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Izaki T, Himichi T, Sakaki M. Cardiac cycle modulates social pain. Biol Psychol 2024; 192:108853. [PMID: 39116917 DOI: 10.1016/j.biopsycho.2024.108853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/22/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
Social pain is a painful feeling evoked by social rejection, exclusion, or the loss of other important people. Previous research suggests that physical pain is reduced by increased signals from baroreceptors that monitor blood pressure. This pre-registered study investigated whether social pain is attenuated by increased baroafferent signals, as observed in physical pain. Given that baroafferent signals increase during cardiac systole and decrease during diastole, we hypothesized that feelings of pain induced by social rejection would be lower when exclusion events are presented at the cardiac systole than when they are presented at the diastole. Participants completed the cyberball task, a computerized ball-tossing game involving two other players. In the rejection condition, the ball was rarely thrown to the participant, while the other players kept tossing it to each other. Throws between other players were defined as exclusion events and were presented either at the cardiac systole (a systole condition) or at the diastole (a diastole condition). We found that exclusion events evoked significantly less social pain in the systole condition than in the diastole condition. Furthermore, the effects of cardiac cycle were more pronounced in participants with higher heart rate variability than those with lower heart rate variability. Our results suggest that cardiac afferent signals contribute not only to physical pain but also to social pain.
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Affiliation(s)
- Tsubasa Izaki
- School of Economics & Management, Kochi University of Technology, Kochi, Japan.
| | - Toshiyuki Himichi
- School of Economics & Management, Kochi University of Technology, Kochi, Japan
| | - Michiko Sakaki
- Hector Research Institute of Education Sciences and Psychology, University of Tübingen, Tübingen, Germany; Research Institute, Kochi University of Technology, Kochi, Japan
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Wesselbaum D. Association of Hypertension with Well-Being: Results from the Behavioral Risk Factor Surveillance System (BRFSS) Study. High Blood Press Cardiovasc Prev 2024; 31:401-404. [PMID: 38775926 PMCID: PMC11322268 DOI: 10.1007/s40292-024-00653-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/14/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION It remains unclear how hypertension affects subjective well-being, especially in light of its potential gender-specific impacts. AIM In this study, we aimed to study the association between hypertension and subjective well-being and the potential gender differences in this relationship as well as mediating factors. METHODS We use individual-level data from > 1 million Americans who participated in six waves of the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. We employ descriptive and regression analyses to determine the association between hypertension and subjective well-being while controlling for the usual well-being covariates identified from the related literature. RESULTS Hypertension was negative associated with subjective well-being (p < 0.001) and our results for covariates were in line with the findings in the related literature. The association between hypertension and subjective well-being was only found in males (p < 0.001) but not in females. The relationship is mediated by age and exercising but only for females. CONCLUSION Hypertension is negatively associated with well-being among males. The diagnosis of hypertension should not only lead to medical treatments but also involve a careful psychological management.
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Canli U, Aldhahi MI, Küçük H. Association of Physiological Performance, Physical Fitness, and Academic Achievement in Secondary School Students. CHILDREN (BASEL, SWITZERLAND) 2024; 11:396. [PMID: 38671613 PMCID: PMC11049434 DOI: 10.3390/children11040396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/23/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
This study aimed to compare the physiological performance and physical fitness based on the academic achievement levels of secondary school students and to explore the effect of gender on the relationship between physiological performance, physical fitness, and academic achievement. In this cross-sectional study, 304 children aged 13-14 years were recruited. To assess physical fitness, students performed a 20 m sprint test, a pro-agility test, a one-mile endurance run/walk test, and a countermovement jump test. At the end of the one-mile endurance run/walk test, the estimated VO2peak value of the participants was calculated. The physiological performance of the students was determined by measuring their resting heart rate and blood pressure. Students were grouped into three categories based on their academic achievement levels. The assessment of academic achievement considered their scores from the previous academic year. The scores were divided into three levels: poor (average score of 69 points or less), average (scores ranging from 70 to 84 points), and good (scores of 85 points or higher). The study revealed a notable disparity among students' VO2Max measurements based on their academic achievement (F = 8.938, p < 0.001, η2 = 0.056). However, we observed that the group with poor academic achievement displayed lower diastolic blood pressure values than the groups with average and good performances. Finally, no significant gender differences were evident in the relationship between academic achievement and any of the physical and physiological parameters.
