Task demands and the pressures of everyday life: Associations between cardiovascular reactivity and work blood pressure and heart rate.

Associations between cardiovascular stress reactivity and blood pressure and heart rate recorded in everyday life were hypothesized to depend on the stressfulness of the ambulatory monitoring period relative to standardized tasks and on activity levels at the time of measurement. One hundred two female and 60 male school teachers carried out high- and low-demand tasks under standardized conditions and ambulatory monitoring during the working day. Stress ratings during the day were close to those recorded during the low-demand task. Reactions to the low-demand task were significant predictors of ambulatory blood pressure and heart rate independent of baseline, age, gender, and body mass. Associations were more consistent for ambulatory recordings taken when participants were seated than when they were standing and when the ambulatory monitoring day was considered to be as stressful as usual or more stressful than usual, and not less stressful than usual. Laboratory-field associations of cardiovascular activity depend in part on the congruence of stressfulness and physical activity level in the 2 situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of different stress settings on cardiovascular parameters and their relationship to daily life blood pressure in normotensives, borderline hypertensives and hypertensives

The aim of this study was to compare a traditional stress setting, consisting of two mental arithmetic tasks and two Stroop test modifications, and a stress setting of varying task demand and decision latitude according to Karasek's job strain model, with respect to their feasibility to elicit differences in cardiovascular reactivity and recovery in 20 normotensives, 20 borderline hypertensives, and 20 non-medicated hypertensives, carefully selected by means of World Health Organization criteria. In addition, the relationship between laboratory and everyday blood pressure was investigated. All subjects were tested under both stress settings in counterbalanced order. Blood pressure was recorded both intermittently from the brachial artery (Riva-Rocci) and continuously from the finger (Finapres). Heart rate and electrodermal activity were continuously measured as well. Furthermore, daily life blood pressure recorded by means of 24 h ambulatory monitoring during a normal working day served as criterion for the re-classification of the blood pressure groups by means of discriminant analysis using physiological recordings from baseline, test phases and rest phases. The groups did not show significant differences in their reactivity to the various mental stressors including the Karasek-model oriented ones but marked differences in their behaviour occurred during the 10 min of recovery following each stress setting. Both systolic and diastolic blood pressure in hypertensives failed to recover during this period. The results also showed the superiority of the Finapres method with respect to reflecting the dynamics of physiological recovery processes. None of the stress settings showed an advantage in predicting blood pressure in daily life. In general, the results question the validity of mental laboratory stressors for the prediction of cardiovascular changes in daily life but point to a possible role of recovery processes after stress in the development of essential hypertension.     

Office and ambulatory blood pressure in patients with craniomandibular disorders

To assess the physiologic response to daily life stress in patients with craniomandibular disorders (CMD), office and ambulatory blood pressure and heart rate were studied in 25 female patients and 25 controls. Significant differences (p < 0.05) were found between the groups for heart rate before the clinical examination and that in the patient group when compared before and after the clinical examination. Higher values were found for mean daytime systolic and diastolic blood pressure in the control group compared with the patient group (p < 0.05). The mean number of systolic blood pressure > or = 140 mmHg during 24 h and daytime was significantly higher (p < 0.05) in the control group than in the patient group. In this study the CMD patients with muscular diagnosis were not more stressed than healthy subjects in the daily activities as evaluated by ambulatory blood pressure measurements.     

Social support at work, heart rate, and cortisol: A self-monitoring study.

This study assessed the influence of work social support on self-monitored heart rate, blood pressure, and salivary cortisol recorded on 3 work days and 2 leisure days from 61 nurses and 32 accountants (40 men, 53 women). Heart rate and blood pressure were higher during the day at work than in the evening or on leisure days. Cortisol was higher on leisure than work days and was lower in the evening than in the day. Low social support at work was associated with elevated heart rate during the daytime and evening of work days, an effect that persisted after controlling for psychological distress, age, sex, smoking, and physical activity. Work social support was not related to cortisol on work days, but on leisure days cortisol was elevated among individuals reporting high social support. There were few differences between men and women, and no important occupational effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Salivary alpha-amylase as a measure of endogenous adrenergic activity

