Elevated resting blood pressure and dampened emotional response

Emotional dampening in hypertension: Impaired recognition of implicit emotional content in auditory and cross-modal stimuli

Research shows a reduced responsivity to implicit as well as explicit facial emotion recognition (emotional dampening) in prehypertensives and hypertensives. This study explored auditory and audiovisual emotion recognition in prehypertensives and hypertensives. Participants (N = 175) who were normotensives, prehypertensives, and hypertensives (n = 57, 58, and 60, respectively) completed an auditory implicit task (matching auditory target with auditory distractors) and two cross-modal implicit tasks (matching visual target with auditory distractors, and vice-versa), and an auditory explicit task (labelling emotions in audio-clips). Findings showed an aberrant speed-accuracy trade-off, where prehypertensives focused more on accuracy at the cost of speed while hypertensives showed the opposite. Discriminant function analysis revealed that blood pressure (BP)-associated emotional dampening is a highly specific but moderately sensitive correlate of hypertension. Our study highlights that prehypertensives and hypertensives demonstrate emotional dampening in implicit (but not explicit) auditory emotion recognition and a greater deficit for auditory than visual recognition of implicit emotions. Findings show emotional dampening as an observable correlate of elevated BP and hypertension.

Linking Blood Pressure-Associated Emotional Dampening to Trait Empathy

Gradual and sustained increases in resting blood pressure are accompanied by gradual and sustained reductions in the capacity to consciously experience several affective and somatosensory processes. Burgeoning theory suggests that this phenomenon, termed cardiovascular emotional dampening, contributes to heart disease risk by interfering with our ability to effectively respond to environmental demands. Interpersonal relationships are contexts in which this risk cascade likely occurs, but prior researchers have paid little attention to how emotional dampening might influence these relationships. As empathy is a construct used to describe facets of emotion-linked responding that facilitate interpersonal relationships, if emotional dampening influences interpersonal relationships, then we might expect resting blood pressure to covary with measures of empathy as it does with other previously studied aspects of affective responding. We recruited 175 healthy undergraduate college student participants (120 Women; M age = 19.17, SD age = 2.08) to complete a counterbalanced procedure in which we measured resting blood pressure and related it to participants' responses on the Toronto Alexithymia Scale, the Questionnaire of Cognitive and Affective Empathy, and a demographic survey. Bivariate comparisons revealed a significant inverse relationship between average resting systolic blood pressure (SBP) and cognitive empathy, as well as a significant inverse relationship between SBP and affective empathy. Multiple regression analyses revealed that SBP remained a significant predictor of cognitive empathy, but not affective empathy, after controlling for related covariates (i.e., sex, age, and alexithymia). SBP predicted cognitive empathy such that higher SBP was associated with lower cognitive empathy. Thus, people with higher resting blood pressures might experience increased interpersonal distress because of a reduced capacity for empathetic accuracy and perspective-taking. We discuss the implications and future directions of these findings.

Associations between mental health, blood pressure and the development of hypertension

Multiple studies have reported a link between mental health and high blood pressure with mixed or even contradictory findings. Here, we resolve those contradictions and further dissect the cross-sectional and longitudinal relationship between mental health, systolic blood pressure, and hypertension using extensive psychological, medical and neuroimaging data from the UK Biobank. We show that higher systolic blood pressure is associated with fewer depressive symptoms, greater well-being, and lower emotion-related brain activity. Interestingly, impending hypertension is associated with poorer mental health years before HTN is diagnosed. In addition, a stronger baseline association between systolic blood pressure and better mental health was observed in individuals who develop hypertension until follow-up. Overall, our findings offer insights on the complex relationship between mental health, blood pressure, and hypertension, suggesting that-via baroreceptor mechanisms and reinforcement learning-the association of higher blood pressure with better mental health may ultimately contribute to the development of hypertension.

