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Hohneck A, Reyser C, Usselmann R, Heinemann L, Weingaertner S, Reckling H, Schumacher G, Burkholder I, Merx K, Hofmann WK, Hofheinz RD. Hemodynamic and Stress Response After Sound Intervention with Different Headphone Systems: A Double-Blind Randomized Study in Healthy Volunteers Working in the Health Care Sector. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:360-370. [PMID: 37819750 DOI: 10.1089/jicm.2022.0757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Objectives: Two headphone systems using different sound systems were compared to investigate the effects of a sound intervention on cardiovascular parameters, indicators of stress, and subjective feelings. Methods: One hundred volunteers who work in the health care sector reporting elevated workplace-related stress were enrolled and randomized to a 12-min sound intervention (classical music) with either conventional headphones ("MEZE 99 Classic") or with the same-but internally modified-headphone (called "Lautsaenger"). Cardiovascular parameters were measured with the VascAssist2.0, both before and after sound interventions. In addition, participants were asked to complete questionnaires on burnout risk and emotions/stress. Results: The study population consisted mainly of female participants (n = 83), with the majority being students (42%). Median age was 32.5 years (range 21-71). In terms of cardiovascular parameters, a significant reduction in aortic pulse wave velocity, as measure of arterial stiffness, and heart rate was observed within both treatment arms. Both systolic blood pressure and arterial flow resistance were reduced by sound intervention, while these effects were only documented with Lautsaenger. Treatment groups were comparable in terms of subjective feedback by participants: a significant increase in emotional wellbeing was achieved with both headphone systems. Conclusions: A single short-term sound intervention seems to be able to achieve objective cardiovascular improvements in healthy volunteers reporting subjective symptoms of workplace-related stress, using two different headphone systems. Moreover, significant emotional improvement was reported within both arms. Trial Registration: ISRCTN registry 70947363, date of registration August 13, 2021.
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Affiliation(s)
- Anna Hohneck
- Department of Cardiology, Angiology, Hemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Christina Reyser
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Rimma Usselmann
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Lara Heinemann
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Weingaertner
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Hardy Reckling
- Corporate Health Management, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Iris Burkholder
- Department of Nursing and Health, University of Applied Sciences of the Saarland, Saarbruecken, Germany
| | - Kirsten Merx
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Ralf-Dieter Hofheinz
- Department of Hematology and Oncology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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Rasero J, Verstynen TD, DuPont CM, Kraynak TE, Barinas-Mitchell E, Scudder MR, Kamarck TW, Sentis AI, Leckie RL, Gianaros PJ. Stressor-evoked brain activity, cardiovascular reactivity, and subclinical atherosclerosis in midlife adults. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.05.24302236. [PMID: 38370849 PMCID: PMC10871357 DOI: 10.1101/2024.02.05.24302236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Background Cardiovascular responses to psychological stressors have been separately associated with preclinical atherosclerosis and hemodynamic brain activity patterns across different studies and cohorts; however, what has not been established is whether cardiovascular stress responses reliably link indicators of stressor-evoked brain activity and preclinical atherosclerosis that have been measured in the same individuals. Accordingly, the present study used cross-validation and predictive modeling to test for the first time whether stressor-evoked systolic blood pressure (SBP) responses statistically mediated the association between concurrently measured brain activity and a vascular marker of preclinical atherosclerosis in the carotid arteries. Methods 624 midlife adults (aged 28-56 years, 54.97% female) from two different cohorts underwent two information-conflict fMRI tasks, with concurrent SBP measures collected. Carotid artery intima-media thickness (CA-IMT) was measured by ultrasonography. A mediation framework that included harmonization, cross-validation, and penalized principal component regression was then employed, while significant areas in possible direct and indirect effects were identified through bootstrapping. Sensitivity analysis further tested the robustness of findings after accounting for prevailing levels of cardiovascular disease risk and brain imaging data quality control. Results Task-averaged patterns of hemodynamic brain responses exhibited a generalizable association with CA-IMT, which was mediated by an area-under-the-curve measure of aggregate SBP reactivity. Importantly, this effect held in sensitivity analyses. Implicated brain areas in this mediation included the ventromedial prefrontal cortex, anterior cingulate cortex, insula and amygdala. Conclusions These novel findings support a link between stressor-evoked brain activity and preclinical atherosclerosis accounted for by individual differences in corresponding levels of stressor-evoked cardiovascular reactivity.
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Affiliation(s)
- Javier Rasero
- Department of Psychology, Carnegie Mellon University, PA
- School of Data Science, University of Virginia, Charlottesville, VA
| | | | - Caitlin M DuPont
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Thomas E Kraynak
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | | | - Mark R Scudder
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Thomas W Kamarck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Amy I Sentis
- School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Regina L Leckie
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Li Z, Pulopulos M, Allaert J, De Smet S, De Wandel L, Kappen M, Puttevils L, Razza LB, Schoonjans E, Vanhollebeke G, Baeken C, De Raedt R, Vanderhasselt MA. Vagally-mediated HRV as a marker of trait rumination in healthy individuals? A large cross-sectional analysis. Psychophysiology 2024; 61:e14448. [PMID: 37779356 DOI: 10.1111/psyp.14448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023]
Abstract
The tendency to ruminate (i.e., repetitive, self-referential, negative thoughts) is a maladaptive form of emotional regulation and represents a transdiagnostic vulnerability factor for stress-related psychopathology. Vagally-mediated heart rate variability (vmHRV) provides a non-invasive, surrogate measure of vagal modulation of the heart, and higher HRV is considered an indicator of susceptibility, or ability to respond to stress. Past research has suggested a link between trait rumination and vmHRV; however, inconsistent results exist in healthy individuals. In this study, we investigated the association between the tendency to ruminate, brooding, and reflection (using the Ruminative Response Scale) with vmHRV measured at baseline in a healthy population using a large cross-sectional dataset (N = 1189, 88% female; mean age = 21.55, ranging from 17 to 48 years old), which was obtained by combining samples of healthy individuals from different studies from our laboratory. The results showed no cross-sectional correlation between vmHRV and trait rumination (confirmed by Bayesian analysis), even after controlling for important confounders such as gender, age, and depressive symptoms. Also, a non-linear relationship was rejected. In summary, based on our results in a large sample of healthy individuals, vmHRV is not a marker of trait rumination (as measured by the Ruminative Response Scale).
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Affiliation(s)
- Zefeng Li
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Matias Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jens Allaert
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Stefanie De Smet
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Linde De Wandel
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Mitchel Kappen
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Louise Puttevils
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Lais B Razza
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Emmanuelle Schoonjans
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Gert Vanhollebeke
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
| | - Chris Baeken
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
- Department of Psychiatry (UZ Brussel), Vrije Universiteit Brussel, Ixelles, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent Experimental Psychiatry Lab, Ghent University, Ghent, Belgium
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Sveinsdóttir SÞ, Jóhannsdóttir KR. Is Positive Affect as a Trait Related to Higher Heart Rate Variability in a Stressful Situation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6919. [PMID: 37887657 PMCID: PMC10606158 DOI: 10.3390/ijerph20206919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Most of the studies on the effect of trait positive affect (PA) and cardiovascular activity have focused on heart rate (HR) and blood pressure (BP) rather than heart rate variability (HRV). However, trait PA might sustain homeostasis for the autonomic system (ANS) by reducing activity in the sympathetic system (SNS) and increasing the activity in the parasympathetic system (PNS). A common index for the PNS is the vagal tone measured indirectly through HRV. The present study assessed whether trait PA influences cardiovascular response to various stress tasks by monitoring participants' HRV measured by RMSSD (root mean square of successive differences) along with HR and interbeat interval (IBI). A total of 54 participants performed various cognitive tasks and Trier Social Stress Tasks while their vital signs were monitored, and trait PA was measured with PANAS. The cognitive tasks included both high- and low-stress tasks, including fatigue-inducing 20 min Stroop tasks. The results showed overall higher HRV as measured by RMSSD for participants who have higher levels of trait PA, indicating more PNS activity compared with low-trait-PA individuals, particularly at the end of the task performance during the fatigue induction. High-trait-PA individuals also had a lower HR during the fatigue-inducing task and a higher IBI. The results support previous work by further indicating a more adaptive response and consequently better emotional regulation for high-trait-PA individuals in a complex, prolonged task setting.
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Moazzami K, Cheung B, Sullivan S, Shah A, Almuwaqqat Z, Alkhoder A, Mehta PK, Pearce BD, Shah AJ, Martini A, Obideen M, Nye J, Bremner JD, Vaccarino V, Quyyumi AA. Hemodynamic Reactivity to Mental Stress in Patients With Coronary Artery Disease. JAMA Netw Open 2023; 6:e2338060. [PMID: 37847500 PMCID: PMC10582791 DOI: 10.1001/jamanetworkopen.2023.38060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/25/2023] [Indexed: 10/18/2023] Open
Abstract
Importance The clinical significance of hemodynamic reactivity to mental stress in the population with coronary artery disease (CAD) is unclear. Objective To investigate the association between hemodynamic reactivity to mental stress and the risk of adverse cardiovascular events in patients with stable CAD. Design, Setting, and Participants This cohort study included individuals with stable CAD from 2 prospective studies from a university-based hospital network: the Mental Stress Ischemia Prognosis Study (MIPS) and the Myocardial Infarction and Mental Stress Study 2 (MIMS2). Participants were enrolled between June 2011 and March 2016 and followed up for a median of 6.0 (IQR, 5.6-6.0) years in MIPS and 4.6 (IQR, 3.8-5.3) years in MIMS2. Data were analyzed from December 1, 2022, to February 15, 2023. Exposures The rate-pressure product (RPP) was calculated as the mean systolic blood pressure times the mean heart rate at rest. Rate-pressure product reactivity was calculated as the maximum RPP during a standardized mental stress test minus the RPP at rest. Main Outcomes and Measures The primary outcome was a composite of cardiovascular death or nonfatal myocardial infarction. The secondary end point additionally included hospitalizations for heart failure. Results From the total of 938 individuals from the pooled cohort (mean [SD] age, 60.2 [10.1] years; 611 [65.1%] men), 631 participated in MIPS and 307 in MIMS2. A total of 373 individuals (39.8%) were Black, 519 (55.3%) were White, and 46 (4.9%) were of unknown race or ethnicity. The RPP increased by a mean (SD) of 77.1% (23.1%) during mental stress (mean [SD] absolute change, 5651 [2878]). For every SD decrease in RPP reactivity with mental stress, the adjusted hazard ratios for the primary and secondary end points were 1.30 (95% CI, 1.04-1.72) and 1.30 (95% CI, 1.06-1.56), respectively, in MIPS and 1.41 (95% CI, 1.06-1.97) and 1.21 (95% CI, 1.02-1.60), respectively, in MIMS2. In the pooled sample, when RPP reactivity to mental stress was added to a model including traditional clinical risk characteristics, model discrimination for adverse events improved (increase in C statistic of 5% for the primary end point; P = .009). Conclusions and Relevance In this cohort study of individuals with stable CAD, a blunted cardiovascular reactivity to mental stress was associated with adverse outcomes. Future studies are needed to assess the clinical utility of mental stress reactivity testing in this population.