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Affiliation(s)
- Umut Canli
- Sports Science Faculty, Tekirdag Namik Kemal University, Suleymanpasa, Tekirdag 59010, Turkey;
| | - Monira I. Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Hamza Küçük
- Yasar Dogu Faculty of Sport Sciences, Ondokuz Mayıs University, Samsun 55270, Turkey;
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Blöchl M, Schaare HL, Kumral D, Gaebler M, Nestler S, Villringer A. Vascular risk factors, white matter microstructure, and depressive symptoms: a longitudinal analysis in the UK Biobank. Psychol Med 2024; 54:125-135. [PMID: 37016768 DOI: 10.1017/s0033291723000697] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
BACKGROUND Cumulative burden from vascular risk factors (VRFs) has been associated with an increased risk of depressive symptoms in mid- and later life. It has been hypothesised that this association arises because VRFs disconnect fronto-subcortical white matter tracts involved in mood regulation, which puts older adults at higher risk of developing depressive symptoms. However, evidence for the hypothesis that disconnection of white matter tracts underlies the association between VRF burden and depressive symptoms from longitudinal studies is scarce. METHODS This preregistered study analysed longitudinal data from 6,964 middle-aged and older adults from the UK Biobank who participated in consecutive assessments of VRFs, brain imaging, and depressive symptoms. Using mediation modelling, we directly tested to what extend white matter microstructure mediates the longitudinal association between VRF burden and depressive symptoms. RESULTS VRF burden showed a small association with depressive symptoms at follow-up. However, there was no evidence that fractional anisotropy (FA) of white matter tracts mediated this association. Additional analyses also yielded no mediating effects using alternative operationalisations of VRF burden, mean diffusivity (MD) of single tracts, or overall average of tract-based white matter microstructure (global FA, global MD, white matter hyperintensity volume). CONCLUSIONS Our results lend no support to the hypothesis that disconnection of white matter tracts underlies the association between VRF burden and depressive symptoms, while highlighting the relevance of using longitudinal data to directly test pathways linking vascular and mental health.
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Affiliation(s)
- Maria Blöchl
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- International Max Planck Research School: Neuroscience of Communication: Structure, Function, and Plasticity, Leipzig, Germany
- Department of Psychology, University of Münster, Münster, Germany
| | - H Lina Schaare
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour) Research Centre Jülich, Germany
| | - Deniz Kumral
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany
- Clinical Psychology and Psychotherapy Unit, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Michael Gaebler
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin School of Mind and Brain, MindBrainBody Institute
- Max Planck Dahlem Campus of Cognition, Berlin, Germany
| | - Steffen Nestler
- Department of Psychology, University of Münster, Münster, Germany
| | - Arno Villringer
- Department for Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University Clinic Leipzig, Leipzig, Germany
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Farhangi MA, Fathi Azar E, Manzouri A, Rashnoo F, Shakarami A. Prolonged screen watching behavior is associated with high blood pressure among children and adolescents: a systematic review and dose-response meta-analysis. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:89. [PMID: 37653414 PMCID: PMC10468885 DOI: 10.1186/s41043-023-00437-8] [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: 03/25/2023] [Accepted: 08/25/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Numerous cardio-metabolic risk factors influence screen-related behaviors in children and adolescents. Numerous studies with inconsistent results revealed a relationship between blood pressure and screen time in the children and adolescents. This systematic review and meta-analysis summarized the data regarding the relationship between screen time and hypertension (HTN) in children and adolescents. METHODS We examined three electronic databases, including Scopus, PubMed, and Embase to find the recent research on the relationship between screen time and HTN up to 19 July 2022. Twenty papers were included in the final two-class and dose-response meta-analysis. We conducted subgrouping to identify the source of heterogeneity. RESULTS The highest category of screen time increased the odds of HTN by 8% [odds ratio (OR): 1.15; 95% confidence interval (CI): 1.08, 1.23; P < 0.001; I2 = 83.20%] and 1.9 mmHg increase in systolic blood pressure [weighted mean difference (WMD): 1.89; 95% CI: 0.18-3.62; P = 0.030; I2 = 83.4]. However, there was no significant difference in diastolic blood pressure. Moreover, screen time in hypertensive children and adolescents was 0.79 h (47.4 min) higher than normotensive subjects (WMD: 0.79; 95% CI: 0.02, 1.56; P = 0.046; I2 = 92.8). A departure from linearity was observed between increased screen time [digital video discs, personal computers, and video games and HTN (Pnonlinearity = 0.049). CONCLUSION This systematic meta-analysis review is the first to demonstrate a positive correlation between screen time and HTN in children and adolescents.
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Affiliation(s)
| | - Elahe Fathi Azar
- Department of Occupational Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Manzouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Rashnoo
- Department of General and Minimally Invasive Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Shakarami
- Department of Cardiovascular Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran.
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Schaare HL, Blöchl M, Kumral D, Uhlig M, Lemcke L, Valk SL, Villringer A. Associations between mental health, blood pressure and the development of hypertension. Nat Commun 2023; 14:1953. [PMID: 37029103 PMCID: PMC10082210 DOI: 10.1038/s41467-023-37579-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/18/2023] [Indexed: 04/09/2023] Open
Abstract
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.
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Affiliation(s)
- H Lina Schaare
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Otto-Hahn-Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany.