Behavioural approach-avoidance tendencies among individuals with elevated blood pressure

Emotional dampening (blunted responses to affective stimuli or experiences) has been reported in individuals with clinical and subclinical levels of elevated blood pressure (BP). Our aim in the present study was to explore how the basic motivational systems of approach and avoidance to positively- and negatively-valenced stimuli are affected in elevated BP. High BP (n = 27) and Low BP (n = 29) participants completed an approach-avoidance task. In this task, participants pulled the joystick towards them when viewing a happy face (approach) and pushing it away when viewing an angry face (avoid) in the congruent condition, and reversed these action-to-emotion pairings in the incongruent condition. A mixed-design ANOVA revealed a significant main effect of condition, such that overall participants were faster across trials in the congruent than trials of the incongruent condition. There was also an emotion x BP interaction. Among the Low BP group, there were no RT differences to happy and angry expressions (across congruent and incongruent conditions) but those with High BP were quicker to respond to actions paired with angry than happy facial expressions (across conditions). Findings suggest that valence-specific motivational reactions are not dampened with an increase in BP, and are rather sensitized for the negative emotion of anger.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04337-2.

Atypical interoception as a common risk factor for psychopathology: A review

The inadequacy of a categorial approach to mental health diagnosis is now well-recognised, with many authors, diagnostic manuals and funding bodies advocating a dimensional, trans-diagnostic approach to mental health research. Variance in interoception, the ability to perceive one's internal bodily state, is reported across diagnostic boundaries, and is associated with atypical functioning across symptom categories. Drawing on behavioural and neuroscientific evidence, we outline current research on the contribution of interoception to numerous cognitive and affective abilities (in both typical and clinical populations), and describe the interoceptive atypicalities seen in a range of psychiatric conditions. We discuss the role that interoception may play in the development and maintenance of psychopathology, as well as the ways in which interoception may differ across clinical presentations. A number of important areas for further research on the role of interoception in psychopathology are highlighted.

Abnormalities in emotional and motor reactions among young prehypertensive individuals: employing continuous blood pressure analysis

Background:

Essential hypertension is an important risk factor for cerebrovascular diseases and a major cause of premature death in industrialized societies. A predisposing factor for essential hypertension is prehypertension: blood pressure (BP) values at rest that are at the higher end of the normal range. Abnormally enhanced cardiovascular responses to motor and emotional tasks have been found as predictors of essential hypertension. Yet, knowledge regarding the BP reaction to aversive stimuli and motor reaction in prehypertension is limited.

Methods:

We compared the reaction to aversive and neutral stimuli inducing an emotional response (experiment 1) and to the isometric handgrip exercise (IHE) inducing a motor response (experiment 2), between prehypertensive and normotensive controls. BP reactions were measured and analyzed in a continuous fashion, in contrast to previous studies that averaged BP responses across blocks. We applied a multilevel B-spline model, a continuous analysis that enabled a better understanding of the BP time course and the detection of subtle differences between groups.

Results:

In both tasks, we found that prehypertensive individuals showed enhanced DBP reactions compared with normotensive controls; prehypertensive individuals exhibited lower BP responses to aversive pictures and higher BP responses to the IHE. These results are in line with previous studies with healthy or hypertensive participants and suggest abnormalities already in the prehypertensive stage.

Conclusion:

Considering the high frequency and health risks related to prehypertension, understanding the autonomic reactions to emotional and motor stimuli in this population is of clinical and theoretical importance and could serve as a behavioural marker to identify at-risk groups.