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Affiliation(s)
- Kasra Moazzami
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Grady Health System, Atlanta, Georgia
| | - Brian Cheung
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Anish Shah
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Zakaria Almuwaqqat
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Ayman Alkhoder
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Puja K. Mehta
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Amit J. Shah
- Grady Health System, Atlanta, Georgia
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia
| | - Afif Martini
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Malik Obideen
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jonathon Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - J. Douglas Bremner
- Atlanta Veterans Affairs Medical Center, Decatur, Georgia
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Arshed A. Quyyumi
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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Thi Ngoc Le H, Xuan Nguyen K, Duy Nguyen T, Quang La H, Thanh Nguyen X, Tien Le D, Quoc Pham H, Xuan Nguyen K, Hoang Nguyen H, Van Pham V, Van Pham C, Pho DC, Nhu Do B, Viet Tran T, Tien Nguyen S, Dinh Le T, Cong Luong T. Effects of Three-Hour Wearing Personal Protective Equipment on Heart Rate Variability in Healthcare Workers for the Treatment of COVID-19 Patients. Int J Gen Med 2023; 16:2531-2539. [PMID: 37346809 PMCID: PMC10281273 DOI: 10.2147/ijgm.s413626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
Background Personal protective equipment (PPE), an essential shield to protect healthcare workers (HCWs) during the COVID-19 pandemic, has been reported to affect their heart rate variability (HRV). Objective To investigate the changes of very short-term heart rate variability in HCWs after three hours of wearing PPE to treat COVID-19 patients at different working times and intensities, and related factors. Methods Sixty-five healthy HCWs were enrolled at the Number 2 Infectious Field Hospital (formed by Military Hospital 103), Vietnam. Two-minute 12-lead electrocardiograms were recorded before wearing and after removing PPE. Results After three hours of wearing PPE, the mean heart rate of HCWs increased (p = 0.048) meanwhile, the oxygen saturation decreased significantly (p = 0.035). Standard deviation of all normal to normal intervals (SDNN), mean intervals RR (mean NN), and root mean square successive difference (rMSSD) after wearing PPE was also reduced significantly. SDNN, Mean NN, and rMSSD decreased as the working intensity increased (as in mild, moderate, and severe patient departments). In univariate regression analysis, logSDNN, logmean NN and logrMSSD were positively correlated with SpO2 and QT interval (r = 0.14, r = 0.31, r = 0.25; r = 0.39, r = 0.77, r = 0.73, respectively) and were negatively correlated with ambient temperature inside PPE (r = -0.41, r = -0.405, r = -0.25, respectively) while logmean NN and log rMSSD were negatively correlated with diastolic blood pressure (r = -0.43, r = -0.39, respectively). In multivariable regression analysis, logSDNN and logmean NN were negatively correlated to ambient temperature inside PPE (r = -0.34, r = -0.18, respectively). Conclusion Time-domain heart rate variability decreased after wearing PPE. Time-domain HRV parameters were related to ambient temperature inside PPE, diastolic blood pressure, QT interval, and SpO2.
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Affiliation(s)
- Han Thi Ngoc Le
- Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Kien Xuan Nguyen
- Department of Military Medical Command and Organization, Vietnam Medical Military University, Hanoi, 10000, Vietnam
| | - Toan Duy Nguyen
- Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Ho Quang La
- Hospital Quality Control Division, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Xuan Thanh Nguyen
- Senior Officer Department, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Dung Tien Le
- Intensive Care, Emergency and Poison Control Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Huy Quoc Pham
- Intensive Care, Emergency and Poison Control Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Khai Xuan Nguyen
- Interventional Radiology Department, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Hiep Hoang Nguyen
- Field Internal Medicine Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Viet Van Pham
- Interventional Radiology Department, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Cong Van Pham
- Intensive Care, Emergency and Poison Control Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Dinh Cong Pho
- Department of Military Science, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Binh Nhu Do
- Department of Military Science, Vietnam Military Medical University, Hanoi, 10000, Vietnam
| | - Tien Viet Tran
- Department of Infectious Diseases, Military Hospital 103, Vietnam Medical Military University, Hanoi, 10000, Vietnam
| | - Son Tien Nguyen
- Department of Rheumatology and Endocrinology, Vietnam Military Hospital 103, Medical Military University, Hanoi, 10000, Vietnam
| | - Tuan Dinh Le
- Department of Rheumatology and Endocrinology, Vietnam Military Hospital 103, Medical Military University, Hanoi, 10000, Vietnam
| | - Thuc Cong Luong
- Cardiovascular Center, Military Hospital 103, Vietnam Military Medical University, Hanoi, 10000, Vietnam
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7
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Neri L, Oberdier MT, van Abeelen KCJ, Menghini L, Tumarkin E, Tripathi H, Jaipalli S, Orro A, Paolocci N, Gallelli I, Dall’Olio M, Beker A, Carrick RT, Borghi C, Halperin HR. Electrocardiogram Monitoring Wearable Devices and Artificial-Intelligence-Enabled Diagnostic Capabilities: A Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:4805. [PMID: 37430719 PMCID: PMC10223364 DOI: 10.3390/s23104805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 07/12/2023]
Abstract
Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data.
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Affiliation(s)
- Luca Neri
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Matt T. Oberdier
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Kirsten C. J. van Abeelen
- Department of Informatics, Systems, and Communication, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Internal Medicine, Radboud University Medical Center, 6525 AJ Nijmegen, The Netherlands
| | - Luca Menghini
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Ethan Tumarkin
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Hemantkumar Tripathi
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Sujai Jaipalli
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Alessandro Orro
- Institute of Biomedical Technologies, National Research Council, 20054 Segrate, Italy
| | - Nazareno Paolocci
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Ilaria Gallelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Massimo Dall’Olio
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Amir Beker
- AccYouRate Group S.p.A., 67100 L’Aquila, Italy
| | - Richard T. Carrick
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Henry R. Halperin
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Radiology, Johns Hopkins University, Baltimore, MD 21205, USA
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8
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Liu X, Lin W, Huang J, Cao Z, Wu M, Chen Z, Zhu W, Tan Z, Yu P, Ma J, Chen Y, Zhang Y, Wang J. Depressive symptoms, anxiety and social stress are associated with diminished cardiovascular reactivity in a psychological treatment-naive population. J Affect Disord 2023; 330:346-354. [PMID: 36871916 DOI: 10.1016/j.jad.2023.02.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND There is now an increasing appreciation of how psychological health can contribute to cardiovascular disease, called the mind-heart connection. A blunted cardiovascular reactivity to depression and anxiety may be responsible for the potential mechanism, however, with inconsistent results. Anti-psychological drugs have an effect on the cardiovascular system and, thus, may disturb their relationship. However, in treatment-naive individuals with psychological symptoms, no research has specifically evaluated the relationship between psychological state and cardiovascular reactivity. METHODS We included 883 treatment-naive individuals who came from a longitudinal cohort study of Midlife in the United States. Symptoms of depression, anxiety, and stress were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), Spielberger Trait Anxiety Inventory (STAI), the Liebowitz Social Anxiety scale (LSAS) and the Perceived Stress Scale (PSS), respectively. Cardiovascular reactivity was measured using standardized, laboratory-based stressful tasks. RESULTS Treatment-naive individuals with depressive symptoms (CES-D ≥ 16), anxiety symptoms (STAI ≥ 54), and higher stress levels (PSS ≥ 27) had lower cardiovascular reactivity as assessed by systolic blood pressure (SBP) reactivity, diastolic blood pressure (DBP) reactivity and heart rate (HR) reactivity (P < 0.05). Pearson analyses showed that psychological symptoms were correlated with lower SBP reactivity, DBP reactivity, and heart rate reactivity (P < 0.05). Multivariate linear regression showed that depression and anxiety were negatively related to lower cardiovascular reactivity (SBP, DBP and HR reactivity) after full adjustments (P < 0.05). Stress was associated with reduced SBP and DBP reactivity but with a nonsignificant association with HR reactivity (P = 0.056). CONCLUSION Depression, anxiety, and stress symptoms are associated with blunted cardiovascular reactivity in treatment-naive adult Americans. These findings suggest that blunted cardiovascular reactivity is an underlying mechanism linking psychological health and cardiovascular diseases.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Weichun Lin
- Department of Gastroenterology, the Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jingjing Huang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengyu Cao
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Maoxiong Wu
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhiteng Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Wengen Zhu
- Department of Cardiology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Ziqi Tan
- Department of Endocrine, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Peng Yu
- Department of Endocrine, the Second Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Jianyong Ma
- Department of Pharmacology and Systems Physiology, University of Cincinnati College of Medicine, Cincinnati, United States
| | - Yangxin Chen
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yuling Zhang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
| | - Jingfeng Wang
- Department of Cardiology, Sun Yat-Sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China; Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Guangdong-Hong Kong Joint Laboratory for RNA Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
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9
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O'Brien WH, Peijisel C, Koerten H, Bunyarit I, Lim S, Chavanovanich J. Lesser degree of HR and HF-HRV recovery from an evaluative stressor is associated with higher levels of perfectionism and self-compassion. Behav Res Ther 2023; 164:104305. [PMID: 37028227 DOI: 10.1016/j.brat.2023.104305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
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10
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Vitale E, Filetti V, Vella F, Senia P, Rapisarda L, Matera S, Lombardo C, Vinnikov D, Rapisarda V, Ledda C. Evaluation of Cardiovascular Activity and Emotional Experience in Healthcare Workers (HCWs) Operating in COVID-19 Wards. J Clin Med 2022; 11:jcm11247372. [PMID: 36555988 PMCID: PMC9782677 DOI: 10.3390/jcm11247372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/24/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
The new 2019 coronavirus or SARS-CoV-2 has been the first biological agent to generate, in this millennium, such a global health emergency as to determine the adoption of public health measures. During this sanitary emergency, the emotional experience of healthcare workers (HCWs) has been hugely tested by several factors. In fact, HCWs have been exposed to greatly tiring physical, psychological and social conditions. The authors investigated the cardiocirculatory activity of a group of HCWs as well as how they perceived stress while working in COVID-19 wards. In particular, every HCW underwent a medical check, an electrocardiographic base exam, systolic and diastolic pressure measurement, and cardio frequency measurement. Furthermore, each HCW was provided with a cardiac Holter device (HoC) and a pressure Holter (Hop). Some psychological factors were considered in order to quantify the stress perceived by each HCW while at work through the administration of two questionnaires: the "Social Stigma towards Patients due to COVID Scale (SSPCS)" and the "Professional Quality of Life Scale (ProQOL)". The HoC and HoP analysis results for HCWs working in COVID-19 OU wards showed significant variations in cardiocirculatory activity. From the analysis of the SSPCS questionnaire answers, it is clear that all of them showed a sense of duty towards their patients. The analysis of the ProQOL questionnaire answers showed that the prevailing attitude is fear; however, HCWs did not absolutely discriminate against those who had COVID-19 nor did they refuse to help those in need. Continuous monitoring of these employees, also carried out through occupational medicine surveillance, allows for the detection of critical conditions and the implementation of actions aimed at preventing chronic processes.