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Maria Blöchl
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute for Psychology, Leipzig University, Leipzig, Germany
| | - Deniz Kumral
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Psychology, Neuropsychology, University of Freiburg, Freiburg, Germany
- Institute of Psychology, Clinical Psychology and Psychotherapy Unit, University of Freiburg, Freiburg, Germany
| | - Marie Uhlig
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Lorenz Lemcke
- Nuclear Magnetic Resonance Unit, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sofie L Valk
- Otto-Hahn-Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Jülich, Jülich, Germany
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- MindBrainBody Institute, Berlin School of Mind and Brain, Berlin, Germany
- Clinic of Cognitive Neurology, Leipzig University, Leipzig, Germany
- Charité University Medicine Berlin, Berlin, Germany
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Pantke PM, Herrmann-Lingen C, Rothenberger A, Poustka L, Meyer T. Is only-child status associated with a higher blood pressure in adolescence? An observational study. Eur J Pediatr 2023; 182:1377-1384. [PMID: 36662268 PMCID: PMC10023605 DOI: 10.1007/s00431-022-04800-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 01/21/2023]
Abstract
Growing up with siblings may affect quality of life as well as hemodynamic parameters including blood pressure. Using weighted data from the nationwide and representative German KiGGs study, we assessed the relationship between only-child status, birth order, and arterial blood pressure in a cohort of 7311 adolescents aged between 11 and 17 years. Our data showed that only-children had the highest mean arterial blood pressure (87.3 ± 8.4 mmHg) as compared to first-born (86.3 ± 8.0), middle-born (86.4 ± 8.7), and youngest-born siblings (86.6 ± 8.2; p = 0.012). The two groups of only-children and first-borns differed significantly with respect to their age- and sex-specific, z-scored data for systolic (p = 0.047), diastolic (p = 0.012), and mean arterial blood pressure (p = 0.005). Linear regression models with blood pressure recordings as dependent variable adjusted to age, migration background, and age- and sex-specific z-scores of body-mass index confirmed that only-child status was an independent predictor of a higher diastolic blood pressure (p = 0.037). A similar result was observed for mean arterial blood pressure (p = 0.033), whereas systolic blood pressure was not associated with only-children status (p = 0.258). Conclusion: In summary, we found a significant and positive relationship between only-child status and blood pressure, with the highest recordings in only-children and the lowest in first-borns. Models adjusted for relevant clinical confounders demonstrated slightly higher blood pressure in only-children compared to first-borns, who are both in an alpha birth order. Although these blood pressure differences were statistically significant, they have limited, if any, clinical meaning in this age group. What is Known: • In children and adults, blood pressure is significantly higher in only-children compared to children with siblings. However, it is unclear whether there are also similar blood pressure differences in adolescents and between only-children and first-borns. What is New: • Among adolescents in the alpha birth order, growing up as an only-child is associated with significantly higher mean blood pressure than among first-borns living with younger siblings.
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Affiliation(s)
- Pauline Marie Pantke
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Von-Siebold-Str. 5, 37073, Göttingen, Germany
| | - Aribert Rothenberger
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Luise Poustka
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universität Göttingen, Göttingen, Germany
| | - Thomas Meyer
- Klinik für Psychosomatische Medizin und Psychotherapie, Universität Göttingen, Göttingen, Germany.
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Göttingen, Von-Siebold-Str. 5, 37073, Göttingen, Germany.
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Headache Is Associated with Low Systolic Blood Pressure and Psychosocial Problems in German Adolescents: Results from the Population-Based German KiGGS Study. J Clin Med 2021; 10:jcm10071492. [PMID: 33916726 PMCID: PMC8038357 DOI: 10.3390/jcm10071492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/23/2021] [Indexed: 11/17/2022] Open
Abstract
Studies have reported controversial results on the relationship between headache and blood pressure. The aim of this post hoc study was twofold: first, to further investigate this relationship and, second, to assess the impact of psychosocial factors on this association in a population-based study of German children and adolescents. The analysis was conducted on study participants aged between 11 and 17 years (n = 5221, weighted from the total study cohort) from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Health-related quality of life was assessed by self- and parent-rated German-language KINDL-R questionnaires (Children’s Quality of Life Questionnaire), while mental problems were analyzed using the Strengths and Difficulties Questionnaire (SDQ). Our findings confirmed that blood pressure was significantly lower in adolescents reporting episodes of headache than in those without headache (114.0 ± 10.2 mmHg vs. 115.5 ± 11.0 mmHg, p < 0.001). Logistic regression models adjusted to sex, age, body mass index, contraceptive use, and serum magnesium concentration demonstrated that headache was significantly associated with self-rated KINDL-R (Exp(B) = 0.96, 95% confidence interval (95% Cl) = 0.96–0.97, p < 0.001), parent-rated KINDL-R (Exp(B) = 0.97, 95% CI = 0.96–0.98, p < 0.001), as well as self-rated SDQ (Exp(B) = 1.08, 95% CI = 1.07–1.10, p < 0.001), and parent-rated SDQ (Exp(B) = 1.05, 95% CI = 1.04–1.06, p < 0.001). There was evidence that quality of life and mental problems mediated the effect of blood pressure on headache, as revealed by mediation models. Our results from the nationwide, representative KiGGS survey showed that low blood pressure is a significant predictor of headache, independent of quality of life and mental problems. However, these psychosocial factors may mediate the effect of blood pressure on headache in a still unknown manner.
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Menawi W, Najem T, Khalil A, Suleiman J, Dabas A, Abdullah RA, Shareef N, Khraiwesh T. Self-rated health and psychological health among hypertensive patients in Palestine. Health Psychol Open 2020; 7:2055102920973258. [PMID: 33282328 PMCID: PMC7686639 DOI: 10.1177/2055102920973258] [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] [Indexed: 11/16/2022] Open
Abstract
The study has investigated the self-rated psychological health of hypertensive patients in Palestine. To that end, a stratified random sample of 502 hypertensive patients (aged ⩾ 18 years) was asked to complete a validated Arabic version of the General Health Questionnaire (GHQ-28). After collection, the data were analyzed using descriptive statistics, Mann-Whitney U test and logistic regression. In this study, it was found the mean scores for GHQ were statistically higher for females than males (p < 0.05). The females were found to be 1.701 (95% CI = 1.025-2.823) times more at risk of psychological disorders compared to males. In conclusion, improvement of social determinants of hypertensive patients can make a difference in their psychological/mental health.