Replication and extension of the link between the cardiovascular system and sensitivity to social pain in healthy adults

Resting blood pressure (BP) and heart rate variability (HRV) are linked to physical pain. Research also shows a link between social pain and physical pain, and an inverse association between resting BP and social pain. However, little is known regarding the relationship between resting HRV and social pain. Therefore, the present study aimed to replicate the link between social pain and physical pain, and the inverse relationship between resting BP and social pain, and explore the relationship between resting HRV and social pain. One-hundred twenty three healthy adults completed 1) resting cardiovascular measurements of BP and low-frequency (LF) and high-frequency (HF) HRV powers, 2) social pain sensitivity assessment via the Brief Fear of Negative Evaluation (BFNE) and Mehrabian's Sensitivity to Rejection (MSR) scales, and 3) physical pain sensitivity assessment via subjective pain responses during cold pressor test. The results indicated that no association was observed between social pain and physical pain, whereas resting BP was inversely associated with the MSR scores. Resting LF-HRV was inversely associated with social pain, whereas resting HF-HRV was positively associated with social pain. These findings suggest that physical pain and social pain may share biological substrates that are involved in BP regulation and pain control.

Blood pressure-associated emotional dampening and risky behavior: Elevated resting blood pressure predicts risky simulated driving in women

Elevated resting blood pressure (BP) is associated with dampened responses to emotionally meaningful stimuli. This BP-associated emotional dampening may also influence threat appraisal and, hence, motivation to avoid risk. The present study was designed to determine if resting BP is associated with risky driving behavior assessed in a high fidelity driving simulator. Fifty-one healthy women (n = 20) and men (n = 31) rested for BP determinations both before and after a simulated driving scenario in a DriveSafety automotive simulator with six visual channels, single-axis motion, and functioning controls and instrumentation. Resting systolic (SBP) and diastolic (DBP) BPs were obtained systematically with a calibrated GE Dinamap Pro V100. Risky driving was assessed by speed relative to the posted speed limit, and a speed-adjusted time to collision index of tailgating. Regression analyses indicated that sex interacted with resting BP, with significant associations between BP and risk in women, but not men. For example, risky driving in women was associated with higher resting DBP (p = .006), with similar but less reliable effects for resting SBP (p = .058). These results provide some partial, preliminary support for the notion that BP-associated emotional dampening may reduce threat appraisal and thereby decrease motivation for risk avoidance, but these effects are confined to women in this simulated driving scenario. Interacting central nervous system (CNS) mechanisms controlling BP and emotional responsivity may mediate the relationship between BP and risk-taking behavior. Relative expression of this relationship in women and men may depend on multiple psychosocial and physiological mechanisms. The association of higher BP with increased risk-taking behaviors may have relevance to the early pathogenesis of essential hypertension.

Reduced emotional responsiveness in individuals with marginal elevation in blood pressure within the normal range: Evidence from altered affect-modulated startle response

Reduced responsiveness to emotional stimuli ('emotional dampening') has been observed in normotensives with elevated blood pressure (BP) and hypertensives but it is not known whether this is due to aberrant responding to emotional information at the involuntary level and whether it is also associated with minimal elevations in BP in the normal range. In this study, we examined emotional dampening using the affect-modulated startle paradigm given its proven sensitivity to motivational states of approach and withdrawal, typically independent of conscious intentional control. Acoustically elicited startle eye-blink modulation was measured using electromyography of the orbicularis oculi muscle beneath the left eye in 59 healthy individuals while they viewed pleasant, unpleasant and neutral standardized pictures. The expected startle attenuation to pleasant pictures, and startle potentiation to unpleasant pictures, relative to neutral pictures, was found in people in the comparison (N = 29) but not elevated BP (N = 30) group. This finding was further supported by significant moderating effect (assessed using ANCOVA and sub-sample analysis) of BP on valence-startle amplitude relationship. The comparison BP group also showed slower latencies to response onset for pleasant stimuli compared to neutral and unpleasant, with no effect of valence in the elevated BP group. However, BP did not moderate the valence-onset latency relationship. Our findings indicate that previously reported emotional dampening associated with elevated BP extends to reduced involuntary emotional reactivity and to individuals with even minimal BP elevations (i.e. higher but still within the normal range). Future research needs to confirm these findings in hypertensive individuals, preferably using within-subjects designs.

