Influence of ethnicity and gender on cardiovascular responses to active coping and inhibitory-passive coping challenges

Effort analysis of gender differences in cardiovascular response: Further evidence involving a traditionally feminine incentive

Participants were presented a moderately- or impossibly difficult cumulative mental addition task with instructions that they could win a traditionally feminine- or masculine incentive if they achieved a 90% success rate. When the incentive was feminine, systolic blood pressure responses during the task period were stronger under moderately difficult conditions among women, but low irrespective of difficulty among men - creating a gender difference only when difficulty was moderate. By contrast, when the incentive was masculine, systolic-, mean arterial- and, to a lesser degree, diastolic blood pressure responses during the task period were stronger under moderately difficult conditions irrespective of gender. The former finding confirmed expectations and adds substantively to the body of evidence favoring a recent effort analysis of gender influence on CV response to performance challenge. The latter findings conflict with what was first expected, but can be understood in terms of post hoc reasoning extended in light of participants' ratings of the masculine incentive.

Optimism and Planning for Future Care Needs among Older Adults

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism was associated with more planning. High optimism may be a barrier to future planning in certain social and cultural contexts.

Alpha-adrenergic receptor gene polymorphisms and cardiovascular reactivity to stress in Black adolescents and young adults

Cardiovascular reactivity to stress and α-adrenergic receptor (α-AR) function may contribute to the development of hypertension. As Black Americans have an increased risk of hypertension, we evaluated associations between α(1A) -AR (Arg492Cys), α(2A) -AR (-1291C/G), and α(2B) -AR (Ins/Del301-303) gene variants and cardiovascular reactivity in 500 normotensive Black youth. Heart rate, preejection period, total peripheral resistance, and blood pressure were measured during cold and psychological stress. The Arg492Cys polymorphism in the α(1A) -AR gene was associated with heart rate reactivity to stress, but the association depended on sex. The -1291C/G promoter polymorphism in the α(2A) -AR gene was associated with vascular reactivity to stress; vasoconstriction increased as a linear function of the number of copies of the variant G allele. Thus, specific associations emerged between genetic variations in α-Ars and cardiovascular reactivity in young Blacks.

Sexual arousal in East Asian and Euro-Canadian women: a psychophysiological study

INTRODUCTION

Studies of ethnic differences in self-report measures of sexuality have shown East Asian women to be more sexually conservative and less sexually experienced than Caucasian women. There is also strong evidence supporting the notion of ethnic group differences in general measures of nonsexual psychophysiological arousal; however, there have been no previous studies exploring ethnicity and physiological sexual arousal.

AIM

The objective of this study was to explore group differences in self-reported and physiological sexual arousal in Euro-Canadian and East Asian women living in Canada; we also aimed to explore the association between level of acculturation (both mainstream and heritage) and sexual arousal in East Asian women only.

METHODS

Seventy-five women (N=38 Euro-Canadian, N=37 East Asian) completed a battery of questionnaires and underwent psychophysiological sexual arousal testing using the vaginal photoplethysmograph. They also completed a self-report measure of subjective arousal before and after erotic stimulus exposure.

MAIN OUTCOME MEASURES

All women completed the Female Sexual Function Index, Vancouver Index of Acculturation, and Sexual Beliefs and Information Questionnaire. Change in genital sexual arousal (vaginal pulse amplitude; VPA), and change in subjective sexual arousal were measured during exposure to erotic stimuli.

RESULTS

The groups did not differ in the percent increase in VPA induced by erotic stimuli, nor was there a correlation between VPA and subjective sexual arousal. Among East Asian women alone, neither heritage nor mainstream acculturation was correlated with change in VPA.

CONCLUSIONS

East Asian and Euro-Canadian women who show similar ratings of sexual behaviors and self-reported sexual arousal do not differ in physiological or subjective arousal induced by erotic stimuli in the laboratory.