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Affiliation(s)
- Wafaa Menawi
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Taghreed Najem
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Aziza Khalil
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Jiyana Suleiman
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | - Areej Dabas
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
| | | | - Noor Shareef
- Faculty of Medicine and Health Sciences,
An-Najah National University, Palestine
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Abstract
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.
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Affiliation(s)
- Diego Montano
- Department of Medical Sociology, Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
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Quality of life and mental health in adolescent users of oral contraceptives. Results from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Qual Life Res 2020; 29:2209-2218. [PMID: 32144614 PMCID: PMC7363664 DOI: 10.1007/s11136-020-02456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 11/17/2022]
Abstract
Objective Using data from the nationwide, cross-sectional KiGGS (German Health Interview and Examination Survey for Children and Adolescents) study, we investigated whether hormonal contraception in adolescents aged 15 to 17 years was linked to health-related quality of life and mental health problems. Methods Study participants had undergone standardized recordings of blood pressure and measurements of serum 25-hydroxyvitamin D [25(OH)D]. Quality of life was assessed by self- and parent-rated KINDL-R questionnaires, whereas mental health problems were screened by means of the Strengths and Difficulties Questionnaire (SDQ). Results Self-rated quality of life was similar between users (n = 522) and non-users (n = 1173, 69.2%) of oral contraceptives (69.2 ± 11.2 vs. 69.2 ± 11.0, p = 0.943), as was the parent-rated version (72.9 ± 10.6 vs. 72.9 ± 10.5, p = 0.985). Likewise, no significant differences were observed between the two groups with respect to both self- (10.9 ± 4.4 vs. 10.8 ± 4.6, p = 0.732) and parent-rated SDQ scores (7.2 ± 4.8 vs. 7.0 ± 4.6. p = 0.390). However, serum 25(OH)D (59.5 ± 32.9 vs. 46.1 ± 28.0 nmol/L, p < 0.001) and mean arterial blood pressure (88.2 ± 7.4 vs. 86.5 ± 7.7 mmHg, p < 0.001) were significantly higher in users than in non-users. There was a trend towards a higher rate of psychotropic drug prescription in participants taking oral contraceptive pills as compared to those not receiving hormonal contraception (17.8% vs. 14.4%, p = 0.052). A series of linear regression models with either KINDL-R or SDQ as dependent variable confirmed that there were no associations between components of mental well-being and contraceptive drug use, irrespective of whether self- or parent-ratings were included in these models. Conclusions In a large, representative sample of German adolescents, exposure to exogenous contraceptive hormones was associated with higher arterial blood pressure and serum 25(OH)D concentration, whereas hormonal contraception was not linked to health-related quality of life or mental well-being.
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Duttge G, Meyer T. [Physician's obligations to inform about complications based on a recent warning from drug authorities]. Med Klin Intensivmed Notfmed 2020; 116:332-338. [PMID: 32034432 PMCID: PMC8102277 DOI: 10.1007/s00063-020-00656-5] [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: 07/26/2019] [Revised: 11/15/2019] [Accepted: 12/22/2019] [Indexed: 11/01/2022]
Abstract
BACKGROUND Based on a recent warning from the drug authorities about increased suicidality among users of hormonal contraceptives, this article discusses the legal consequences of translating novel findings from clinical trials into altered contents of gaining informed consent during the medical consultation. METHODS AND RESULTS Comprehensive information in accordance with § 630e German Civil Code (BGB) requires that rare drug reactions be mentioned by the prescribing physician, when they are associated with serious sequelae. This act regulates the treating physician's obligations to inform about complications for both preventive and curative treatment options. In this paper, we refer to the scientific evidence level of data from clinical trials as the key feature for implementing altered medical information in the proper conduct of acquiring the consent of the patient in line with § 630e BGB. The article discusses how additions and amendments to the package leaflet and the expert information will impact on the obligations for the treating party to provide information for the patient in order to obtain informed consent. In particular, we focus on the relationship between the obligations for the physician prescribing oral contraceptives on an individual case and the generalized information conditions according to § 11 and § 11a German Medicinal Products Act. DISCUSSION Current warnings of the drug authorities in the form of red-hand letters do not necessarily have legal consequences for gaining informed consent during the medical consultation.
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Affiliation(s)
- G Duttge
- Zentrum für Medizinrecht, Georg-August-Universität Göttingen, Göttingen, Deutschland
| | - T Meyer
- Klinik für Psychosomatische Medizin und Psychotherapie, Georg-August-Universität Göttingen, Waldweg 33, 37073, Göttingen, Deutschland.