Blood pressure reaction to negative stimuli: Insights from continuous recording and analysis

Individuals with a tendency toward abnormally enhanced cardiovascular responses to stress are at greater risk of developing essential hypertension later in life. Accurate profiling of continuous blood pressure (BP) reactions in healthy populations is crucial for understanding normal and abnormal emotional reaction patterns. To this end, we examined the continuous time course of BP reactions to aversive pictures among healthy participants. In two experiments, we showed participants negative and neutral pictures while simultaneously measuring their continuous BP and heart rate (HR) reactions. In this study, BP reactions were analyzed continuously, in contrast to previous studies, in which BP responses were averaged across blocks. To compare time points along a temporal continuum, we applied a multi-level B-spline model, which is innovative in the context of BP analysis. Additionally, HR was similarly analyzed in order to examine its correlation with BP. Both experiments revealed a similar pattern of BP reactivity and association with HR. In line with previous studies, a decline in BP and HR levels was found in response to negative pictures compared to neutral pictures. In addition, in both conditions, we found an unexpected elevation of BP toward the end of the stimuli exposure period. These findings may be explained by the recruitment of attention resources in the presence of negative stimuli, which is alleviated toward the end of the stimulation. This study highlights the importance of continuous measurement and analysis for characterizing the time course of BP reactivity to emotional stimuli.

Depressive Symptoms and Blood Pressure

Abstract. In the present investigation it is hypothesized that depressive symptoms and antidepressant therapy are associated with systolic and diastolic blood pressure. Moreover, in additional analyses, the interaction effects of age, gender, and depressive symptoms are estimated, and discussed in the context of previous findings. Data from the German Health Interview and Examination Survey for Adults (DEGS1) were analyzed ( N = 7,987) by means of multi-response Bayesian hierarchical regression models. Missing data were imputed by the method of chain equations. Independent variables included depressive symptoms, antidepressant medication, gender, age, smoking, physical activity, family history of hypertension, body mass index, and antihypertensive medication. The estimates obtained in the multi-response model revealed that depressive symptoms were negatively associated with arterial blood pressure (−0.09, 99% CI [−0.147; −0.040]). Antidepressant therapy was found to be positively associated with increased blood pressure (1.035, 99% CI [0.333; 1.990]). There were negative interaction effects of depressive symptoms and age among women only (−0.006 99% CI [−0.010; −0.001]). The results agree with previous findings reporting a negative association between depressive symptoms and blood pressure. In addition, regarding the trajectory of blood pressure across the lifespan, interaction effects of depressive symptoms and age were found among females. The results indicate a linear increase in blood pressure with increasing age which, however, tends to flatten and decrease by around age 55 in both males and females. Potential physiological mechanisms may be related to affect regulation taking place at higher levels of cognitive processing and affecting blood pressure regulation, and/or cardiovascular mechanisms related to cerebral blood flow, arterial blood pressure, and depressive symptoms which have not been sufficiently explained so far.

Duration of Perseverative Thinking as Related to Perceived Stress and Blood Pressure: An Ambulatory Monitoring Study

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.

Blood Pressure, Emotional Dampening, and Risk Behavior: Implications for Hypertension Development

OBJECTIVE

Elevated resting blood pressure (BP) is associated with risk for hypertension and emotional dampening, including reduced responses to emotionally meaningful stimuli. Perception of threat is a critical motivator in avoidance of risky health-damaging behavior. We hypothesize that BP-associated dampening of threat appraisal may increase risk-taking behavior.

METHODS

We measured resting BP, perception of affect, and risk behavior in 92 healthy women (n = 49) and men (n = 43) recruited from university students and staff as well as members of the surrounding community. Mean (SE) age for the sample was 21.5 (4.3) year. BP was measured using an automated BP monitor, and risk behavior was assessed with a modified National College Health Risk Behavior Survey. We also measured recognition of affect using the Perception of Affect Task (PAT).

RESULTS

Risk-taking behavior was positively correlated with both systolic (r(89) = .278, p = .008) and diastolic BP (r(89) = .309, p < .003). Regression analyses indicated that the association between risk-taking behavior and BP was not mediated by PAT scores.