Specific coping strategies of Africans during urbanization: Comparing cardiovascular responses and perception of health data

Specific coping mechanisms of Africans during urbanization were compared to and correlated with cardiovascular responses and perception of health data. Subjects included men (N=286) and women (N=360). The COPE questionnaire classified subjects as active (AC) or passive (PC) copers and the General Health Questionnaire measured subjective perception of health. The Finapres recorded blood pressure continuously before and during application of a handgrip test. Analyses adjusting for age, body mass index and resting cardiovascular data revealed that AC rural subjects showed predominantly cardiac responses and PC rural subjects predominantly vascular responses. All urbanized African men and women showed higher resting blood pressure, vascular responsiveness and hypertension prevalences than their rural counterparts. All rural AC subjects, especially women, and all urban PC subjects, especially men, reported a poorer perception of health. In conclusion, subjects with a PC style showed a predominantly vascular response in rural and urban areas whereas subjects with an AC style seem to shift from a predominant cardiac output response to a predominant vascular resistance response when moving from a rural to an urban area.

Blood pressure stress reactivity and left ventricular mass in a random community sample of African-American and caucasian men and women

Exaggerated blood pressure (BP) reactivity to stress may contribute to left ventricular (LV) hypertrophy, a major risk factor for cardiovascular morbidity. This study examined the extent to which BP responses to acute stress are associated with LV mass and relative wall thickness in a community sample of African-American and white men and women. BP was measured at rest and in response to 2 acute challenges (mental arithmetic and handgrip). Systolic BP at rest was positively associated with LV mass and relative wall thickness (p < 0.001). The associations between the responses to the stressors and LV mass were not significant. African-American and white men who exhibited high BP responses to the arithmetic stressor had greater relative wall thickness than those with low reactivity (p < 0.05). In conclusion, BP reactivity is not related to LV mass, but may be related to concentric remodeling.

The influence of hostility and family history of cardiovascular disease on autonomic activation in response to controllable versus noncontrollable stress, anger imagery induction, and relaxation imagery

Autonomic activation in response to controllable versus noncontrollable stress, anger imagery induction, and relaxation imagery was studied among 80 participants between the ages of 18 and 34 years. Participants differed in level of trait hostility and family history of cardiovascular disease. Results were obtained through power spectral analyses of electrocardiograph R-R intervals, which produced an index of autonomic nervous system activation. For both male and female populations, parasympathetic regulation was diminished during anger induction for individuals with high levels of trait hostility and having a family history of cardiovascular disease. Similar results were obtained for women during the uncontrolled stress condition. Based on family history of cardiovascular disease and trait hostility, men responded differentially to relaxation imagery induction, whereas no differences were found among females.

Association Between Hemodynamic Profile During Laboratory Stress and Ambulatory Pulse Pressure

Hemodynamic responses underlying blood pressure reactivity to laboratory stress are theoretically linked to cardiovascular pathophysiology. The present study investigated whether a vascular response predicted ambulatory pulse pressure, a known risk factor for cardiovascular disease. A new model of hemodynamic profile, previously developed by the authors, was applied to 24-h ambulatory data from 30 female and 34 male healthy young adults. Of these, 40 were monitored during a naturalistic stressor (university examination). For females, hemodynamic profile significantly predicted nighttime systolic blood pressure, and 24-h, day-, and nighttime diastolic blood pressure, but not ambulatory pulse pressure. A vascular or mixed hemodynamic profile significantly predicted 24-h and daytime ambulatory pulse pressure in males. The findings are consistent with theories of pathogenic mechanisms involving vascular changes and suggest that, for males, a vascular or mixed hemodynamic profile measured during laboratory stress may be a risk marker for cardiovascular disease, by its association with ambulatory pulse pressure.

Ethnic differences in cardiovascular responses to laboratory stress: a comparison between asian and white americans

Compared to other ethnic groups, Asian Americans show significantly lower rates of cardiovascular disease (CVD). We tested the hypothesis that Asian Americans would show reduced cardiovascular responses to laboratory stressors than Caucasians. Forty-three Asians (18 men, 25 women) and 77 Caucasians (36 men, 41 women) with a mean age of 24 years (SD = 3.93) participated in a stress reactivity protocol consisting of four tasks (speech, serial subtraction, mirror tracing, handgrip) while heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured. Asian Americans demonstrated overall lower reactivity across tasks for SBP F(1,117 = 7.48, p < .01) and a trend toward lower HR response F(1,117 = 3.18, p < .10). A significant ethnicity by task interaction was observed for HR reactivity F(3,351 = 2.94, p < .05) such that Caucasians showed greater responses for the subtraction task.

