Parental history of hypertension and hostility moderate cardiovascular responses to interpersonal conflict

Psychological Profiles in the Prediction of Leukocyte Telomere Length in Healthy Individuals

BACKGROUND

Shorter telomere length (TL) may signal premature cellular aging and increased risk for disease. While depression and psychosocial stress have been associated with shorter telomeres, other psychological risk factors for cardiovascular disease have received less attention.

PURPOSE

To evaluate the association between TL and psychological risk factors (symptoms of anxiety and depression, hostility and defensiveness traits) for heart disease, and to examine whether chronological age and sex moderate the associations observed.

METHODS

132 healthy men and women (Mage = 45.34 years) completed the Marlowe-Crowne Social Desirability Scale, the Beck Depression Inventory II, The Beck Anxiety Inventory and the Cook-Medley Hostility Scale. Relative TL was measured by quantitative polymerase chain reaction (PCR) of total genomic DNA samples. A series of hierarchical linear regressions were performed controlling for pertinent covariates.

RESULTS

Shorter TL was observed among individuals high in defensiveness (β = -.221) and depressive symptoms (β = -.213), as well as in those with less hostility (β =.256) and anxiety (β =.220)(all Ps<.05). Psychological variables explained 19% of the variance over and above that explained by covariates (age, sex, exercise, alcohol consumption, systemic inflammation, and 24-hr mean arterial pressure). Age moderated the relation between TL and defensiveness (β =.179, p =.03). Sex did not influence any of the relations.

CONCLUSIONS

Telomere length is associated with psychological burden though the direction of effect differs depending on the psychological variables under study. Further research is needed to determine the reasons for and implications of these seemingly contradictory findings.

Cardiovascular and affective responses to social stress in adolescents with internalizing and externalizing problems

Behavioral responses to stress and challenge are based in emotional and physiological arousal reactions. Adolescents with maladaptive or problematic behavior patterns, such as internalizing or externalizing problems, are likely to show atypical emotional and physiological reactions to stress. Relations between problems and reactions to stress were examined in a sample of 55 young adolescents with normal to clinical levels of internalizing and externalizing problems. Youth had their self-reported emotional states, heart rate, and blood pressure levels measured before and after engaging in two socially challenging, evaluative manipulations. Internalizing problems were associated with less positive affect but greater anxiety and cardiovascular arousal, whereas externalizing problems predicted greater hostility and positive affect but less cardiovascular arousal. The necessity of recognizing and incorporating comorbid characteristics and multiple response systems into studies of the links between problems and reactivity is emphasized in the discussion.

Low social support and poor emotional regulation are associated with increased stress hormone reactivity to mental stress in systemic hypertension

CONTEXT

There is strong evidence for a physiological hyperreactivity to stress in systemic hypertension, but data on associated or potentially moderating psychological factors are scarce.

OBJECTIVE

The objective of the study was to identify psychological correlates of physiological stress reactivity in systemic hypertension.

DESIGN

This was a cross-sectional, quasi-experimentally controlled study. Study participants underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience.

SETTING

The study was conducted in the population in the state of Zurich, Switzerland.

SUBJECTS

Subjects included 22 hypertensive and 26 normotensive men (mean +/- sem 44 +/- 2 yr).

MAIN OUTCOME MEASURES

We assessed the psychological measures social support, emotional regulation, and cognitive appraisal of the stressful situation. Moreover, we measured salivary cortisol and plasma epinephrine and norepinephrine before and after stress and several times up to 60 min thereafter as well as blood pressure and heart rate.

RESULTS

We found poorer hedonistic emotional regulation (HER) and lower perceived social support in hypertensives, compared with normotensives (P < 0.01). Compared with normotensives, hypertensives showed higher cortisol, epinephrine, and norepinephrine secretions after stress (P < 0.038) as well as higher systolic and diastolic blood pressure (P < 0.001). Cortisol reactivity and norepinephrine secretion were highest in hypertensive men with low HER (P < 0.05). In contrast, hypertensives with high HER did not significantly differ from normotensives in both cortisol and norepinephrine secretion after stress. Epinephrine secretion was highest in hypertensives with low social support but was not different between hypertensives with high social support and normotensives.

CONCLUSIONS

The findings suggest that both low social support and low HER are associated with elevated stress hormone reactivity in systemic hypertension.

Interactive effects of avoidant coping and parental hypertension on Rate Pressure Product reactivity in women

BACKGROUND

Previous research suggests that personality, situational context variables, and genes might interact to potentiate cardiovascular stress responses.

PURPOSE

Our purpose is to examine interactive effects of dispositional avoidant coping and parental hypertension on cardiovascular reactivity to three different laboratory stressors.

METHOD

Participants were 63 healthy female students. Stressors were an evaluated videotaped speech, the cold pressor, and viewing of the speech video. Heart rate and blood pressure were continuously recorded during baselines and tasks.