CONCLUSIONS

Results show that persons with higher resting BP levels report increased risk-taking behavior. PAT scores, while correlated with systolic BP, did not mediate the relationship between BP and risk. The relationship between BP and risk behavior reflects the potential involvement of central nervous system regulation of both BP and emotional responsivity, and its relationship to health-damaging behavior and risk for hypertension.

Taking rejection to heart: Associations between blood pressure and sensitivity to social pain

A reliable finding from the physical pain literature is that individuals with higher resting (i.e., tonic) blood pressure experience relatively less pain in response to nociceptive stimuli. Converging lines of evidence suggest that biological factors that influence the experience of physical pain may also relate to social pain. An open question, however, is whether higher blood pressure per se is a biological factor associated with lower sensitivity to social pain. This possible association was tested in three studies. Consistent with prior findings on physical pain, higher resting blood pressure was associated with lower self-reported sensitivity to social pain across individuals (Study 1 r = -.303, Study 2 r = -.262, -.246), even after adjusting for confounding factors related to blood pressure (Study 3 r = -.222). Findings suggest a previously unknown biological correlate of sensitivity to social pain, providing further evidence for possible shared substrates for physical and social pain.

Poor emotional responsiveness in clinical hypertension: Reduced accuracy in the labelling and matching of emotional faces amongst individuals with hypertension and prehypertension

Psychological factors are known to play an important part in the origin of many medical conditions including hypertension. Recent studies have reported elevated blood pressure (even in the normal range of variation) to be associated with a reduced responsiveness to emotions or 'emotional dampening'. Our aim was to assess emotional dampening in individuals with more extreme blood pressure levels including prehypertensives (N = 58) and hypertensives (N = 60) by comparing their emotion recognition ability with normotensives (N = 57). Participants completed novel facial emotion matching and facial emotion labelling tasks following blood pressure measurement and their accuracy of emotion recognition and average response times were compared. The normotensives demonstrated a significantly higher accuracy of emotion recognition than the prehypertensives and the hypertensives in labelling of facial emotions. This difference generalised to the task where two facial halves (upper & lower) had to be matched on the basis of emotions. In neither the labelling nor matching emotion conditions did the groups differ in their speed of emotion processing. Findings of the present study extend reports of 'emotional dampening' to hypertensives as well as to those at-risk for developing hypertension (i.e. prehypertensives) and have important implications for understanding the psychological component of such medical conditions as hypertension.

Exploring the relationship between frontal asymmetry and emotional dampening

Cardiovascular emotional dampening is the term used to describe the inverse relationship between resting blood pressure and emotional responsivity which extends from normotensive to hypertensive ranges. Little is known about its underlying physiological mechanisms, but it is thought to involve some disruption in emotion processing. One area that has yet to be explored in the literature is the relationship between emotional dampening and frontal asymmetry, a psychophysiological indicator for motivational direction and emotional valence bias. The present study explored that relationship using data from a sample of 48 healthy college students. Measures of baseline resting blood pressure and frontal cortical activity were recorded, after which participants completed a series of emotion-related tasks. Results revealed a significant relationship between resting systolic blood pressure and left frontal activity. Likewise, left frontal activity was associated with neutral appraisal of emotionally valenced stimuli within the tasks. The findings from the present study yield support for a link between emotional dampening and left frontal activity. Implications are discussed.

Assessing emotional processing difficulties in normotensive individuals with high and isolated blood pressure elevations

This study examined the effect of sense modality (auditory/visual) on emotional dampening (reduced responsiveness to emotions with elevation in blood pressure). Fifty-six normotensive participants were assessed on tasks requiring labelling and matching of emotions in faces and voices. Based on median split of systolic and diastolic blood pressures (SBP and DBP, respectively), participants were divided into low BP, high BP and isolated BP groups. On emotion-labelling tasks, analysis revealed reduced emotion recognition in the high BP than the low BP group. On emotion-matching tasks, reduced emotion recognition was noted in high and also isolated BP group as compared to low BP group for the task that required matching a visual target with one of the four auditory distractors. Our findings show for the first time that even isolated elevations in either SBP or DBP may result in emotional dampening. Furthermore, the study highlights that the emotional dampening effect generalises to explicit processing (labelling) of emotional information in both faces and voices-and that these effects tentatively occur during more pragmatic and covert (matching) emotion recognition processes too. These findings require replication in clinical hypertensives.