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Bieber AK, Pehrson LJ, Vento S, Malaga-Dieguez L, Spruill TM, Trachtman H. The Psychosocial Impact of a Diagnosis of Hypertension in Pediatric Patients. Kidney Int Rep 2020; 5:228-230. [PMID: 32043037 PMCID: PMC7000847 DOI: 10.1016/j.ekir.2019.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 10/31/2019] [Accepted: 11/11/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Amy Kalowitz Bieber
- Department of Pediatrics, Division of Nephrology, New York University Langone Health, New York, New York, USA
| | - Laura Jane Pehrson
- Department of Pediatrics, Division of Nephrology, New York University Langone Health, New York, New York, USA
| | - Suzanne Vento
- Department of Pediatrics, Division of Nephrology, New York University Langone Health, New York, New York, USA
| | - Laura Malaga-Dieguez
- Department of Pediatrics, Division of Nephrology, New York University Langone Health, New York, New York, USA
| | - Tanya M. Spruill
- Department of Population Health, New York University Langone Health, New York, New York, USA
| | - Howard Trachtman
- Department of Pediatrics, Division of Nephrology, New York University Langone Health, New York, New York, USA
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Pinho R, Wang B, Becker A, Rothenberger A, Outeiro TF, Herrmann-Lingen C, Meyer T. Attention-deficit/hyperactivity disorder is associated with reduced levels of serum low-density lipoprotein cholesterol in adolescents. Data from the population-based German KiGGS study. World J Biol Psychiatry 2019; 20:496-504. [PMID: 29243550 DOI: 10.1080/15622975.2017.1417636] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objectives: Attention-deficit/hyperactivity disorder (ADHD) is a multifactorial, complex and the most common neurodevelopmental disorder in childhood. In this analysis, we tested the hypothesis that altered serum lipid patterns are associated with ADHD. Methods: Using data from the nationwide, population-based German Health Interview and Examination Survey for Children and Adolescents (KiGGS), we compared serum levels of total cholesterol, high-density (HDL) and low-density lipoprotein (LDL) cholesterol, and also triglycerides, in participants with physician-diagnosed and/or suspected ADHD, as defined by a value of ≥7 on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire (SDQ), with non-ADHD controls. Results: Among 6,898 participants aged between 11 and 17 years, 666 (9.7%) had a physician-based diagnosis of ADHD and/or suspected ADHD. We found correlations between the parent-rated SDQ scores on the hyperactivity-inattention subscale and concentrations of triglycerides (r = 0.064, p < .001), total cholesterol (r = -0.026, p = .033), HDL cholesterol (r = -0.059, p < .001) and LDL cholesterol (r = -0.027, p = .031). In multivariate models, low serum levels of LDL cholesterol remained a significant predictor of ADHD (Exp(β) = 0.382, 95% confidence interval = 0.165-0.888, p = .025). Conclusions: Our findings in a large, nationwide and representative sample of German adolescents demonstrated a small, but significant and inverse link between LDL cholesterol levels and symptoms of ADHD. Further studies are required to decipher the biochemical mechanisms behind this relationship.
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Affiliation(s)
- Raquel Pinho
- Department of Experimental Neurodegeneration, Centre for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Centre Göttingen , Göttingen , Germany.,Faculty of Medicine, University of Porto , Porto , Portugal
| | - Biyao Wang
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen , Göttingen , Germany
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen , Göttingen , Germany
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen , Göttingen , Germany
| | - Tiago F Outeiro
- Department of Experimental Neurodegeneration, Centre for Nanoscale Microscopy and Molecular Physiology of the Brain, University Medical Centre Göttingen , Göttingen , Germany.,Max Planck Institute for Experimental Medicine , Göttingen , Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Göttingen, University of Göttingen, and German Centre for Cardiovascular Research (DZHK) , Göttingen , Germany
| | - Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Göttingen, University of Göttingen, and German Centre for Cardiovascular Research (DZHK) , Göttingen , Germany
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15
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Exploring the Association of Hypertension With Risk for Depression: Evidence for Tamed Neurobehavioral Arousal Versus Central Emotional Dysregulation. Psychosom Med 2019; 80:504-507. [PMID: 29851869 DOI: 10.1097/psy.0000000000000611] [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] [Indexed: 12/19/2022]
Abstract
Depression is an established predictor of adverse cardiovascular disease outcomes. Less is known about cardiovascular risk factors as predictors of depression. In this issue of Psychosomatic Medicine (2018;80:508-514), Patel et al. report data indicating that pre-existing hypertension may be inversely associated with the atypical but not typical form of depression. We highlight here the strengths and limitations of the article and discuss the findings in light of research linking blood pressure and emotion regulation. In general, evidence suggests that higher blood pressure is associated with reduced expression of negative emotions and pain. Two prominent models of interaction have been proposed and supported by epidemiological and experimental research: one assumes that elevations in blood pressure lead to reduced arousal and pain sensitivity through baroreceptor activation and possibly additional afferent mechanisms. Operant conditioning may then result in (chronic) hypertension. The other one posits that impaired emotion processing as indicated by dampened emotion recognition may lead to disinhibition of hypothalamic centers and thereby result in sustained increases in blood pressure. These models are described in context of the current literature and open research questions are formulated.