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Affiliation(s)
- Ermanno Vitale
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Veronica Filetti
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Francesca Vella
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Paola Senia
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Lucia Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Serena Matera
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Claudia Lombardo
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, 95123 Catania, Italy
| | - Denis Vinnikov
- Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
- Department of Occupational Health Risks Laboratory, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
- Correspondence:
| | - Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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11
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Kelley TM, Manning K. Realizing the power of thought and innate mental health:two overlooked ingredients for resolving traumatic memories. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2022. [DOI: 10.1080/19349637.2022.2080031] [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]
Affiliation(s)
- Thomas Michael Kelley
- Criminology & Criminal Justice, Wayne State University, Detroit, Michigan, United States
| | - Ken Manning
- Department of Criminology & Criminal Justice, Insight Principles, Sudbury, Massachusetts, United States
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12
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Sara JDS, Toya T, Ahmad A, Clark MM, Gilliam WP, Lerman LO, Lerman A. Mental Stress and Its Effects on Vascular Health. Mayo Clin Proc 2022; 97:951-990. [PMID: 35512885 PMCID: PMC9058928 DOI: 10.1016/j.mayocp.2022.02.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/24/2022] [Accepted: 02/08/2022] [Indexed: 01/13/2023]
Abstract
Coronary artery disease continues to be a major cause of morbidity and mortality despite significant advances in risk stratification and management. This has prompted the search for alternative nonconventional risk factors that may provide novel therapeutic targets. Psychosocial stress, or mental stress, has emerged as an important risk factor implicated in a higher incidence of cardiovascular events, and although our understanding of this far ranging and interesting phenomenon has developed greatly over recent times, there is still much to be learned regarding how to measure mental stress and how it may impact physical health. With the current coronavirus disease 2019 global pandemic and its incumbent lockdowns and social distancing, understanding the potentially harmful biological effects of stress related to life-changing events and social isolation has become even more important. In the current review our multidisciplinary team discusses stress from a psychosocial perspective and aims to define psychological stress as rigorously as possible; discuss the pathophysiologic mechanisms by which stress may mediate cardiovascular disease, with a particular focus to its effects on vascular health; outline existing methods and approaches to quantify stress by means of a vascular biomarker; outline the mechanisms whereby psychosocial stressors may have their pathologic effects ultimately transduced to the vasculature through the neuroendocrine immunologic axis; highlight areas for improvement to refine existing approaches in clinical research when studying the consequences of psychological stress on cardiovascular health; and discuss evidence-based therapies directed at reducing the deleterious effects of mental stress including those that target endothelial dysfunction. To this end we searched PubMed and Google Scholar to identify studies evaluating the relationship between mental or psychosocial stress and cardiovascular disease with a particular focus on vascular health. Search terms included "myocardial ischemia," "coronary artery disease," "mental stress," "psychological stress," "mental∗ stress∗," "psychologic∗ stress∗," and "cardiovascular disease∗." The search was limited to studies published in English in peer-reviewed journals between 1990 and the present day. To identify potential studies not captured by our database search strategy, we also searched studies listed in the bibliography of relevant publications and reviews.
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Key Words
- cad, coronary artery disease
- cbt, cognitive behavioral therapy
- cvd, cardiovascular disease
- fmd, flow-mediated dilatation
- il, interleukin
- mi, myocardial infarction
- ms, mental stress
- msimi, mental stress induced myocardial ischemia
- pat, peripheral arterial tonometry
- ped, peripheral endothelial dysfunction
- pet, positron emission tomography
- rh, reactive hyperemia
- ses, socioeconomic status
- tnf, tumor necrosis factor
- vsmc, vascular smooth muscle cells
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Affiliation(s)
| | - Takumi Toya
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Ali Ahmad
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Wesley P Gilliam
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Lliach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Amir Lerman
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.
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Morais-Silva G, Gomes-de-Souza L, Costa-Ferreira W, Pavan JC, Crestani CC, Marin MT. Cardiovascular Reactivity to a Novel Stressor: Differences on Susceptible and Resilient Rats to Social Defeat Stress. Front Physiol 2022; 12:781447. [PMID: 35250603 PMCID: PMC8889071 DOI: 10.3389/fphys.2021.781447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Prolonged and heightened responses to stress are known factors that influence the development of mood disorders and cardiovascular diseases. Moreover, the coping strategies related to the experience of adverse events, i.e., resilience or the susceptibility to stress, are determinants for the individual risk of developing such diseases. Susceptible rats to the social defeat stress (SDS), identified by the social interaction test (SIT), show behavioral and cardiovascular alterations after SDS exposure that are not found in resilient rats. However, it is not elucidated yet how the cardiovascular system of susceptible and resilient phenotypes responds to a new stressor after SDS exposure. Thus, using the SDS exposure followed by the SIT, we evaluated heart rate, blood pressure (BP), tail skin temperature, and circulating corticosterone responses to an acute session of restraint stress in susceptible and resilient rats to SDS. Susceptible rats showed resting tachycardia and exaggerated BP response to restraint stress, while resilient rats did not present such alterations. In contrast, both phenotypes showed increased plasma corticosterone and a drop in tail skin temperature to restraint stress, which was similar to that observed in control animals. Our results revealed an increased cardiovascular reactivity in response to a new stressful stimulus in susceptible rats, which might be related to a greater risk for the development of cardiovascular diseases.
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Affiliation(s)
- Gessynger Morais-Silva
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Lucas Gomes-de-Souza
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Willian Costa-Ferreira
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Jacqueline C. Pavan
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
| | - Carlos C. Crestani
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
| | - Marcelo T. Marin
- Laboratory of Pharmacology, School of Pharmaceutical Sciences of Araraquara, São Paulo State University, Araraquara, Brazil
- Joint Graduate Program in Physiological Sciences (PIPGCF), UFSCar/UNESP, Araraquara, Brazil
- *Correspondence: Marcelo T. Marin,
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14
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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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15
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Rosario-Hernández E, Rovira-Millán LV, Merino-Soto C. Review of the Internal Structure, Psychometric Properties, and Measurement Invariance of the Work-Related Rumination Scale - Spanish Version. Front Psychol 2021; 12:774472. [PMID: 34899526 PMCID: PMC8656259 DOI: 10.3389/fpsyg.2021.774472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The aim of the current study was to examine the internal structure and assess the psychometric properties of the Work-Related Rumination Scale (WRRS) – Spanish version in a Puerto Rican sample of workers. This instrument is a 15-item questionnaire, which has three factors, affective rumination, problem-solving pondering, and detachment. This measure is used in the occupational health psychology context; however, there is little evidence of its psychometric properties. Materials and Methods: A total sample of 4,100 from five different study samples was used in this cross-sectional study design in which the WRRS was used. We conducted confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) to examine the internal structure of the Work-Related Rumination Scale. Measurement invariance across sex and age was examined. Results: The three-factor model was supported; however, four items were eliminated due to their cross-loadings and factorial complexity. This 11-item Spanish version of the WRRS was invariant across sex and age. Reliability of the three-factors of WRRS were within the range of 0.74 to 0.87 using Cronbach’s alpha and McDonald’s omega. Correlations between the three factors were as expected as well as with other established measures. Conclusion: The results suggest that the WRRS-Spanish version appears to be a reliable and valid instrument to measure work-related rumination using its three factors. Comparison across sex and age appear to be useful in occupational health psychology research setting since results suggest that the WRRS is invariant regarding those variables.
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Affiliation(s)
- Ernesto Rosario-Hernández
- Clinical Psychology Programs, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR, United States.,Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, United States
| | - Lillian V Rovira-Millán
- Psychology Program, Department of Social Sciences, University of Puerto Rico, Cayey, PR, United States
| | - César Merino-Soto
- Psychology Research Institute, School of Psychology, University of San Martín de Porres, Lima, Peru
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16
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Dupre ME, Farmer HR, Xu H, Navar AM, Nanna MG, George LK, Peterson ED. The Cumulative Impact of Chronic Stressors on Risks of Myocardial Infarction in US Older Adults. Psychosom Med 2021; 83:987-994. [PMID: 34297011 PMCID: PMC8578196 DOI: 10.1097/psy.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between cumulative exposure to chronic stressors and the incidence of myocardial infarction (MI) in US older adults. METHODS Nationally representative prospective cohort data of adults 45 years and older (n = 15,109) were used to investigate the association between the cumulative number of chronic stressors and the incidence of MI in US older adults. Proportional hazards models adjusted for confounding risk factors and differences by sex, race/ethnicity, and history of MI were assessed. RESULTS The median age of participants was 65 years, 714 (4.7%) had a prior MI, and 557 (3.7%) had an MI during follow-up. Approximately 84% of participants reported at least one chronic stressor at baseline, and more than half reported two or more stressors. Multivariable models showed that risks of MI increased incrementally from one chronic stressor (hazard ratio [HR] = 1.28, 95% confidence interval [CI] = 1.20-1.37) to four or more chronic stressors (HR = 2.71, 95% CI = 2.08-3.53) compared with those who reported no stressors. These risks were only partly reduced after adjustments for multiple demographic, socioeconomic, psychosocial, behavioral, and clinical risk factors. In adults who had a prior MI (p value for interaction = .038), we found that risks of a recurrent event increased substantially from one chronic stressor (HR = 1.30, 95% CI = 1.09-1.54) to four or more chronic stressors (HR = 2.85, 95% CI = 1.43-5.69). CONCLUSIONS Chronic life stressors are significant independent risk factors for cardiovascular events in US older adults. The risks associated with multiple chronic stressors were especially high in adults with a previous MI.