Affective impairment in chronic low blood pressure

OBJECTIVE

Physical complaints such as faintness, dizziness, cold limbs and headaches have been well-established in chronic low blood pressure (hypotension). This study investigated the occurrence of adverse emotional states and the symptoms of depression in this condition. As autonomic dysregulation, particularly diminished sympathetic tone, is believed to be involved in the etiology of hypotension, the impact of different facets of autonomic cardiovascular control on mood and depressive symptoms was also explored.

METHODS

Forty individuals with chronic hypotension and forty normotensive control persons were presented with the Mood Scale and Beck Depression Inventory. Stroke volume, cardiac output, pre-ejection period, Heather index and aortic peak blood flow velocity were recorded under resting conditions as indices of beta-adrenergic inotropic drive. Respiratory sinus arrhythmia and baroreflex sensitivity were additionally obtained.

RESULTS

Hypotensive individuals scored markedly higher on both questionnaire scales than controls, indicating an adversely affected emotional state and more severe depressive symptoms. In the entire sample, cardiac output, Heather index, and aortic peak blood flow velocity correlated negatively with the questionnaire scores; according to regression analysis, the Heather index explained the largest proportion of test score variance.

CONCLUSION

Although hypotension does not constitute a serious medical condition, the findings of an adverse affective state and increased burden with depressive symptoms corroborate the view that it can have a considerable impact on wellbeing and quality of life. The correlations of the beta-adrenergic indices with the questionnaire scales indicate that cardiac sympathetic regulation plays a key role in the psychophysiological mediation of hypotension-related mood impairment.

Resting blood pressure differentially predicts time course in a tonic pain experiment

Resting blood pressure (BP) shows a negative relationship with pain sensitivity (BP-related hypoalgesia). In chronic pain conditions, this relationship is inverted. The precise mechanisms responsible for the inversion are unknown. Using a tonic pain protocol, we report findings closely resembling this inversion in healthy participants. Resting BP and state measures of anxiety and mood were assessed from 33 participants (21 female). Participants then immersed their dominant hand in painfully hot water (47 °C) for five trials of 1-min duration, with 30-s intertrial intervals. Throughout the trials, participants continually registered their pain. After a 35-min intermission, the trial sequence was repeated. A disassociation of the negative relationship of resting systolic BP (as per Trial 1) was found using hierarchical linear modeling (p < .001, R(2)  = .07). The disassociation unfolds over each consecutive trial, with an increasingly positive relationship. In Sequence 2, the initially negative relationship is almost completely absent. Furthermore, the association of BP and pain was found to be moderated by anxiety, such that only persons with low anxiety exhibited BP hypoalgesia. Our findings expand the existing literature by incorporating anxiety as a moderator of BP hypoalgesia. Furthermore, the protocol emulates the changing relationship between BP and pain observed in chronic pain patients. The protocol has potential as a model for chronic pain; however, future research should determine if similar physiological systems are involved. The finding holds potential diagnostic or prognostic relevance for certain clinical pain conditions, especially those involving dysfunction of the descending modulation of pain.

Sleep deprivation affects reactivity to positive but not negative stimuli

OBJECTIVE

The current study examined the effects of partial and total sleep deprivation on emotional reactivity.

METHODS

Twenty-eight partially sleep-deprived participants and 31 totally sleep-deprived participants rated their valence and arousal responses to positive and negative pictures across four testing sessions during the day following partial sleep deprivation or during the night under total sleep deprivation.