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16
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Michels N, Matthys D, Thumann B, Marild S, De Henauw S. Children's stress-related reports and stress biomarkers interact in their association with metabolic syndrome risk. Stress Health 2018; 34:523-533. [PMID: 29733496 DOI: 10.1002/smi.2813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 01/27/2023]
Abstract
The purpose was to examine the cross-sectional associations of stress-related reports and stress biomarkers with metabolic syndrome (MetS) risk in children while also testing the interaction between stress biomarkers and stress reports. In 353 children (5-10 years old, 7.9% overweight/obese), MetS risk was measured by blood pressure, waist circumference, glucose homeostasis, triglycerides, and high-density cholesterol. Stress was measured by stress-related reports (events, emotions, and internalizing/externalizing problems) and two biomarkers: salivary cortisol (total-day and morning output) and heart rate variability (percentage of consecutive normal RR intervals differing more than 50 ms and low-to-high-frequency ratio). Cross-sectional regression analyses with z scored total MetS risk as outcome were adjusted for age, sex, and socio-economic status. Only internalizing problems were directly related to a higher MetS risk score (β = 0.236). Cortisol and heart rate variability were significant moderators: High cortisol morning output resulted in a positive (unfavourable) report-MetS relationship (β = 0.259-0.552), whereas low percentage of consecutive normal RR intervals differing more than 50 ms resulted in a negative (favourable) report-MetS relationship (β = -0.298) and low low-to-high-frequency ratio in a positive (unfavourable) report-MetS relationship (β = 0.478). In conclusion, stress can sometimes be a disadvantageous factor in metabolic health of otherwise healthy children. The cortisol biomarker seems relevant because metabolic risk was highest when stress-related reports were accompanied by high morning cortisol output.
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Affiliation(s)
- Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dante Matthys
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Barbara Thumann
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology, BIPS, Bremen, Germany
| | - Staffan Marild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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17
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Cross-Sectional and Longitudinal Associations of Systolic Blood Pressure With Quality of Life and Depressive Mood in Older Adults With Cardiovascular Risk Factors: Results From the Observational DIAST-CHF Study. Psychosom Med 2018; 80:468-474. [PMID: 29742752 DOI: 10.1097/psy.0000000000000591] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Although diagnosed arterial hypertension and antihypertensive medication usually have an adverse impact on quality of life, recent studies suggest that actual blood pressure may be positively related to better well-being. However, data in older patients with cardiovascular risk factors are lacking, for whom such an association may be of particular relevance. METHODS In 1300 adults aged 50 to 85 years with cardiovascular risk factors (51.5% men, mean age = 65.7 ± 8.2 years) participating in an observational study, we performed standardized measurements of blood pressure and assessed quality of life and depressive symptoms at baseline and 1-year follow-up using the Short Form-36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS). RESULTS Bivariate analysis demonstrated that systolic blood pressure was associated with higher SF-36 mental component summary scores (r = 0.100, p < .001) and reduced HADS depression (r = -0.082, p = .003). Multivariate regression models adjusting for age, sex, and disease severity confirmed that higher systolic blood pressure significantly predicted both better mental quality of life (β = 0.070, p = .012) and less depressive mood (β = -0.083, p = .003) at baseline, independently of antihypertensive medication and diagnosed hypertension. Moreover, the beneficial effects of baseline systolic blood pressure remained stable for both summary components of the SF-36 as well as HADS depression at 1-year follow-up. All results remained unchanged, when limiting the analyses to the 1072 patients with diagnosed hypertension. CONCLUSIONS In older adults with cardiovascular risk factors, higher systolic blood pressure readings are independently related to better quality of life and fewer depressive symptoms in both cross-sectional and longitudinal settings, although the magnitude of the effect sizes is typically small.
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Petek T, Hertiš T, Marčun Varda N. Health-related quality of life in paediatric arterial hypertension: a cross-sectional study. BMC Pediatr 2018; 18:146. [PMID: 29716573 PMCID: PMC5930650 DOI: 10.1186/s12887-018-1120-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 04/22/2018] [Indexed: 11/30/2022] Open
Abstract
Background The prevalence of paediatric hypertension is increasing worldwide, especially due to the childhood obesity epidemic, and is an important public-health concern. While the Health-Related Quality of Life (HRQoL) was already shown to be impaired in the adult hypertensive population, a scarcity of data still exists on HRQoL in paediatric hypertensive patients. Our purpose was thus to assess the HRQoL of children and adolescents with arterial hypertension, using self- and proxy-reports, and to determine the correlations between child and parent questionnaire scores. Methods The Paediatric Quality of Life Inventory™ 4.0 Generic Core Scales were administered via post to children and adolescents, aged 5-18 years, with primary or secondary arterial hypertension and parents as proxy-reports. Patients were recruited from a paediatric nephrology unit in a tertiary hospital, using an out-patient clinic visit registry. Healthy school children and adolescents from a local primary school, aged 6 to 15 years, and their parents formed the control group. HRQoL group comparisons were calculated with independent samples t-test and child-parent correlations with the Pearson’s r correlation coefficient. Results In total we recruited 139 patient and 199 control group participants as self- and proxy-reports. Scores from self- as well as proxy-reports indicated a significantly lower overall HRQoL in the paediatric hypertensive population (95% CI for mean score difference: − 11.02, − 2.86 for self- and − 10.28, − 2.67 for proxy-reports; p = .001). In self-reports, lower physical (95% CI: -13.95, − 4.89; p = <.001), emotional (95% CI: -12.96, − 2.38; p = .005), school (95% CI: -11.30, − 0.42; p = .035), and psychosocial functioning scores were observed (95% CI: -10.34, − 1.89; p = .005). Parent proxy-reports were lower in physical (95% CI: -14.31, − 5.39; p = <.001), emotional (95% CI: -12.39, − 2.60; p = .003) and psychosocial scores (95% CI: -9.36, − 1.34; p = .009). Pearson’s r values ranged between 0.62 to 0.79 in patient and 0.56 to 0.80 in control sample (p < .001). Interestingly, hypertensive children reported lower social functioning scores than hypertensive adolescents (p < .001). Conclusions This cross-sectional study gives insight into the detrimental impact of hypertension on children’s and adolescents HRQoL, which may inform public health experts. Furthermore, it shows that clinicians should aim to improve patients’ physical and psychosocial well-being throughout their development.