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Affiliation(s)
- Matthew E. Dupre
- Department of Population Health Sciences, Duke University, Durham, NC
- Duke Clinical Research Institute, Duke University, Durham, NC
- Department of Sociology, Duke University, Durham, NC
- Center for the Study of Aging and Human Development, Duke University, Durham, NC
| | - Heather R. Farmer
- Department of Human Development and Family Sciences, University of Delaware, DE
| | - Hanzhang Xu
- Department of Family Medicine and Community Health, Duke University, Durham, NC
- Duke School of Nursing, Duke University, Durham, NC
| | - Ann Marie Navar
- Division of Cardiology, Department of Medicine, University of Texas Southwestern, TX
| | - Michael G. Nanna
- Duke Clinical Research Institute, Duke University, Durham, NC
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC
| | - Linda K. George
- Department of Sociology, Duke University, Durham, NC
- Center for the Study of Aging and Human Development, Duke University, Durham, NC
- Department of Psychology and Neuroscience, Duke University, Durham, NC
| | - Eric D. Peterson
- Division of Cardiology, Department of Medicine, University of Texas Southwestern, TX
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17
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COVID 19-related burnout among healthcare workers in India and ECG based predictive machine learning model: Insights from the BRUCEE- Li study. Indian Heart J 2021; 73:674-681. [PMID: 34673026 PMCID: PMC8522680 DOI: 10.1016/j.ihj.2021.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 10/14/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives COVID-19 pandemic has led to unprecedented increase in rates of stress and burn out among healthcare workers (HCWs). Heart rate variability (HRV) has been shown to be reflective of stress and burnout. The present study evaluated the prevalence of burnout and attempted to develop a HRV based predictive machine learning (ML) model to detect burnout among HCWs during COVID-19 pandemic. Methods Mini-Z 1.0 survey was collected from 1615 HCWs, of whom 664, 512 and 439 were frontline, second-line and non-COVID HCWs respectively. Burnout was defined as score ≥3 on Mini-Z-burnout-item. A 12-lead digitized ECG recording was performed and ECG features of HRV were obtained using feature extraction. A ML model comprising demographic and HRV features was developed to detect burnout. Results Burnout rates were higher among second-line workers 20.5% than frontline 14.9% and non-COVID 13.2% workers. In multivariable analyses, features associated with higher likelihood of burnout were feeling stressed (OR = 6.02), feeling dissatisfied with current job (OR = 5.15), working in a chaotic, hectic environment (OR = 2.09) and feeling that COVID has significantly impacted the mental wellbeing (OR = 6.02). HCWs with burnout had a significantly lower HRV parameters like root mean square of successive RR intervals differences (RMSSD) [p < 0.0001] and standard deviation of the time interval between successive RR intervals (SDNN) [p < 0.001]) as compared to normal subjects. Extra tree classifier was the best performing ML model (sensitivity: 84%) Conclusion In this study of HCWs from India, burnout prevalence was lower than reports from developed nations, and was higher among second-line versus frontline workers. Incorporation of HRV based ML model predicted burnout among HCWs with a good accuracy.
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18
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Whittaker AC, Ginty A, Hughes BM, Steptoe A, Lovallo WR. Cardiovascular Stress Reactivity and Health: Recent Questions and Future Directions. Psychosom Med 2021; 83:756-766. [PMID: 34297004 DOI: 10.1097/psy.0000000000000973] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High cardiovascular reactions to psychological stress are associated with the development of hypertension, systemic atherosclerosis, and cardiovascular disease. However, it has become apparent that low biological stress reactivity also may have serious consequences for health, although less is known about the mechanisms of this. The objectives of this narrative review and opinion article are to summarize and consider where we are now in terms of the usefulness of the reactivity hypothesis and reactivity research, given that both ends of the reactivity spectrum seem to be associated with poor health, and to address some of the key criticisms and future challenges for the research area. METHODS This review is authored by the members of a panel discussion held at the American Psychosomatic Society meeting in 2019, which included questions such as the following: How do we measure high and low reactivity? Can high reactivity ever indicate better health? Does low or blunted reactivity simply reflect less effort on task challenges? Where does low reactivity originate from, and what is a low reactor? RESULTS Cardiovascular (and cortisol) stress reactivity are used as a model to demonstrate an increased understanding of the different individual pathways from stress responses to health/disease and show the challenges of how to understand and best use the reconstruction of the long-standing reactivity hypothesis given recent data. CONCLUSIONS This discussion elucidates the gaps in knowledge and key research issues that still remain to be addressed in this field, and that systematic reviews and meta-analyses continue to be required.
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Affiliation(s)
- Anna C Whittaker
- From the Faculty of Health Sciences and Sport (Whittaker), University of Stirling, Stirling, Scotland, United Kingdom; Department of Psychology and Neuroscience (Ginty), Baylor University, Waco, Texas; School of Psychology (Hughes), National University of Ireland, Galway, Ireland; Institute of Epidemiology & Health (Steptoe), University College London, London, United Kingdom; and Department of Psychiatry and Behavioral Sciences (Lovallo), Norman, University of Oklahoma Health Sciences Center and VA Medical Center, Oklahoma
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19
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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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McAllister MJ, Martaindale MH. Women demonstrate lower markers of stress and oxidative stress during active shooter training drill. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 6:100046. [PMID: 35757370 PMCID: PMC9216655 DOI: 10.1016/j.cpnec.2021.100046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/26/2022] Open
Abstract
It has been well documented that police officers are frequently engaged in a variety of high stress situations during their normal daily tasks, such as civilian encounters where force is needed or domestic violence situations, that cause significant increases in a variety of physiological and psychological stress markers. Chronic exposure to stressors increases risk for cardiovascular disease (CVD) progression. The purpose of this study was to compare male and female salivary and blood markers of stress in response to an active shooter training drill (ASD) to determine if acute stress differentially impacts men and women to better understand if interventions should be targeted. Thirty-one participants (males = 15 [mean age: 23], females = 16 [mean age: 21]) participated in an ASD involving professional actors playing the role of one active gunman, as well as four victims. The ASD lasted approximately 50 seconds. Blood samples were collected 15 min prior as well as after the ASD and analyzed for epinephrine (EPI), norepinephrine (NE), and hydrogen peroxide (H2O2) levels. Saliva samples were collected 30 and 5 min prior to the ASD and 5 and 30 min after the ASD, and were analyzed for cortisol, α-amylase, uric acid, and secretory immunoglobulin-A (SIgA). Our analysis revealed that acute (~50 sec) psychological stress in the form of an ASD resulted in significant increases in blood and salivary stress and oxidative stress markers in both men and women. However, four of the seven markers were lower in female participants (cortisol, uric acid, H2O2, and α-amylase presented significant main effects for sex). In addition, SIgA was significantly lower in women compared to men 30 min prior to, and five min post ASD. These findings suggest females may be at a lower risk to stress induced oxidative stress and CVD. Acute psychological stress results in significant increases in blood and saliva stress and oxidative stress markers. Stress markers were attenuated in female participants. Blood oxidative stress was lower in female participants.
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21
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Llabre MM. Insight Into the Hispanic Paradox: The Language Hypothesis. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2021; 16:1324-1336. [PMID: 33621473 DOI: 10.1177/1745691620968765] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hispanics have a lower burden of heart disease than would be predicted from their risk factors. Explanations for this phenomenon, the Hispanic paradox, focus on specific characteristics of the culture that affect stress appraisal and accumulation, including social connections. Features of culture evolve in the context of language, which influences the way emotions are appraised and expressed. The Spanish language, a unifying component defining Hispanic cultures, has unique features that may promote emotional expression, expand the emotional concepts implicated in the construction of emotion, and influence the appraisal of stress. Under chronic stress conditions, sustained responses can become maladaptive, leading to disease. Features of the Spanish language allow its speakers a wide range of emotion schemas by virtue of its emotion lexicon, the ability to easily minimize or exaggerate expressions, and ease in considering hypothetical situations with the use of the subjunctive. The hypothesis here proposes that the Spanish language is directly and indirectly (via culture) responsible for mitigating some of the effects of acute stress responses in Hispanics and, therefore, limits stress accumulation and is partly responsible for the Hispanic paradox.
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22
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Achnak S, Schippers A, Vantilborgh T. To deny, to justify, or to apologize: Do social accounts influence stress levels in the aftermath of psychological contract breach? BMC Psychol 2021; 9:5. [PMID: 33407889 PMCID: PMC7789714 DOI: 10.1186/s40359-020-00505-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022] Open
Abstract
Background Workplace stress carries considerable costs for the employees’ wellbeing and for the organization’s performance. Recent studies demonstrate that perceptions of psychological contract breach are a source of stress for employees. That is, when employees notice that their employer does not fulfil certain obligations, they will perceive that certain resources are threatened or lost, which in turn translates into increased stress. In this study, we zoom in on how stress unfolds in the aftermath of breach, dependent on the organization’s reaction to the breach. More specifically, we examined the influence of different types of social accounts (i.e., denial, apology, blaming and exonerating justification) on individuals’ stress resolution process using physiological (i.e., heart rate) and psychological (self-report) data. Method We used an experimental design in which we manipulated psychological contract breach and social account type. To test our hypotheses, we performed two sets of functional Principal Component Analyses: first to examine the effects of breach and second to examine the effects of social accounts. Results Our results indicate that breach elicits a physiological stress reaction, reflected in a short-lived increase in heart rate. However, no increase in the self-reported stress measure was found. Further, we did not find a significant effect of social accounts on the psychological and physiological recovery process. Conclusions The current research allows us to demonstrate that psychological contract breach will trigger a short-lived increase in heart rate. Further research is needed to better understand unfolding trajectories of physiological reactions to contract breach and the effect of social accounts as organizational recovery efforts.