RESULTS

After controlling for age, body mass index, smoking status, reported exercise, alcohol consumption, oral contraceptive use, parental hypertension, and avoidant coping, the interaction term of parental hypertension and avoidant coping was the best predictor of rate pressure product (RPP) reactivity to the speech task and to the video-viewing task. In contrast, reactivity to the cold pressor was not significantly predicted by this interaction term. Furthermore, there were no significant main effects of parental hypertension and avoidant coping on RPP reactivity in any of the tasks. There were no significant interactive effects for diastolic blood pressure.

CONCLUSIONS

Consistent with an interactive model of cardiovascular reactivity, parental hypertension plus avoidant coping led to enhanced RPP reactivity. This effect, however, was only evident during self-threatening stressors. The results suggest that the coincidence of genetic and personality factors might enhance risk for cardiovascular diseases.

Cardiovascular reactivity and family history of hypertension: A meta-analysis

A regression-based meta-analysis examined the degree to which the effects of a family history of hypertension on cardiovascular reactivity are moderated by the magnitude of cardiovascular responses elicited in challenge/task conditions. Mean change scores for negative family history groups were regressed on mean change scores for positive family history groups. The slopes of separate regression lines obtained for systolic and diastolic blood pressure and heart rate were significantly less than 1.0 and the y-intercepts for these regression lines were significantly greater than zero. This pattern indicates that family history differences in cardiovascular reactivity to stress are greatest in situations that elicit the smallest baseline-stressor change scores in non-family-history groups.

Diagnosis and treatment of hypertension in children and adolescents

PURPOSE

To provide nurse practitioners (NPs) with updated information regarding the etiology, diagnosis, and treatment of childhood hypertension.

DATA SOURCES

Extensive review of the scientific literature regarding hypertension, including the latest NIH recommendations.

CONCLUSIONS

Hypertension affects more than 350,000 American children. While the majority of hypertension in early childhood occurs from secondary causes, the incidence of essential hypertension in later childhood and adolescence is rising, raising concerns as elevated pressures in childhood "track" into adulthood. Early detection and treatment of elevated childhood pressures represent important steps in reducing long-term cardiovascular risk.

IMPLICATIONS FOR PRACTICE

NPs must be able to accurately differentiate between primary and secondary hypertension in childhood. Secondary hypertension requires prompt diagnosis and treatment, and controlling primary childhood hypertension has lifelong implications. Given the familial predisposition to hypertension, it is important for adult NPs to be aware of the risks faced by children of hypertensive patients.

Mood states and impedance cardiography-derived hemodynamics

OBJECTIVE

This exploratory study investigated the relation between psychological mood states and hemodynamic variables obtained at rest.

METHODS

We measured resting hemodynamic variables using impedance cardiography, blood pressure, heart rate, and the Profile of Mood States (POMS) in 71 participants.

RESULTS

Mood states were not significantly associated with heart rate, systolic, diastolic, or mean arterial pressure. In comparison with these basic measures of physiology, a number of impedance derived measures of hemodynamics were associated with mood states. Log stroke volume was negatively correlated with POMS tension-anxiety (r = -.319, p = .009) and fatigue-inertia (r = -. 316, p = .009). Log cardiac output was negatively associated with fatigue-inertia (r = -.346, p < .01). Log total peripheral vascular resistance was positively correlated with POMS fatigue-inertia (r = .276, p = .024).

CONCLUSIONS

Our findings suggest that mood states are associated with hemodynamic variables underlying blood pressure.

Hostile attitudes predict elevated vascular resistance during interpersonal stress in men and women

OBJECTIVE

Existing research indicates that hostility is associated with enhanced blood pressure responses during social stress, but little is known about the hemodynamic patterns underlying these blood pressure increases, particularly in women. The present study examined hemodynamic responses to a low-anger interpersonal stressor, testing the hypotheses that hostile individuals show enhanced vascular responses and that low hostile individuals show enhanced myocardial responses.

METHODS

Eighty undergraduate men and women were categorized as high or low in hostility on the basis of median splits of Cook-Medley Hostility Scale scores. Participants discussed a controversial topic with a confederate who disagreed with them, and hemodynamic responses were assessed with impedance cardiography.

RESULTS

High hostile individuals exhibited greater increases in diastolic blood pressure and total peripheral resistance and smaller increases in cardiac output during an interpersonal stressor than did low hostile individuals. Systolic blood pressure and heart rate increases were greater among high hostile relative to low hostile females and comparable among low and high hostile males. Affective responses and task perceptions were generally similar for high and low hostile participants, but the relationship between task perception and hemodynamic responses varied on the basis of hostility level.

CONCLUSIONS

These findings suggest that hostility in both men and women is associated with heightened vascular and dampened cardiac responsivity to interpersonal stress that is not deliberately anger provoking. Moreover, they indicate that the associations between task perception and hemodynamic responses vary between high and low hostile individuals.