Ethnicity, gender, and age effects on adrenoceptors and physiological responses to emotional stress

We examined the unique and joint effects of ethnicity, gender, and age on cardiovascular and catecholamine responses to the anger recall interview, and beta(2)-adrenergic receptor density and function on peripheral blood mononuclear cells. Participants were 179 nonsmoking, normotensive men and women aged 18-49 years. All subjects showed similar blood pressure increases during the anger recall interview. Black men, however, showed the smallest increases in heart rate in conjunction with an attenuated peripheral vasodilatation. Black women and Whites showed similar increases in heart rate and peripheral vasodilatation. Increasing age was associated with greater norepinephrine increases to anger recall in Black males. Black men also exhibited higher epinephrine levels throughout the protocol, higher dissociation constant to (125)I-pindolol, and age-dependent increases in beta(2)-receptor density. Relative to Whites and Black females, arousal of negative affect in Black males led to a pattern of sympathetic nervous system activity that may help explain the higher prevalence of hypertension in this population.

Depressive symptoms and cardiovascular reactivity to laboratory behavioral stress

Although a growing literature associates depressive symptoms with cardiovascular disease (CVD), the mechanisms underlying this association have not been clearly determined. The cardiovascular reactivity (CVR) hypothesis suggests that chronically elevated CVR during psychological distress can confer disease risk via vascular alterations. This investigation is a quantitative review of studies that evaluated the association of depressive symptoms with CVR. A total of 60 hypotheses were tested: 21 tests involved systolic blood pressure (SBP), 21 involved diastolic blood pressure (DBP), and 18 involved heart rate (HR). The aggregate effect size for the relation between depressive symptoms and HR reactivity was moderate (d = 0.37); aggregate effect sizes were small for SBP reactivity (d = 0.13) and DBP reactivity (d = 0.17). Effect sizes involving SBP reactivity were homogenous, whereas effect sizes involving DBP and HR reactivity were higher for studies that examined participants with CVD. These findings provide partial support for the associations of depressive symptoms with CVR.

Applying latent growth curve modeling to the investigation of individual differences in cardiovascular recovery from stress

OBJECTIVE

This paper provides an introduction to latent growth curve (LGC) modeling, a modern method for analyzing data resulting from change processes such as cardiovascular recovery from stress. LGC models are superior to traditional approaches such as repeated measures analysis of variance and simple change scores.

METHODS

The basic principles of LGC modeling are introduced and applied to data from 167 men and women whose systolic blood pressure was assessed before, during, and after the cold pressor and evaluated speech stressors and who had completed the Cook-Medley Hostility Inventory.

RESULTS

The LGC models revealed that systolic blood pressure recovery follows a different nonlinear trajectory after speech relative to the cold pressor. The difference resulted not from the initial decline at the completion of the stressor, but from higher levels at the end of the stressor and slower rate of change in decline for the speech. Hostility predicted the trajectory for speech but not for cold pressor. This relationship did not differ as a function of gender, although men had larger systolic blood pressure responses than women to both stressors.

CONCLUSIONS

LGC modeling yields an understanding of the processes and predictors of change that is not attainable through traditional statistical methods. Although our application concerns cardiovascular recovery from stress, LGC modeling has many other potential applications in psychosomatic research.

Perceived racism and blood pressure: a review of the literature and conceptual and methodological critique

Racial disparities in health, including elevated rates of hypertension (HT) among Blacks, are widely recognized and a matter of serious concern. Researchers have hypothesized that social stress, and in particular exposure to racism, may account for some of the between-group differences in the prevalence of HT and a portion of the within-group variations in risk for HT. However, there have been surprisingly few empirical studies of the relationship between perceived racism and blood pressure (BP) or cardiovascular reactivity (CVR), a possible marker of mechanisms culminating in cardiovascular disease. This article reviews published literature investigating the relationship of perceived racism to HT-related variables, including self-reported history of HT, BP level, or CVR. Strengths and weaknesses of the existing research are discussed to permit the identification of research areas that may elucidate the biopsychosocial mechanisms potentially linking racism to HT. We hope to encourage investigators to invest in research on the health effects of racism because a sound and detailed knowledge base in this area is necessary to address racial disparities in health.