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Affiliation(s)
- Safâa Achnak
- Work and Organizational Psychology (WOPs), Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
| | - Arjen Schippers
- Experimental Psychology, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Tim Vantilborgh
- Work and Organizational Psychology (WOPs), Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
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Abstract
Gentrification in the largest 50 US cities has more than doubled since the 1990s. The process of gentrification can bring about improved neighborhood conditions, reduced rates of crime, and property value increases. At the same time, it can equally foster negative conditions associated with poorer health outcomes, such as disrupted social networks from residential displacement and increases in stress. While neighborhood environment is consistently implicated in health outcomes research, gentrification is rarely conceptualized as a public health issue. Though research on gentrification is growing, empirical studies evaluating the health impacts of gentrification in the US are poorly understood. Here we systematically review US population-based empirical studies examining relationships between gentrification and health. Electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science, and Academic Search Complete) were searched using a combination of terms to identify peer-reviewed studies published on or before July 9, 2018, reporting associations between gentrification and health. Study title and abstract screenings were followed by full-text review of all studies meeting the following inclusion criteria of: ≥ 1 quantitative measure of association for a health outcome, within the context of gentrification; peer-reviewed research; located in the US; and English language. Of 8937 studies identified, 6152 underwent title and abstract screening, and 50 studies underwent full-text screening, yielding six studies for review. Gentrification exposure measures and health outcomes examined varied widely. Most studies reported little to no overall association between gentrification and health outcomes; however, gentrification was repeatedly associated with undesirable health effects among Black and economically vulnerable residents. Despite seemingly overall null associations between gentrification and health, evidence suggests that gentrification may negatively impact the health of certain populations, particularly Black and low-income individuals. Complexities inherent in operationalizing gentrification point toward the need for validated measures. Additionally, understanding how gentrification-health associations differ across health endpoints, race/ethnicities, socioeconomic status, and life course can provide insight into whether this process contributes to urban inequality and health disparities. As gentrification occurs across the US, it is important to understand how this process impacts health. While aging cities reinvest in the revitalization of communities, empirical research examining relationships between gentrification and health can help inform policy decisions.
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Cross A, Naughton F, Sheffield D. What is the role of stress cardiovascular reactivity in health behaviour change? A systematic review, meta-analysis and research agenda. Psychol Health 2020; 36:1021-1040. [PMID: 32998581 DOI: 10.1080/08870446.2020.1825714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The stress reactivity hypothesis posits that the extremes of exaggerated and low or blunted cardiovascular reactivity (CVR) to stress may lead to adverse health outcomes via psychophysiological pathways. A potential indirect pathway between CVR and disease outcomes is through health-related behaviour and behaviour change. However, this is a less well understood pathway. Design: A registered systematic review was undertaken to determine the association between cardiovascular reactivity (CVR) and health behaviour change, as well as identify mediators and moderators. Eight papers that met the inclusion criteria, focused on smoking cessation and weight loss, were identified. Results: Pooling data from studies exploring the prospective relationship between CVR (as systolic blood pressure) and smoking cessation found that exaggerated CVR was associated with smoking relapse (Hedges' g = 0.39, SE = 0.00, 95% CI 0.38 - 0.40, p < .001; I2 = 0%; N = 257) but did not find evidence that CVR responses were associated with changes in weight. In order to advance our understanding of reactivity as a modifiable determinant of health behaviour change, our review recommends exploring the association between CVR and other health behaviours, to determine the influence of blunted reactivity versus low motivational effort identify mediators and moderators and determine the focus of interventions.
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Affiliation(s)
- Ainslea Cross
- School of Psychology, University of Derby, Derby, UK
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, UK
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25
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Abstract
Resource sharing has always been a central component of human sociality. Children require heavy investments in human capital; during working years, help is needed due to illness, disability, or bad luck. While hunter-gatherer elders assisted their descendants, more recently, elderly withdraw from work and require assistance as well. Willingness to share has been critically important for our past evolutionary success and our present daily lives. Here, we document a strong linear relationship between the public and private sharing generosity of a society and the average length of life of its members. Our findings from 34 countries on six continents suggest that survival is higher in societies that provide more support and care for one another. We suggest that this support reduces mortality by meeting urgent material needs, but also that sharing generosity may reflect the strength of social connectedness, which itself benefits human health and wellbeing and indirectly raises survival.
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26
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Cavanagh L, Obasi EM. The Moderating Role of Coping Style on Chronic Stress Exposure and Cardiovascular Reactivity Among African American Emerging Adults. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 22:357-366. [PMID: 32696119 DOI: 10.1007/s11121-020-01141-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Chronic stress exposure may contribute to dysregulation of cardiovascular functions and increase CVD risk among African Americans. This study investigated the direct and interactive effects of chronic stress exposure and coping styles on cardiovascular reactivity to acute stress. A sample of African American emerging adults (n = 277) completed a battery of self-report assessments and underwent the Trier Social Stress Test (TSST) across two time points. Prior chronic stress exposure was negatively associated with heart rate (HR) reactivity among females at 1-month follow-up. Task-oriented coping was positively associated with HR reactivity, while avoidance-oriented coping showed a negative association. Higher use of emotion-oriented coping moderated the relationship between chronic stress exposure and HR reactivity, resulting in more robust reactivity. Among females, but not males, lower use of avoidance-oriented coping moderated the relationship between prior chronic stress exposure and HR reactivity, also resulting in more robust reactivity. Prior chronic stress exposure and the use of maladaptive coping strategies may confer negative impacts on cardiovascular reactivity, particularly among African American females. Using adaptive coping styles may mitigate these effects and improve cardiovascular reactivity. These findings provide preliminary support for psychosocial determinants of health within a controlled laboratory experiment and highlight important gender differences to consider in prevention efforts for African American cardiovascular health disparities.
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Affiliation(s)
- Lucia Cavanagh
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, 77204, Houston, TX, USA
| | - Ezemenari M Obasi
- Department of Psychological, Health, and Learning Sciences, University of Houston, 491 Farish Hall, 77204, Houston, TX, USA. .,Health Research Institute, University of Houston, 1100 Health 2, 77204, Houston, TX, USA.
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27
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Kalmbach DA, Buysse DJ, Cheng P, Roth T, Yang A, Drake CL. Nocturnal cognitive arousal is associated with objective sleep disturbance and indicators of physiologic hyperarousal in good sleepers and individuals with insomnia disorder. Sleep Med 2020; 71:151-160. [PMID: 32247571 PMCID: PMC8212183 DOI: 10.1016/j.sleep.2019.11.1184] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/01/2019] [Accepted: 11/02/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cognitive arousal is central to models of sleep disturbance and insomnia, but findings remain mixed regarding whether cognitive arousal is associated with objective sleep disturbance and physiologic hyperarousal. This study explored associations of objective nocturnal wakefulness and indicators of physiologic hyperarousal with cognitive arousal in healthy sleepers and individuals with insomnia. METHODS In sum, 52 adults (51.9% women; 18 with insomnia disorder, 34 healthy sleepers) underwent two overnight polysomnography (PSG) studies (adaptation + baseline nights) and a multiple sleep latency test (MSLT). Baseline depression was assessed and presleep cognitive arousal and somatic arousal were recorded for each night. Multivariate regression was used to evaluate associations of PSG sleep parameters with insomnia, cognitive arousal, and somatic arousal. RESULTS Analyses showed that high levels of nocturnal cognitive arousal were associated with prolonged sleep latency, lower sleep efficiency, and shorter total sleep time by PSG on both nights. An association between nocturnal cognitive arousal and wake after sleep onset was observed on night one only. Moreover, greater nocturnal cognitive arousal was associated with greater likelihood of obtaining short sleep and with longer MSLT sleep latencies. Insomnia diagnosis, depression, and somatic arousal were not associated with PSG sleep parameters or MSLT latency. CONCLUSIONS Heightened cognitive arousal at night is linked to objective sleep disturbances and indicators of physiologic hyperarousal at night and during the day. For patients with insomnia, cognitive arousal may contribute to the 24-hr physiologic hyperarousal. Cognitive arousal may be a critical therapeutic target for severe or treatment-resistant sleep disturbance.
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Affiliation(s)
- David A Kalmbach
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Daniel J Buysse
- Center for Sleep and Circadian Science, Departments of Psychiatry and Clinical and Translational Science, University of Pittsburgh Medical Center, Pittsburgh, PA 15213 USA
| | - Philip Cheng
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Thomas Roth
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Alexander Yang
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
| | - Christopher L Drake
- Thomas Roth Sleep Disorders & Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI 48202 USA
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28
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Saarinen AIL, Keltikangas-Järvinen L, Hintsa T, Pulkki-Råback L, Ravaja N, Lehtimäki T, Raitakari O, Hintsanen M. Does Compassion Predict Blood Pressure and Hypertension? The Modifying Role of Familial Risk for Hypertension. Int J Behav Med 2020; 27:527-538. [PMID: 32347444 PMCID: PMC7497423 DOI: 10.1007/s12529-020-09886-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background This study investigated (i) whether compassion is associated with blood pressure or hypertension in adulthood and (ii) whether familial risk for hypertension modifies these associations. Method The participants (N = 1112–1293) came from the prospective Young Finns Study. Parental hypertension was assessed in 1983–2007; participants’ blood pressure in 2001, 2007, and 2011; hypertension in 2007 and 2011 (participants were aged 30–49 years in 2007–2011); and compassion in 2001. Results High compassion predicted lower levels of diastolic and systolic blood pressure in adulthood. Additionally, high compassion was related to lower risk for hypertension in adulthood among individuals with no familial risk for hypertension (independently of age, sex, participants’ and their parents’ socioeconomic factors, and participants’ health behaviors). Compassion was not related to hypertension in adulthood among individuals with familial risk for hypertension. Conclusion High compassion predicts lower diastolic and systolic blood pressure in adulthood. Moreover, high compassion may protect against hypertension among individuals without familial risk for hypertension. As our sample consisted of comparatively young participants, our findings provide novel implications for especially early-onset hypertension. Electronic supplementary material The online version of this article (10.1007/s12529-020-09886-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aino I L Saarinen
- Research Unit of Psychology, University of Oulu, P.O. Box 2000 (Erkki Koiso-Kanttilan katu 1), 90014, Oulu, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Taina Hintsa
- Department of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Laura Pulkki-Råback
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Niklas Ravaja
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Mirka Hintsanen
- Research Unit of Psychology, University of Oulu, P.O. Box 2000 (Erkki Koiso-Kanttilan katu 1), 90014, Oulu, Finland.
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Witvliet CVO, Root Luna L, Worthington EL, Tsang JA. Apology and Restitution: The Psychophysiology of Forgiveness After Accountable Relational Repair Responses. Front Psychol 2020; 11:284. [PMID: 32231606 PMCID: PMC7082420 DOI: 10.3389/fpsyg.2020.00284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/06/2020] [Indexed: 11/13/2022] Open
Abstract
Apology and restitution each represents wrongdoers' accountable repair responses that have promoted victims' self-reported empathy and forgiveness in crime scenario research. The current study measured emotional and stress-related dependent variables including physiological measures, to illuminate the links between predictors of forgiveness and health-relevant side effects. Specifically, we tested the independent and interactive effects of apology and restitution on forgiveness, emotion self-reports, and facial responses, as well as cardiac measures associated with stress in 32 males and 29 females. Apology and restitution each independently increased empathy, forgiveness, gratitude, and positive emotions, while reducing unforgiveness, negative emotion, and muscle activity above the brow (corrugator supercilii, CS). The presence of a thorough apology-regardless of whether restitution was present-also calmed heart rate, reduced rate pressure products indicative of cardiac stress, and decreased muscle activity under the eye (orbicularis oculi, OO). Interactions pointed to the more potent effects of restitution compared to apology for reducing unforgiveness and anger, while elevating positivity and gratitude. The findings point to distinctive impacts of apology and restitution as factors that foster forgiveness, along with emotional and embodied changes relevant to health.