RESULTS

The results suggest that valence and arousal ratings decreased under both sleep deprivation conditions. In addition, partial and total sleep deprivation had a greater negative effect on positive events than negative events.

CONCLUSION

These results suggest that sleep-deprived persons are more likely to respond less to positive events than negative events. One explanation for the current findings is that negative events could elicit more attentive behavior and thus stable responding under sleep deprivation conditions. As such, sleep deprivation could impact reactivity to emotional stimuli through automated attentional and self-regulatory processes.

Reduced cerebral and cardiovascular hemodynamics during sustained affective stimulation in young women with chronic low blood pressure

Although low blood pressure has been associated with lower affect and higher depressive symptoms in the elderly, the presence of possible impairment in emotional reactivity in chronic hypotensive individuals in early adulthood remains largely unexplored. Using a combination of transcranial Doppler sonography, beat-to-beat blood pressure recording and impedance cardiography we assessed central and peripheral hemodynamic changes in 15 undergraduate women with chronic hypotension (Age: 23.9 ± 2.7 years) and 15 normotensive controls (Age: 23.7 ± 3.1 years) during sustained exposure to pleasant, unpleasant and neutral pictures. Overall, systolic blood pressure (SBP) increased in normotensives and decreased in hypotensives during picture viewing as compared to baseline. Also, compared to normotensives, in hypotensives mean cerebral blood flow velocity increased to a lesser extent during the viewing of pleasant pictures and the magnitude of this increase was negatively associated with subjective emotional arousal. In addition, in hypotensives screening SBP was positively associated with valence rating of pleasant contents. These findings indicate a close association between chronic low blood pressure and reduced processing of pleasant stimuli in young adulthood.

From Brain to Behavior: Hypertension's Modulation of Cognition and Affect

Accumulating evidence from animal models and human studies of essential hypertension suggest that brain regulation of the vasculature is impacted by the disease. Human neuroimaging findings suggest that the brain may be an early target of the disease. This observation reinforces earlier research suggesting that psychological factors may be one of the many contributory factors to the initiation of the disease. Alternatively or in addition, initial blood pressure increases may impact cognitive and/or affective function. Evidence for an impact of blood pressure on the perception and experience of affect is reviewed vis-a-vis brain imaging findings suggesting that such involvement in hypertensive individuals is likely.

Decreased Cognitive/CNS Function in Young Adults at Risk for Hypertension: Effects of Sleep Deprivation

Hypertension has been linked to impaired cognitive/CNS function, and some of these changes may precede development of frank essential hypertension. The stress and fatigue of sleep deprivation may exacerbate these cognitive changes in young adults at risk. We hypothesize that individuals at risk for hypertension will show significant declines in cognitive function during a night of sleep deprivation. Fifty-one young adults were recruited for 28-hour total sleep deprivation studies. Hypertension risk was assessed by mildly elevated resting blood pressure and by family history of hypertension. A series of cognitive memory tasks was given at four test sessions across the sleep deprivation period. Although initially comparable in cognitive performance, persons at risk showed larger declines across the night for several indices of working memory, including code substitution, category, and order recall. These results suggest that cognitive/CNS changes may parallel or precede blood pressure dysregulation in the early stages of hypertension development. The role of CNS changes in the etiology of essential hypertension is discussed.

Cardiovascular-emotional dampening: the relationship between blood pressure and recognition of emotion

OBJECTIVE

Persons with elevated blood pressure (BP) show dampened emotional responses to affect-laden stimuli. We sought to further examine cardiovascular-emotional dampening by examination of the relationship between resting hemodynamic measures and recognition of emotion in an African American community-based sample.

METHODS

Participants were 106 African American men and women (55 women; mean age = 52.8 years), mainly low in socioeconomic status, and part of the Healthy Aging in Nationally Diverse Longitudinal Samples pilot study. Participants evaluated emotional expressions in faces and sentences using the Perception of Affect Test (PAT). Resting BP, total peripheral resistance (TPR), cardiac output, and heart rate were obtained continuously using a Portapres BP monitor.