Mirror Tracing and the Provocation of Vascular-Dominant Reaction Pattern Through Heightened Attention

Abstract After a hint from Lang et al.'s (1997) defence cascade, researchers considered cognitive process experienced when encountering mental stress to be composed of four elements: (serially) first attention (Attent), second unpleasant affect (UnplAff) and sometimes pleasant affect (PlAff), and third cognitive coping (CogCop). The present study investigates the effect of each cognitive element on the provocation of the well-known vascular-dominant reaction pattern during mirror tracing: elevation of mean blood pressure mainly because of increases in total peripheral resistance. Twenty-four male students first underwent four computer-simulated mirror-tracing practices of 3 min each, then a 7 min adaptation followed by a 3 min baseline, and further four kinds of actual mirror tracing trials (Attent, UnplAff, PlAff, and CogCop) of 3 min each. Results on the cardiovascular measures indicated that every mirror-tracing trial indisputably provoked the vascular-dominant reaction pattern. An alpha-adrenergic vascular sympathetic activation was heightened. Self-report measures on the four cognitive elements suggested that heightened Attent seemed to contribute to provoking the reaction pattern. Although the UnplAff and PlAff trials had an active coping feature in a narrow sense, they could not provoke the cardiac-dominant reaction pattern. Differences in task difficulty among the mirror tracings could not explain the results. The implications of these results are discussed in order to better understand cardiovascular hemodynamics during mental stress.

Reactivity as a predictor of subsequent blood pressure: racial differences in the Coronary Artery Risk Development in Young Adults (CARDIA) Study

This study investigated the association between cardiovascular reactivity and subsequent ambulatory blood pressure in 316 black and white men and women in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Cardiovascular laboratory reactivity was examined in subjects 20 to 33 years old, and ambulatory blood pressure and heart rate were measured 3 years later. Average ambulatory pressure during a 24-hour period was regressed separately on stress reactivity and standard covariate risk factors in each race/gender subgroup. Blacks had higher blood pressure and heart rates than whites, men had higher blood pressure than women, and women had higher heart rates than men. After controlling for age, baseline systolic pressure, familial history of hypertension, smoking, alcohol consumption, body mass index, and exercise, systolic blood pressure reactivity to star tracing and cold pressor stress were significantly associated with systolic ambulatory pressure in black men and women 3 years later (partial r=0.24 to 0.37). Heart rate reactivity to video challenge and star tracing were also significantly predictive of subsequent ambulatory heart rate in blacks. Diastolic star tracing reactivity was significantly associated with subsequent ambulatory blood pressure in black women (r=0.23), and diastolic reactivity to video and star tracing were significantly predictive of ambulatory diastolic pressure in white men (r=0.39). We conclude that hyperresponsivity to stress may be a risk factor for subsequent blood pressure elevation in blacks and may be one pathway leading to the higher prevalence of hypertension in blacks than in whites.

A meta-analytic examination of basal cardiovascular activity in posttraumatic stress disorder

OBJECTIVE

The objective of this meta-analytic study was to determine whether individuals with posttraumatic stress disorder (PTSD) have higher levels of basal cardiovascular activity relative to comparable groups of individuals without PTSD.

METHODS

Meta-analytic data methods were applied to 34 studies that gathered indicators of basal cardiovascular activity including: heart rate (HR), systolic blood pressure, and diastolic blood pressure on subjects diagnosed with PTSD and two types of comparison groups. In total, cardiovascular measures were analyzed for 2670 subjects across all studies.

RESULTS

Results indicate that individuals with a current PTSD diagnosis have higher resting HR relative to both trauma-exposed individuals without a PTSD diagnosis and non-trauma-exposed individuals. The results also suggest that PTSD is associated with elevations in blood pressure; however, the effect sizes were smaller in magnitude than those obtained for heart rate. A subset analysis revealed that the effect sizes for comparisons on basal HR were greatest in studies with the most chronic PTSD samples.

CONCLUSION

The meta-analysis supports previous qualitative reviews, finding a positive association between PTSD and basal cardiovascular activity. The discussion addresses possible mechanisms of action and the health-related implications of these findings.