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Affiliation(s)
| | | | - Everett L Worthington
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, United States
| | - Jo-Ann Tsang
- Baylor University, Department of Psychology and Neuroscience, Waco, TX, United States
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30
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Beliefs About Emotions, Negative Meta-emotions, and Perceived Emotional Control During an Emotionally Salient Situation in Individuals with Emotional Disorders. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10064-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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31
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Awuah RB, de-Graft Aikins A, Dodoo FNA, Meeks KA, Beune EJ, Klipstein-Grobusch K, Addo J, Smeeth L, Bahendeka SK, Agyemang C. Psychosocial factors and hypertension prevalence among Ghanaians in Ghana and Ghanaian migrants in Europe: The RODAM study. Health Psychol Open 2019; 6:2055102919885752. [PMID: 31763049 PMCID: PMC6851611 DOI: 10.1177/2055102919885752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Despite progress made to prevent and control hypertension, its prevalence has
persisted in many countries. This study examined the associations between
psychosocial factors and hypertension among Ghanaian non-migrants and migrants.
Data were drawn from the Research on Obesity and Diabetes among African Migrants
(RODAM) project. Findings show that among migrant women, those who experienced
periods of stress at home/work had higher odds of hypertension. Among
non-migrants, women with depression symptoms were more likely to be
hypertensive. Furthermore, there was a positive association between negative
life events and hypertension among non-migrant men. The findings highlight the
importance of psychosocial factors in addressing hypertension prevalence in
Ghanaian populations.
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Affiliation(s)
| | | | | | | | | | | | - Juliet Addo
- London School of Hygiene & Tropical Medicine, UK
| | - Liam Smeeth
- London School of Hygiene & Tropical Medicine, UK
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32
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Brownlow BN, Sosoo EE, Long RN, Hoggard LS, Burford TI, Hill LK. Sex Differences in the Impact of Racial Discrimination on Mental Health Among Black Americans. Curr Psychiatry Rep 2019; 21:112. [PMID: 31686220 DOI: 10.1007/s11920-019-1098-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Greater racial discrimination is associated with poorer mental health among Black Americans; yet, there remains an incomplete understanding of sex differences in exposure to racial discrimination, and further, of how sex differences in coping with racial discrimination may heighten or diminish risk for poorer mental health. RECENT FINDINGS Black men may experience greater exposure to both structural and communal forms of racial discrimination, whereas Black women may face both a wider range of potential sources, as well as encounter greater variability in the subjective experience of racial discrimination. For both Black women and men, racial discrimination may be similarly associated with maladaptive coping strategies (i.e., emotional eating, rumination) that also are linked to poorer mental health; however, emerging findings suggest that mindfulness may partially buffer these deleterious effects. Overall, the recent literature reveals mixed findings with respect to sex differences in the experience and negative mental health impact of racial discrimination. Despite this heterogeneity, evidence documents sex differences in the settings, type, and qualitative experience of racial discrimination among Black Americans. Additionally, growing evidence indicating that racial discrimination is associated with physiological markers of stress reactivity and psychopathology risk further bolsters its characterization as a unique form of chronic stress among Black Americans and other minority groups in the USA.
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Affiliation(s)
- Briana N Brownlow
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Effua E Sosoo
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Risa N Long
- Department of Family Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lori S Hoggard
- Department of Psychology, Rutgers-The State University of New Jersey, New Brunswick, NJ, USA
| | - Tanisha I Burford
- Department of Psychology, North Carolina Central University, Durham, NC, USA
| | - LaBarron K Hill
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
- Center for Biobehavioral Health Disparities Research, Duke University-Social Science Research Institute, Durham, NC, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
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Birk JL, Cornelius T, Edmondson D, Schwartz JE. Duration of Perseverative Thinking as Related to Perceived Stress and Blood Pressure: An Ambulatory Monitoring Study. Psychosom Med 2019; 81:603-611. [PMID: 31274822 PMCID: PMC6713609 DOI: 10.1097/psy.0000000000000727] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Psychological distress may be intensified and prolonged by perseverative thinking (e.g., rumination, worry). The tendency to engage frequently in perseverative thinking has been linked to increased blood pressure (BP). Research is needed to investigate the physiological consequences of time spent perseverating by testing the momentary association between the duration of perseverative thinking and BP. The present study examines the extent to which the duration of perseverative thinking is associated with momentary perceived stress and ambulatory BP elevations during daily life. METHODS Participants (N = 373) drawn from a larger project on BP and cardiovascular health completed 24-hour ambulatory BP monitoring accompanied by ecological momentary assessments of their perseverative thoughts and feelings. Multilevel models tested associations among perseveration duration, momentary perceived stress, and systolic and diastolic BP, adjusting for person-level and momentary covariates. RESULTS Higher within-subject perseveration duration was associated with higher stress (B = 0.29; 95% confidence interval [CI] = 0.24-0.33; p < .001). Although higher perseveration duration was not associated with substantially higher systolic (B = 0.16 mm Hg; 95% CI = 0.00-0.33 mm Hg; p = .056) or diastolic (B = 0.07 mm Hg; 95% CI = -0.05 to 0.19 mm Hg; p = .25) BP, the associations between higher perseveration duration and higher systolic (p = .032) and diastolic (p = .036) BP were significantly mediated by a higher intensity of momentary perceived stress. CONCLUSIONS Findings support the clinically important notion that physiological consequences of perceived stress can be maintained and even heightened by maladaptively prolonged mental activity.
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Affiliation(s)
- Jeffrey L Birk
- From the Center for Behavioral Cardiovascular Health, Columbia University Medical Center (Birk, Cornelius, Edmondson, Schwartz), New York, New York
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Piotrowska-Półrolnik M, Holas P, Krejtz I, Symonides B. Relationship between alexithymia and variability of blood pressure measured with ABPM in hypertensive patients. Gen Hosp Psychiatry 2019; 60:1-5. [PMID: 31229676 DOI: 10.1016/j.genhosppsych.2019.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/17/2019] [Accepted: 04/23/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Studies indicates that dysregulation of emotions plays an important role in the etiology of elevated blood pressure (BP). One of the signatures of emotional dysregulation is alexithymia defined as an impaired ability to experience and express emotions. Previous work indicated that primary hypertension (HT) is marked by higher alexithymia, but little research examined the relationship between alexithymia and variability of evaluated BP with 24 h Ambulatory Blood Pressure Monitoring (ABPM) in HT patients. METHOD Fifty-five participants diagnosed with hypertension and a matched group of thirty-nine healthy participants filled in The Toronto Alexithymia Scale (TAS-20), a clinical-demographic questionnaire, and were assessed with 24 h ABPM. RESULTS After removing those with white coat HT, as expected, hypertensive individuals had a higher total score and all three alexithymia subscales. Furthermore, alexithymia was positively correlated with average values of systolic BP. CONCLUSION These findings provided support for the contention that alexithymia is associated with elevated BP, the higher level of alexithymia the higher systolic BP in 24 h BP measurement. Future studies may examine the causal relationship between alexithymia and HT and evaluate the effectiveness of emotional regulation training interventions to reduce BP in people suffering from primary hypertension.
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Affiliation(s)
| | - Paweł Holas
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
| | - Izabela Krejtz
- Psychology Department, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Bartosz Symonides
- Department of Internal Medicine, Hypertension and Angiology, Medical University of Warsaw, Warsaw, Poland
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Chauntry AJ, Williams SE, Whittaker AC. Blunted cardiovascular responses to acute psychological stress predict low behavioral but not self‐reported perseverance. Psychophysiology 2019; 56:e13449. [DOI: 10.1111/psyp.13449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/03/2019] [Accepted: 07/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Aiden J. Chauntry
- School of Sport, Exercise & Rehabilitation Sciences University of Birmingham Birmingham UK
- School of Sport, Exercise, and Health Sciences, National Centre for Sport and Exercise Medicine Loughborough University Loughborough UK
| | - Sarah E. Williams
- School of Sport, Exercise & Rehabilitation Sciences University of Birmingham Birmingham UK
| | - Anna C. Whittaker
- School of Sport, Exercise & Rehabilitation Sciences University of Birmingham Birmingham UK
- Faculty of Health Sciences and Sport University of Stirling Stirling UK
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Aladro-Gonzalvo AR, Araya-Vargas GA, Solera-Herrera A, Moncada-Jiménez J, Machado-Díaz M. Exercise protects cardiovascular recovery from stress in a sample of black ethnicity adolescents. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03889-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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The hypertension advantage and natural selection: Since type 2 diabetes associates with co-morbidities and premature death, why have the genetic variants remained in the human genome? Med Hypotheses 2019; 129:109237. [PMID: 31371084 DOI: 10.1016/j.mehy.2019.109237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/18/2019] [Indexed: 12/30/2022]
Abstract
Type 2 diabetes is a major public health crisis around the world. It is estimated that more than 300 million people worldwide have type 2 diabetes. Furthermore, the World Health Organization estimates that deaths from the complications of diabetes will increase by two thirds between 2008 and 2030. Since type 2 diabetes is a major public health crisis, why have the genetic variants for diabetes not been removed from the genome by natural selection? We hypothesize that insulin resistance, a predisposition to type 2 diabetes, and the associated elevation in sympathetic nervous system activity and arterial blood pressure provided an advantage to humans who lived as hunter-gatherers. Specifically, sympathetic hyperactivity stimulates the renin-angiotensin aldosterone system, promotes sodium reabsorption, and increases blood volume, heart rate, stroke volume and peripheral vascular resistance, thus inducing hypertension. The hypertension in turn provides a hemodynamic advantage for hunter-gatherers. Specifically, sympathetic hyperactivity and increased blood pressure increases blood flow delivery to working muscles by increasing cardiac output and shunting blood from non-active tissue. This natural selection for hypertension occurred during the time in human evolutionary history when the lifespan of most individuals was probably 30-40 years, and morbidity and mortality from cardiovascular disorders was limited. Thus, the selection pressure for elevation in sympathetic nervous system activity and blood pressure provided an advantage for hunting and gathering that would be greater than the selection pressure exerted by the manifestations of cardiovascular disease in aged individuals.