RESULTS

Total PAT scores were inversely related to systolic (r = -0.30) and diastolic (r = -0.24) BPs, TPR (r = -0.36), and age (r = -0.31; p values < .01) and were positively related to cardiac output (r = 0.27) and education (r = 0.38; p values < .01), as well as with mental state (r = 0.25) and body mass index (r = -0.20; p values < .05). Accuracy of emotion recognition on the PAT tasks remained inversely related to TPR and BP after adjustment for demographic variables, medication, mental state, and body mass index.

CONCLUSIONS

Elevated BP and TPR were associated with reduced perception of affect. TPR was the most consistent independent hemodynamic correlate of emotional dampening for the PAT scores. These results suggest potentially important links among central nervous system regulation of emotions, hemodynamic processes, and hypertension development.

Attenuation of positive and negative affect in men and women at increased risk for hypertension: a function of endogenous barostimulation?

We hypothesized that activation of endogenous baroreflexes would be associated with reduced responsivity to affective stimuli and that this effect would be enhanced in individuals at risk for hypertension. Images from the International Affective Picture System were presented during systolic and diastolic phases of the cardiac cycle. Affective responsivity was measured using electromyographic activity, skin conductance, and ratings of arousal and valence. Compared to offspring of normotensives, individuals with a parental history of hypertension showed reduced responsivity to both positive and negative affective stimuli; however, responsivity did not differ as a function of cardiac cycle phase. Although these findings do not support a barostimulation mechanism of affective dampening, it is premature to discount the baroreflex inhibition hypothesis given the limited affective reactions elicited by visual stimuli presented in the laboratory.

Effects of opioid blockade on the modulation of pain and mood by sweet taste and blood pressure in young adults

Increased blood pressure and sweet taste are often associated with decreased pain sensitivity. Animal research suggests that endogenous opioids are involved in both these relationships. Fifty-eight healthy young adults (36 male, 22 female) participated in two sessions receiving a placebo tablet or 50mg of naltrexone on counterbalanced days. On each day, three cold-pressor tests were administered while the participant held a sweet solution, water, or nothing in their mouth when their hand was in the water. 2 Drug x 3 Solution x 2 Gender x Pre-Drug Resting Blood Pressure general linear models (GLM) were conducted separately for systolic (SBP) and diastolic (DBP) pressure. Consistent with previous research, significant main effects of SBP were observed in GLMs of pain tolerance and pain unpleasantness ratings. A main effect of solution on tolerance was seen in the GLM with DBP, which was qualified by an interaction of solution by blood pressure. Sweet taste increased pain tolerance among those with lower DBP across drug conditions. This suggests some overlap between mechanisms of sweet taste and blood pressure analgesia, without implicating opioid activity in sweet taste analgesia. However, the GLM of tolerance also produced a significant drug by DBP interaction suggesting that blood pressure-related analgesia is at least partially opioid-mediated. Also participants with higher DBP showed dampened mood reactivity to the experiment, which was partially reversible by naltrexone. These results are consistent with findings suggesting that endogenous opioid activity may contribute to generally reduced pain sensitivity, and perhaps mood reactivity, in those with higher BP.

Emotion and Pain: A Functional Cerebral Systems Integration

Emotion and pain are psychological constructs that have received extensive attention in neuropsychological research. However, neuropsychological models of emotional processing have made more progress in describing how brain regions interact to process emotion. Theories of emotional processing can describe inter-hemispheric and intra-hemispheric interactions during emotional processing. Due to similarities between emotion and pain, it is thought that emotional models can be applied to pain. The following review examines the neuropsychology of emotion and pain using a functional cerebral systems approach. Specific comparisons are made between pain and anger. Attention is given to differences in cerebral function and physiology that may contribute to the processing of emotion and pain. Suggestions for future research in emotion and pain are given.