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Affiliation(s)
- Tadej Petek
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.
| | - Tjaša Hertiš
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia
| | - Nataša Marčun Varda
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.,Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000, Maribor, Slovenia
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Pediatric Hypertension: Impact on the Heart, Brain, Kidney, and Retina. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0577-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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20
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Duschek S, Hoffmann A, Reyes Del Paso GA. Affective impairment in chronic low blood pressure. J Psychosom Res 2017; 93:33-40. [PMID: 28107890 DOI: 10.1016/j.jpsychores.2016.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/21/2016] [Accepted: 12/10/2016] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Stefan Duschek
- UMIT - University of Health Sciences Medical Informatics and Technology, Institute of Psychology, Austria.
| | - Alexandra Hoffmann
- UMIT - University of Health Sciences Medical Informatics and Technology, Institute of Psychology, Austria
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21
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Meyer T, Becker A, Sundermann J, Rothenberger A, Herrmann-Lingen C. Attention deficit-hyperactivity disorder is associated with reduced blood pressure and serum vitamin D levels: results from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Eur Child Adolesc Psychiatry 2017; 26:165-175. [PMID: 27197525 DOI: 10.1007/s00787-016-0852-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 04/15/2016] [Indexed: 01/03/2023]
Abstract
Alterations in blood pressure in attention-deficit/hyperactivity disorder (ADHD), specifically during dopaminergic stimulant intake, are not fully understood. It has been reported that vitamin D deficiency might modify dopaminergic pathways and thus influence ADHD symptoms. Using data from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study, we compared blood pressure and vitamin D levels in healthy controls to both diagnosed ADHD patients and suspected ADHD subjects, as defined by a value of ≥7 on the hyperactivity-inattention subscale of the Strengths and Difficulties Questionnaire. In a total cohort of n = 6922 study participants aged 11-17 years, mean arterial blood pressure was significantly higher in controls (86.7 ± 8.2 mmHg) than in the two groups of confirmed (85.5 ± 7.8 mmHg, p = 0.004, n = 430) and suspected ADHD patients (84.6 ± 8.2, p < 0.001, n = 399). In addition, we found an inverse association between vitamin D and blood pressure in both ADHD groups (p < 0.003). Regression analyses adjusted for age, sex, body-mass index, psychotropic medication use, and serum vitamin D levels confirmed that low blood pressure was a significant and independent predictor of ADHD. Furthermore, we observed that vitamin D mediated the effect of systolic blood pressure on ADHD diagnosis (b = 0.007, 95 % confidence interval [CI] 0.001-0.013, p = 0.021, R 2 = 0.050). In a large and representative national sample of German adolescents, we found a significant association between low blood pressure and ADHD symptoms. In addition, we observed that circulating vitamin D mediated the inverse relation between blood pressure and ADHD, although the effect size was very low. These findings highlight the role of dysregulated pathways of the autonomic nervous system in ADHD.
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Affiliation(s)
- Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.
- Department of Psychosomatic Medicine and Psychotherapy, and German Centre for Cardiovascular Research, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany.
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Jessika Sundermann
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Aribert Rothenberger
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany
- Department of Psychosomatic Medicine and Psychotherapy, and German Centre for Cardiovascular Research, University of Göttingen, Von-Siebold-Str. 5, Göttingen, Germany
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22
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Cardiovascular reactivity is independently associated with better mental health. Blood Press Monit 2016; 21:215-23. [DOI: 10.1097/mbp.0000000000000184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Carson V, Hunter S, Kuzik N, Gray CE, Poitras VJ, Chaput JP, Saunders TJ, Katzmarzyk PT, Okely AD, Connor Gorber S, Kho ME, Sampson M, Lee H, Tremblay MS. Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update. Appl Physiol Nutr Metab 2016; 41:S240-65. [DOI: 10.1139/apnm-2015-0630] [Citation(s) in RCA: 656] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This systematic review is an update examining the relationships between objectively and subjectively measured sedentary behaviour and health indicators in children and youth aged 5–17 years. EMBASE, PsycINFO, and Medline were searched in December 2014, and date limits were imposed (≥February 2010). Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth, mean age: 5–17 years), intervention (durations, patterns, and types of sedentary behaviours), comparator (various durations, patterns, and types of sedentary behaviours), and outcome (critical: body composition, metabolic syndrome/cardiovascular disease risk factors, behavioural conduct/pro-social behaviour, academic achievement; important: fitness, self-esteem) study criteria. Quality of evidence by outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation framework. Due to heterogeneity, a narrative analysis was conducted. A total of 235 studies (194 unique samples) were included representing 1 657 064 unique participants from 71 different countries. Higher durations/frequencies of screen time and television (TV) viewing were associated with unfavourable body composition. Higher duration/frequency of TV viewing was also associated with higher clustered cardiometabolic risk scores. Higher durations of TV viewing and video game use were associated with unfavourable behavioural conduct/pro-social behaviour. Higher durations of reading and doing homework were associated with higher academic achievement. Higher duration of screen time was associated with lower fitness. Higher durations of screen time and computer use were associated with lower self-esteem. Evidence ranged from “very low” to “moderate” quality. Higher quality studies using reliable and valid sedentary behaviour measures should confirm this largely observational evidence.