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Juster RP, Doyle DM, Hatzenbuehler ML, Everett BG, DuBois LZ, McGrath JJ. Sexual orientation, disclosure, and cardiovascular stress reactivity. Stress 2019; 22:321-331. [PMID: 30835598 PMCID: PMC6760466 DOI: 10.1080/10253890.2019.1579793] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 01/31/2019] [Indexed: 12/15/2022] Open
Abstract
Stigma may strain the heart health of lesbian, gay, and bisexual (LGB) individuals. To date, however, LGB-related differences in cardiovascular diagnosis, risk factors, and basal biomarkers are inconsistently reported. Using a laboratory-based stress paradigm, the current study assessed whether cardiovascular stress reactivity differs as a function of sexual orientation and disclosure status ("coming out") in a sample of healthy young LGB and heterosexual adults. Eighty-seven participants aged 18-45 (M = 24.61 ± 0.61 SE) identifying as LGB and heterosexual (47%) were exposed to the Trier Social Stress Test, a well-validated laboratory stressor involving public speaking and mental arithmetic. Throughout a two-hour session, ambulatory recordings for heart rate and blood pressure were collected. Self-report questionnaires were also administered to assess psychosocial and demographic variables. Gay/bisexual men showed higher heart rate and lesbian/bisexual women showed marginally higher mean arterial blood pressure in response to a stressor, compared to sex- and age-matched heterosexuals. No significant differences emerged when comparing LGB individuals who had completely disclosed and those that had not completely disclosed their sexual orientation to family and friends. Compared to heterosexuals, heart rate is higher among gay/bisexual men and blood pressure is marginally higher among lesbian/bisexual women when exposed to a laboratory-based stressor. These preliminary findings contribute to small literature on sexual orientation differences in stress reactive biomarkers that requires further exploration. Lay abstract In response to stress exposure in a laboratory, gay/bisexual men showed higher heart rate than heterosexual men. By contrast, lesbian/bisexual showed a non-significant tendency towards higher blood pressure than heterosexual women. These preliminary findings suggest that the heart health of LGB individuals might be strained by stigma exposure.
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Affiliation(s)
- Robert-Paul Juster
- Department of Psychiatry and Addiction, University of Montreal, Montreal, Canada
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Nederend I, de Geus EJC, Blom NA, Ten Harkel ADJ. Long-term follow-up after ventricular septal defect repair in children: cardiac autonomic control, cardiac function and exercise capacity. Eur J Cardiothorac Surg 2019; 53:1082-1088. [PMID: 29253118 DOI: 10.1093/ejcts/ezx438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/12/2017] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Survival after surgical repair of a ventricular septal defect (VSD) is good, but, as in almost all congenital heart diseases, late complications are frequent in adulthood. The exact mechanisms, timing and who is at risk are not fully understood. Altered cardiac autonomic nervous system (ANS) activity might play a role in these long-term sequelae. The aim of this study was to extensively evaluate children late after VSD repair including their cardiac ANS activity, cardiac function and exercise capacity. METHODS Thirty-three patients after surgical VSD repair and 66 healthy age-matched controls underwent 24-h monitoring of ANS control and cardiac output using impedance cardiography, detailed echocardiography and cardiopulmonary exercise testing. RESULTS Ambulatory cardiac ANS control was not different between the patients and the controls. Right ventricular function, exercise capacity and ambulatory cardiac output were decreased in patients compared with the controls. No relationships were found between cardiac ANS activity and cardiac function. CONCLUSIONS Long (average time after repair was 9.9 years) after successful surgical correction of a VSD, cardiac ANS control is not different from the controls. Right ventricular function and exercise capacity are impaired in VSD patients. Post-surgical outcome in these patients may be less benign than presently assumed; therefore, follow-up should be continued into adulthood to detect adverse outcomes in a timely fashion.
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Affiliation(s)
- Ineke Nederend
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Pediatric Cardiology, LUMC University Medical Center, Leiden, Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Nico A Blom
- Department of Pediatric Cardiology, LUMC University Medical Center, Leiden, Netherlands
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology, LUMC University Medical Center, Leiden, Netherlands
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Qin QJ, Cui LQ, Li P, Wang YB, Zhang XZ, Guo ML. Rhynchophylline ameliorates myocardial ischemia/reperfusion injury through the modulation of mitochondrial mechanisms to mediate myocardial apoptosis. Mol Med Rep 2019; 19:2581-2590. [PMID: 30720139 PMCID: PMC6423601 DOI: 10.3892/mmr.2019.9908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 01/18/2019] [Indexed: 01/22/2023] Open
Abstract
Rhynchophylline (RP), the primary active ingredient of Uncaria rhynchophylla, has an anti-hypertensive effect and protects against ischemia-induced neuronal damage. The present study aimed to examine the roles and mechanisms of RP in myocardial ischemia-reperfusion (MI/R) injury of rat cardiomyocytes. Cell viability, reactive oxygen species, mitochondrial membrane potential (MMP) and cell apoptosis were examined by a Cell Counting Kit-8 assay and flow cytometry, respectively. An ELISA was performed to assess the expression of oxidative stress markers. Spectrophotometry was used to detect the degree of mitochondrial permeability transition pore (mPTP) openness. Western blotting and reverse transcription- quantitative polymerase chain reaction assays were used to evaluate the associated protein and mRNA expression, respectively. The present results demonstrated that RP increased the cell viability of MI/R-induced cardiomyocytes, and suppressed the MI/R-induced apoptosis of cardiomyocytes. Additionally, RP modulated the Ca2+ and MMP levels in MI/R-induced cardiomyocytes. Furthermore, RP decreased the oxidative stress and mPTP level of MI/R-induced cardiomyocytes. It was additionally observed that RP affected the apoptosis-associated protein expression and regulated the mitochondrial-associated gene expression in MI/R-induced cardiomyocytes. In conclusion, RP ameliorated MI/R injury through the modulation of mitochondrial mechanisms. The potential effects of RP on the protection of MI/R-induced apoptosis of cardiomyocytes suggest that RP may be an effective target for MI/R therapy.
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Affiliation(s)
- Qiao-Ji Qin
- Emergency Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Li-Qiang Cui
- Department of Anesthesiology, Chengyang People's Hospital, Qingdao, Shandong 266109, P.R. China
| | - Peng Li
- Emergency Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Yong-Bin Wang
- Emergency Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Xue-Zhi Zhang
- Emergency Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Ming-Lei Guo
- Emergency Department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
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Alacreu-Crespo A, Costa R, Abad-Tortosa D, Salvador A, Serrano MÁ. Good decision-making is associated with an adaptive cardiovascular response to social competitive stress. Stress 2018; 21:528-537. [PMID: 29932804 DOI: 10.1080/10253890.2018.1483329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Competition elicits different psychological and cardiovascular responses depending on a person's skills. Decision-making has been considered a distal factor that influences competition, but there are no studies analyzing this relationship. Our objective was to analyze whether decision-making affects the response to competition. Specifically, we aimed to test whether good performers on a decision-making test, the Iowa Gambling Task (IGT), showed an adaptive cardiovascular response to competition. In all, 116 participants (44 women) performed the IGT and were classified into Good or Poor decision-makers. Subsequently, they were exposed to a stress task in two different conditions: a face-to-face competition (winners/losers) or a control condition, while an electrocardiogram was recorded. In the competition group, good decision-makers increased their high-frequency respect to the total heart rate variability (HF/HRV) levels during the task, compared to Poor decision-makers. Again, competition group good decision-makers, showed lower LF and higher HF/HRV reactivity than the control group, which represents lower HRV stress pattern. Moreover, in the group of losers, good decision-makers had a decline in low frequency (LF) during the task and faster recovery than poor decision-makers. In conclusion, good decision-makers have a more adaptive stress response and higher levels of mental effort, based on total HRV interpretation. Decision-making skills could be a factor in a more adaptive cardiovascular response to competition.
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Affiliation(s)
| | - Raquel Costa
- Department of Psychobiology, University of Valencia, Valencia, Spain
| | | | - Alicia Salvador
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
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Matsumura K, Noguchi H, Rolfe P, Yamakoshi T, Matsuoka Y. Differential Effect of Two Mental Stress Tasks on Arterial Stiffness. JAPANESE PSYCHOLOGICAL RESEARCH 2018. [DOI: 10.1111/jpr.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Ambulatory Blood Pressure Reactivity as a Moderator in the Association Between Daily Life Psychosocial Stress and Carotid Artery Atherosclerosis. Psychosom Med 2018; 80:774-782. [PMID: 30020145 PMCID: PMC7523702 DOI: 10.1097/psy.0000000000000627] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We examined whether associations between daily psychosocial stressor exposures and carotid artery intima-medial thickness (IMT) may be stronger among those showing larger stress-related cardiovascular reactivity (CVR) during the course of daily living. METHODS A total of 474 healthy working adults (ages 30-54 years) collected ambulatory blood pressure and recorded their daily experiences, using electronic diaries, during two 2-day periods for a week. Measures of mean momentary task strain and social conflict were used as indices of stressor exposure, and partial regression coefficients linking momentary strain and conflict with ambulatory blood pressure fluctuations were used as measures of CVR. IMT was assessed in the carotid arteries using B-mode ultrasound. RESULTS After covariate adjustment, associations between mean task strain exposure and IMT were significant among those high in CVR to strain (for systolic blood pressure, p = .006, for diastolic blood pressure, p = .011) but not among those low in strain CVR. Similarly, associations involving mean conflict exposure were significant among those high in CVR to social conflict (p < .001 for systolic blood pressure, p = .001 for diastolic blood pressure) but not among low social conflict reactors. Significant moderation effects were more consistently shown for task strain than for social conflict, but the overall pattern of results was robust across two different types of statistical modeling procedures. CONCLUSIONS Individual differences in CVR may moderate the effects of daily psychosocial stress on subclinical CVD among healthy employed adults. Using ecological momentary assessment to measure stress exposure as well as stress reactivity may facilitate our ability to detect these effects.