Psychophysiological correlates of individual differences in patterns of hemodynamic reactivity

The present study delineates a method for the quantification of six hemodynamic reactivity patterns, in response to a laboratory stressor, and examines the psychophysiological correlates of individual differences in these patterns. One hundred and ninety-four young adult men and women participated in rest periods and two laboratory stressors, mental arithmetic and an anger recall interview. Measures were taken of blood pressure, heart rate, and cardiac output, from which total peripheral resistance was derived, as well as state reports of feelings during the tasks. Six hemodynamic reactor patterns were identified: Non-reactors, Mild Myocardials, Mild Vasculars, Myocardials, Vasculars, and Dual Reactors, each associated with a unique profile of cardiac output and total peripheral resistance change. Myocardial reactors to the interview had the highest resting levels of blood pressure and total peripheral resistance. Dual reactors had the largest increases in diastolic reactivity; Dual and Myocardial reactors had the largest increases in systolic reactivity. The extreme reactor groups (Dual, Myocardial, Vascular) all reported greater task invigoration than the Non-reactors, who reported greater efforts to relax. Reactor groups were similar on anger-related trait affect. Based on both resting blood pressure and magnitude of task-induced reactivity, Myocardial and Dual reactors may be at the greatest risk for subsequent hypertension.

Effect of low-dose estrogen on hemodynamic response to stress

OBJECTIVE

To determine the effect of low-dose esterified estrogen on hemodynamic responses at rest and during stress in postmenopausal women, and to compare the changes with those seen with conjugated equine estrogen.

DESIGN

Open-label study of esterified estrogen compared with a double-blind, placebo-controlled investigation of conjugated equine estrogen.

SETTING

Healthy volunteers in an academic research environment.

PATIENT(S)

Postmenopausal women with normal endometrium, not currently using hormones.

INTERVENTION(S)

Cardiovascular parameters at rest and in response to stressors were assessed in 11 postmenopausal women before and 6 months after receiving 0.3 mg esterified estrogen. Responses were compared with 42 postmenopausal women randomized to 0.625 mg conjugated equine estrogen or placebo.

MAIN OUTCOME MEASURE(S)

Changes in mean arterial pressure (MAP) and vascular resistance index from before to after treatment.

RESULT(S)

At rest, MAP increased 3.3 +/- 1.5 mm Hg (+/-SD) in the placebo group, while declining 2.3 +/- 1.5 mm Hg and 4.8 +/- 1.4 mm Hg, respectively, in the esterified estrogen and conjugated equine estrogen groups after treatment. During mental stressors, MAP dropped significantly in both treatment groups. At rest and during mental stressors, vascular resistance index decreased with estrogen treatment.

CONCLUSION(S)

Low-dose esterified estrogen improved hemodynamic patterns similar to standard doses of conjugated equine estrogen in postmenopausal women.

Multilevel integrative analyses of human behavior: social neuroscience and the complementing nature of social and biological approaches

Social and biological explanations traditionally have been cast as incompatible, but advances in recent years have revealed a new view synthesized from these 2 very different levels of analysis. The authors review evidence underscoring the complementing nature of social and biological levels of analysis and how the 2 together can foster understanding of the mechanisms underlying complex behavior and the mind. Specifically, they review the utility of considering social influences on biological processes that are often viewed as outside the social domain including genetic constitution, gene expression, disease, and autonomic, neuroendocrine, and immune activity. This research underscores the unity of psychology and the importance of retaining multilevel integrative research that spans molar and molecular levels of analysis. Especially needed in the coming years is more research on the mechanisms linking social and biological events and processes.

Classification of individual differences in cardiovascular responsivity: The contribution of reactor type controlling for race and gender

Classification of 150 normotensive or mildly hypertensive men and women into myocardial, vascular, or mild reactors was accomplished using a regression-based approach. The method was based on the participants' cardiac output (CO) and total peripheral resistance (TPR) reactivity to the speech presentation task. This task purportedly can elicit both myocardial and vascular responses. Cut-scores were based on the y-intercept from the linear regression of the CO reactivity on TPR reactivity and vice versa. A greater percentage of Black men were classified as vascular responders as compared to Black women and White participants. Groups were found to differ on cardiovascular reactivity to the speech preparation, cold pressor, and mirror tracing tasks in predictable ways, after controlling for gender and ethnicity. Groups were also differentiated by ambulatory blood pressure and hypertensive status. The study supports the classification of homogenous groups of participants based on the relative extent to which myocardial or vascular mechanisms dominate the reactivity to stress.