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Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Casey E. Gray
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Veronica J. Poitras
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Travis J. Saunders
- Applied Human Sciences, Faculty of Science, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | | | - Anthony D. Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, 2522, Australia
| | - Sarah Connor Gorber
- Office of the Task Force on Preventive Health Care, Public Health Agency of Canada, Ottawa, ON K1A 0K9, Canada
| | - Michelle E. Kho
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Helena Lee
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB T6G 2H9, Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
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Bunz M, Lenski D, Wedegärtner S, Ukena C, Karbach J, Böhm M, Kindermann I. Heart-focused anxiety in patients with chronic heart failure before implantation of an implantable cardioverter defibrillator: baseline findings of the Anxiety-CHF Study. Clin Res Cardiol 2015; 105:216-24. [PMID: 26481915 DOI: 10.1007/s00392-015-0909-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 08/20/2015] [Indexed: 01/14/2023]
Abstract
AIMS We analysed heart-focused anxiety (HFA) and its predictors in patients with heart failure before implantation of an implantable cardioverter defibrillator (ICD). Herein, we report the baseline data of the Anxiety-CHF Study which investigates HFA before and after ICD implantation. METHODS AND RESULTS HFA, general anxiety and depression, perceived quality of life (QoL) and type D personality were measured with validated psychological instruments. Clinical parameters such as severity of heart failure measured by NYHA class and left ventricular ejection fraction (EF) were determined. One hundred and ten patients were interrogated before ICD implantation (70 % male, mean age = 60.5 ± 14.9 years, mean EF = 31 % ± 9 %, 91 % NYHA II-III, 92 % primary prevention). HFA was present in 53 patients (48.6 %); 37 participants (33.9 %) showed increased levels of general anxiety and 33 patients (30.3 %) showed increased levels of depression with clinical significant levels in 16 subjects (14.7 %) for general anxiety and 13 subjects (11.9 %) for depression. Poor QoL was reported in 30 patients (27.5 %). HFA was correlated with QoL, general anxiety, depression, type D personality, myocardial infarction (MI), and systolic blood pressure. QoL, general anxiety and former MI were significant predictors of HFA (R (2) = 0.453). CONCLUSION Heart-focused anxiety is highly prevalent in heart failure patients prior to ICD implantation. Measures of disease severity such as EF or NYHA class do not predict HFA, neither does Type D personality. HFA is predicted by a history of MI and psychological parameters such as general anxiety and impaired QoL. CLINICALTRIALS. GOV IDENTIFIER NCT02226770.
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Affiliation(s)
- Maxie Bunz
- Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
| | - Denise Lenski
- Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
- Psychotherapy Practice, Saarbrücken, Germany
| | - Sonja Wedegärtner
- Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Christian Ukena
- Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Julia Karbach
- Institut für Psychologie, Goethe-Universität, Frankfurt, Germany
| | - Michael Böhm
- Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Ingrid Kindermann
- Klinik für Innere Medizin III-Kardiologie, Angiologie und Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
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25
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Association between chronic stress and blood pressure: findings from the German Health Interview and Examination Survey for Adults 2008-2011. Psychosom Med 2015; 77:575-82. [PMID: 25967356 DOI: 10.1097/psy.0000000000000183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The magnitude of the contribution of psychosocial stressors to the development of hypertension remains controversial. Using data from the population-based, nationwide German Health Interview and Examination Survey for Adults, we investigated the relationship between objectively measured and subjectively perceived stressors and blood pressure (BP). METHODS The study sample comprised 3352 participants not taking antihypertensive medication, for whom data on stress exposure and resting BP measurements were available. The Trier Inventory for the Assessment of Chronic Stress screening scale (TICS-SSCS) was used as a measurement of self-perceived chronic stress, and work-related stress was assessed using the recently developed occupational Overall Job Index. RESULTS On the basis of bivariate tests, TICS-SSCS was negatively associated with both systolic (β-coefficient [B] = -0.16, standard error = 0.03, p < .001) and diastolic BP (B = -0.10, standard error = 0.02, p < .001). After adjustment for age, sex, and body mass index, the TICS-SSCS but not the Overall Job Index was significantly related to systolic and diastolic BP. When alcohol consumption, smoking, physical activity, residential traffic intensity, caregiving, socioeconomic status, social support, and living without a partner were added to the model, the TICS-SSCS again remained independently associated with both BP measures (p ≤ .007). CONCLUSIONS In a large and representative German study, we found that less perceived stress is associated with higher BP levels, whereas the exposure to objective stressors was unrelated to BP. These findings suggest that stress perception and objective stressors influence BP regulation via different biobehavioral pathways.
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Proneness to worry is negatively associated with blood pressure and baroreflex sensitivity: Further evidence of the blood pressure emotional dampening hypothesis. Biol Psychol 2014; 96:20-7. [DOI: 10.1016/j.biopsycho.2013.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 11/12/2013] [Accepted: 11/12/2013] [Indexed: 11/19/2022]
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The authors reply. Psychosom Med 2014; 76:163-6. [PMID: 24470129 DOI: 10.1097/psy.0000000000000034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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