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Lackner HK, Moertl MG, Schmid-Zalaudek K, Lucovnik M, Weiss EM, Kolovetsiou-Kreiner V, Papousek I. History of Preeclampsia Adds to the Deleterious Effect of Chronic Stress on the Cardiac Ability to Flexibly Adapt to Challenge. Front Physiol 2018; 9:1237. [PMID: 30233410 PMCID: PMC6129979 DOI: 10.3389/fphys.2018.01237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/15/2018] [Indexed: 12/18/2022] Open
Abstract
Preeclampsia, a pregnancy-specific disorder, presents a major health problem during gestation, but is also associated with increased risk for cardiovascular complications in later life. We aimed to investigate whether chronic stress experience and preeclampsia may have additive adverse effects on the cardiac ability to flexibly adapt to challenge, that is, to mount an appropriately vigorous heart rate response to an acute psychological challenge, or whether they may perhaps have synergistic effects (e.g., mutual augmentation of effects). Blunted cardiac responding to challenge has been linked to poor health outcomes in the longer term. Women previously affected by preeclampsia and women after uncomplicated pregnancies were tested 15-17 weeks post-partum in a standardized stress-reactivity protocol, while cardiovascular variables were simultaneously recorded. Changes in heart rate and blood pressure in response to the stressor were analyzed with regard to the effects of history of preeclampsia and chronic stress experience. Findings indicated blunted cardiac responses in women with higher chronic stress experience (p = 0.020) and, independently from that, in women with a history of preeclampsia (p = 0.018), pointing to an additive nature of the effects of preeclampsia and chronic stress on impaired cardiovascular functioning. Consequently, if both are present, a history of preeclampsia may add to the already deleterious effects of the experience of chronic stress. The additive nature of the effects suggests that stress-reducing interventions, albeit they will not eliminate the heightened cardiovascular risk in patients with a history of preeclampsia, may improve their overall prognosis by avoiding further accumulation of risk.
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Affiliation(s)
- Helmut K. Lackner
- Section of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Manfred G. Moertl
- Department of Obstetrics and Gynecology, Clinical Center, Klagenfurt, Austria
| | - Karin Schmid-Zalaudek
- Section of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Miha Lucovnik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Elisabeth M. Weiss
- Institute of Psychology, Biological Psychology Unit, University of Graz, Graz, Austria
| | | | - Ilona Papousek
- Institute of Psychology, Biological Psychology Unit, University of Graz, Graz, Austria
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Ottaviani C. Brain-heart interaction in perseverative cognition. Psychophysiology 2018; 55:e13082. [PMID: 29607505 DOI: 10.1111/psyp.13082] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/28/2022]
Abstract
The move from the concept of homeostasis to that of allostasis has led reactivity stress research to widen the object of its investigation: from the brief physiological response that occurs when one is facing a stressor to what happens when one is anticipating or recovering from a stressor. A paradigmatic example is represented by perseverative cognition, during which human beings react "as if" they were constantly facing a concrete stressor. The core idea behind this review is that the cognitive inflexibility that characterizes perseverative cognition is reflected in both our body (by increased autonomic nervous system rigidity assessed by heart rate variability; HRV) and our brain (by reduced prefrontal-amygdala functional connectivity). This is a review of studies conducted in different settings (laboratory, daily life), populations (healthy, major depression, generalized anxiety), location (United States, Europe), and age groups (children, adults) that consistently replicated the association between autonomic, subjective, and behavioral measures of cognitive inflexibility during perseverative cognition. Moreover, compelling neuroimaging data suggest that HRV reduction from pre- to post-induction of perseverative cognition is associated with both structural and functional brain abnormalities reflecting impaired prefrontal inhibitory control over subcortical structures (e.g., diminished prefrontal-amygdala functional connectivity). The integration of neuroscience techniques with clinical autonomic research has advanced our understanding of the neurobiology of brain-heart interaction during perseverative cognition, potentially yielding to more effective treatment packages. This is clinically relevant if one considers that perseverative cognition is a pervasive transdiagnostic factor that carries prognostic risk for both psychological and somatic health.
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Affiliation(s)
- Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
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Schwerdtfeger A, Gaisbachgrabner K, Traunmüller C. Life Satisfaction and Hemodynamic Reactivity to Mental Stress. Ann Behav Med 2018; 51:464-469. [PMID: 27924461 DOI: 10.1007/s12160-016-9858-9] [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: 11/24/2022] Open
Abstract
BACKGROUND Satisfaction with life has been considered a health-protective variable, which could impact cardiovascular morbidity and mortality. However, few studies have examined the physiological pathways involved in the potentially salutary effect of life satisfaction. It was hypothesized that life satisfaction should be associated with a cardiovascular response profile that signals challenge (i.e., higher cardiac output, lower peripheral resistance), rather than threat during a mental stress task. METHODS A sample of 75 healthy, medication-free men without clinical signs of psychological disorders who worked full-time and occupied highly demanding positions participated in this study. They performed two mental stress tasks (n-back) with varying degrees of difficulty. The tasks were embedded between a baseline and a recovery period. Cardiovascular and hemodynamic variables (heart rate, blood pressure, cardiac output, total peripheral resistance) were recorded by means of impedance cardiography. RESULTS Individuals who were more satisfied with their life displayed higher cardiac output and lower peripheral resistance levels during the stress tasks, indicating a challenge rather than a threat profile. Findings were robust when controlled for physical activity, smoking, age, and depressive symptoms. CONCLUSIONS Life satisfaction could be positively correlated with beneficial hemodynamic stress reactivity, indicating that individuals with higher levels of life satisfaction can more adaptively cope with stress. Increased cardiac output and decreased peripheral resistance during stress may constitute one route through which life satisfaction can benefit health.
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Affiliation(s)
- Andreas Schwerdtfeger
- Health Psychology and Applied Diagnostics, University of Wuppertal, D-42119, Wuppertal, Germany. .,Institute of Psychology, University of Graz, Graz, Austria.
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Abstract
OBJECTIVE Stress reactivity research has traditionally focused on the idea that exaggerated responses to stress may have adverse effects on health. Accumulating evidence suggests that attenuated responses to stress and delayed recovery may also be problematic. METHODS This review focuses on the role of the stress response of the hypothalamic-pituitary-adrenocortical axis, the endogenous opioid system, and the cardiovascular system in hypertension, pain perception, and addictive behaviors. Results from multiple methods of assessment and stress paradigms conducted in our laboratory over the past two decades are integrated with research from other investigators and with existing theories. RESULTS Research indicates that exaggerated biological and physiological responses to stress and attenuated pain perception are associated with hypertension and risk for cardiovascular diseases. This research complements work linking reduced stress responses with enhanced pain sensitivity and discomfort. Multiple studies have also demonstrated that an attenuated stress response is linked to exacerbation of withdrawal symptoms and relapse in nicotine addiction. Evidence indicates important moderators (i.e., sex, personality traits, and early life adversity) and hypothalamic-pituitary-adrenocortical- and endogenous opioid system-related mechanisms in the altered response to stress. I integrate these findings in a conceptual model emphasizing that robust stress responses in the context of addiction and relapse should be considered as a marker of resiliency. CONCLUSIONS A blunted stress response may indicate long-term physiological dysregulation that could usher harmful consequences for cardiovascular disease, pain perception, and addictive disorders. The impact of dysregulation is influenced by multiple individual and situational factors that should be considered in evaluating the clinical significance of stress response dysregulation.
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Affiliation(s)
- Mustafa alʼAbsi
- From the University of Minnesota Medical School, Duluth (al'Absi), Duluth, Minnesota
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Villafaina S, Collado-Mateo D, Fuentes JP, Merellano-Navarro E, Gusi N. Physical Exercise Improves Heart Rate Variability in Patients with Type 2 Diabetes: A Systematic Review. Curr Diab Rep 2017; 17:110. [PMID: 28942507 DOI: 10.1007/s11892-017-0941-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW The aim of the present systematic review is to provide an up-to-date analysis of the research on the effects of exercise programs on heart rate variability (HRV) in individuals with type 2 diabetes mellitus (T2DM). An electronic search of the literature (PubMed, PEDro and Web of Science) was performed. "HRV", "heart rate variability", "exercise", "physical" and "diabetes" were the terms used for article retrieval. Lastly, 15 articles were selected. PRISMA methodology was employed and data were extracted according to the PICOS approach. RECENT FINDINGS Although HRV is not routinely measured in the management of T2DM, it is an important measure due to its relation with mortality and diabetic neuropathy. Physical exercise has become a therapy for T2DM, because it improves physical fitness and functional capacity, enhances metabolic control and insulin sensitivity, reduces inflammatory markers and neuropathy symptoms and can increase the regenerative capacity of cutaneous axons, slowing or preventing neuropathy progression. However, it is not clear to what extent physical exercise can improve HRV in this population. Participation in the 15 selected studies was similar in men and women (48.01% men and 51.99% women). All the intervention programs included aerobic training, and it was complemented by strength training in four studies. Duration of physical exercise sessions ranged between 30 and 75 min, the frequency being between 2 and 7 days/week. Statistically significant improvements in groups with diabetes, relative to baseline, were observed in nine studies. More than 3 days per week of aerobic training, complemented by strength training, during at least 3 months seems to improve HRV in T2DM. Weekly frequency might be the most important factor to improve HRV. These aspects could help to design better programs based in scientific evidence, incorporating HRV as an important variable associated with diabetic neuropathy and mortality.
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Affiliation(s)
- Santos Villafaina
- Faculty of Sport Science, University of Extremadura, Av. De Universidad s/n, 10003, Caceres, Spain.
| | - Daniel Collado-Mateo
- Faculty of Sport Science, University of Extremadura, Av. De Universidad s/n, 10003, Caceres, Spain
| | - Juan Pedro Fuentes
- Faculty of Sport Science, University of Extremadura, Av. De Universidad s/n, 10003, Caceres, Spain
| | | | - Narcis Gusi
- Faculty of Sport Science, University of Extremadura, Av. De Universidad s/n, 10003, Caceres, Spain
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Endocrinological and subjective stress responses in children with depressive, anxiety, or externalizing disorders. Dev Psychopathol 2017; 30:605-622. [DOI: 10.1017/s0954579417001146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractIn this study, we used a stress test to investigate endocrinological and subjective stress responses of 8- to 14-year-old children with internalizing or externalizing disorders and healthy controls. The sample (N = 170) consisted of clinical and community children. Parents were given a diagnostic interview to diagnose their children's psychiatric condition. We measured saliva cortisol and subjectively experienced arousal in children before and after the Trier Social Stress Test for Children. Children also rated their performance immediately after the stress test, and 1 hr later they rated their positive and negative thoughts about this stressful event. Children with internalizing or externalizing disorders exhibited a blunted cortisol response compared to healthy controls. Depressed children rated their test performance lower and reported more negative thoughts after the test in comparison to healthy controls, anxious children reported more arousal before and after the task, and children with externalizing disorders reported more positive thoughts. In regression analyses, cortisol and subjective stress responses were both predictive of psychiatric disorders. The study extends previous work on the relation between psychiatric disorders and children's stress responses to an experimentally induced stress task by including a broad range of psychiatric disorders and by integrating endocrinological and subjective stress responses.
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