology 2012; 49:807-14. [PMID: 22416967 DOI: 10.1111/j.1469-8986.2012.01362.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 12/20/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Leoné Malan
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences; North-West University; Potchefstroom; South Africa
| | - Mark Hamer
- Department of Epidemiology and Public Health; University College of London; UK
| | - Manja Reimann
- Department of Neurology, Medical Faculty Carl Gustav Carus; Dresden University of Technology; Dresden; Germany
| | - Hugo Huisman
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences; North-West University; Potchefstroom; South Africa
| | - Johannes Van Rooyen
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences; North-West University; Potchefstroom; South Africa
| | - Alta Schutte
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences; North-West University; Potchefstroom; South Africa
| | - Rudolph Schutte
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences; North-West University; Potchefstroom; South Africa
| | - Johan Potgieter
- School for Psychosocial Behavioral Sciences; North-West University; Potchefstroom; South Africa
| | - Marié Wissing
- School for Psychosocial Behavioral Sciences; North-West University; Potchefstroom; South Africa
| | - Faans Steyn
- Statistical Consultation Service; North-West University; Potchefstroom; South Africa
| | - Yaackob Seedat
- The Renal Hypertension Unit, Nelson Mandela School of Medicine; University of KwaZulu-Natal; South Africa
| | - Nico Malan
- Hypertension in Africa Research Team (HART), School for Physiology, Nutrition and Consumer Sciences; North-West University; Potchefstroom; South Africa
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Aller MA, Arias N, Fuentes-Julian S, Blazquez-Martinez A, Argudo S, Miguel MPD, Arias JL, Arias J. Coupling inflammation with evo-devo. Med Hypotheses 2012; 78:721-31. [PMID: 22405850 DOI: 10.1016/j.mehy.2012.02.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 01/17/2012] [Accepted: 02/15/2012] [Indexed: 02/07/2023]
Abstract
Inflammation integrates diverse mechanisms that are associated not only with pathological conditions, such as cardiovascular diseases, type 2 diabetes, obesity, neurodegenerative diseases and cancer, but also with physiological processes like reproduction i.e. oogenesis and embryogenesis as well as aging. In the current review we firstly propose that the inflammatory response could recapitulate the phylogenia. In this way, highly conserved inflammatory mechanisms that play a main role in the evolutive development of different animal species, both invertebrates as well as vertebrates, are identified. Therefore, we also hypothesize that inflammation could represent a key tool used by nature to modulate organisms according to the environmental conditions in which these develop. Thus, inflammation could be the pathway by which the environmental factors could be related to the evolutionary development. If so, the diverse human chronic inflammatory diseases that nowadays the Western society suffer would represent the way for adapting to the abrupt changes in their lifestyle. Nonetheless, the distribution of the different pathological conditions varies in terms of intensity and magnitude among Western country populations depending on their genetic polymorphism. In this case, it should be considered that this set of diseases, distributed between all the individuals that constitute the Westernized society, would represent a true Social Inflammatory Syndrome whose final result is its remodeling. In this context, the use of inflammation by the Western society could represent the camouflaged expression of efficient mechanisms of evolution and development. In addition, if the different types of the inflammatory response involved in these diverse chronic pathological conditions could trace the biochemical origins of life, perhaps inflammation could represent an archaeological tool of unsuspected usefulness for understanding our own origin.
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Affiliation(s)
- María-Angeles Aller
- Surgery I Department, School of Medicine, Complutense University of Madrid, Spain
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Tolmay CM, Malan L, van Rooyen JM. The relationship between cortisol, C-reactive protein and hypertension in African and Causcasian women: the POWIRS study. Cardiovasc J Afr 2012; 23:78-84. [PMID: 22447476 PMCID: PMC3721929 DOI: 10.5830/cvja-2011-035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 06/14/2011] [Indexed: 11/06/2022] Open
Abstract
Research on the roles that C-reactive protein (CRP) and other risk factors such as cortisol and obesity play in the diagnosis of cardiovascular disease (CVD) in African and Caucasian women has become increasingly imperative when one considers the prevalence of hypertension in these groups. CRP and cortisol have been associated with an increased prevalence of hypertension and obesity. Cortisol has also been linked with both hypertension and the hypothalamic-pituitary-adrenal (HPA) response. African women have previously presented with an increased vascular reactivity. Conversely, Caucasian women have displayed an increased central cardiac reactivity. We included African (n = 102) and Caucasian (n = 115) women in the study, matched for age and body mass index. Elevated CRP levels were observed in African women compared to Caucasian women. A trend of hypocortisolism was exhibited in both hypertensive ethnic groups. Systolic blood pressure (SBP) and a vascular marker, arterial compliance (Cw), predicted hypertension in African women. Conversely, in Caucasian women, only SBP predicted hypertension. These results suggest the apparently diverse roles that dysregulation by the HPA axis, in conjunction with the respective cardiac and vascular responses in both Caucasian and African women, can play in future cardiovascular risk for these groups.
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Affiliation(s)
- Claire M Tolmay
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
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From Brain to Behavior: Hypertension's Modulation of Cognition and Affect. Int J Hypertens 2012; 2012:701385. [PMID: 22518290 PMCID: PMC3296233 DOI: 10.1155/2012/701385] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 10/24/2011] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence from animal models and human studies of essential hypertension suggest that brain regulation of the vasculature is impacted by the disease. Human neuroimaging findings suggest that the brain may be an early target of the disease. This observation reinforces earlier research suggesting that psychological factors may be one of the many contributory factors to the initiation of the disease. Alternatively or in addition, initial blood pressure increases may impact cognitive and/or affective function. Evidence for an impact of blood pressure on the perception and experience of affect is reviewed vis-a-vis brain imaging findings suggesting that such involvement in hypertensive individuals is likely.
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