This investigation was designed to evaluate the production rates and concentrations of salivary alpha-amylase as a measure of adrenergic activity under several conditions of stress in human subjects. Saliva and blood samples were simultaneously collected from men at four 15 min intervals both before and after regimens for exercise, a written examination, or a rest period. The regressions of salivary alpha-amylase on plasma norepinephrine (NE) concentrations were significant for both exercise (P < 0.001) and examination (P < 0.01) protocols. Aerobic exercise induced a 3-fold mean increase in alpha-amylase; both NE and epinephrine (EP) increased approximately 5-fold over control levels. Levels of alpha-amylase and NE returned to control levels within 30-45 min after exercise, but EP remained elevated by approximately 2-fold during the remaining hour of observation. During the written examination, alpha-amylase and NE, but not EP, concentrations increased in parallel. In further studies the effects of exercise and exposure to heat and cold on the relationship of salivary alpha-amylase to heart rate and body temperature were investigated. Greater intensities of exercise were associated with greater increases in alpha-amylase concentrations. During heat exposure in a sauna (66 degrees C for 40 min) amylase, heart rate and body temperature all increased progressively. However, during exposure to cold (4 degrees C for 40 min) amylase increased rapidly, though heart rate and body temperature remained unchanged. Salivary cortisol concentrations were unchanged during exposure to heat or cold. We conclude that salivary alpha-amylase concentrations are predictive of plasma catecholamine levels, particularly NE, under a variety of stressful conditions, and may be a more direct and simple end point of catecholamine activity than are changes in heart rate.     

Stage I ovarian cancer by transvaginal color Doppler sonography: a report of 18 cases

PURPOSE: To evaluate the tolerability and 24 hours efficacy of a new anti-hypertensive drug: cilazapril. METHODS: In an open non comparative study 20 hypertensive patients (16 females, age from 30 to 60 years, average = 49.4) were followed for 6 weeks: 2 wash out and 4 treatment (5 mg OD). Blood pressure (BP) was measured by casual and ambulatory blood pressure monitoring (ABPM) readings. RESULTS: Comparing washout and treatment periods, ABPM averages both for systolic and diastolic BP (mmHg) showed significant decrease in 24 hours, during day and night sub periods. The decrease was not significant between averages considering the "early morning rising pressure" sub period. Heart rate averages showed significant reduction at all sub periods except during night. Adverse effects were mild and resolved spontaneously (n = 3, 15%). CONCLUSION: Cilazapril seems to be efficacious as antihypertensive. Tolerability is excellent. It preserved circadian rhythm despite significantly reducing blood pressure at all periods evaluated except early morning. A bradycardic effect observed mostly during day period should be better evaluated.     

Adverse prognostic value of a blunted circadian rhythm of heart rate in essential hypertension

BACKGROUND: Previous studies revealed a direct association between resting heart rate and risk of mortality in essential hypertension. However, resting heart rate is a highly variable measure since it is affected by the alerting reaction to the visit. OBJECTIVE: To investigate whether the heart rate values recorded during the 24 h of ambulatory blood pressure monitoring are independent predictors of survival of uncomplicated subjects with essential hypertension. METHODS: We followed up 1942 initially untreated and uncomplicated subjects with essential hypertension (mean age 51.7 years, 52% men) for an average of 3.6 years (range 0-10 years). All subjects underwent baseline procedures including 24 h non-invasive blood pressure monitoring with simultaneous assessment of heart rate, one reading every 15 min for 24 h. MAIN OUTCOME MEASURES: All-cause mortality and cardiovascular morbidity. RESULTS: During follow-up there were 74 deaths from all causes (1.06 per 100 person-years) and 182 total (fatal plus non-fatal) cardiovascular morbid events (2.66 per 100 person-years). Clinic, average 24 h, daytime and night-time heart rates exhibited no association with total mortality. However, the subjects who subsequently died had had a blunted reduction of heart rate on going from day to night during the baseline examination. After adjustment for age (P < 0.001), diabetes (P < 0.001) and average 24 h systolic blood pressure (SBP, P= 0.002) in a Cox model, for each 10% less reduction in the heart rate from day to night the relative risk of mortality was 1.30 (95% confidence interval 1.02-1.65, P = 0.04). Rates of death were 0.38, 0.71, 0.94 and 2.0 per 100 person-years among subjects in the four quartiles of the distribution of the percentage reduction in heart rate from day to night The baseline day-night changes in the heart rate exhibited an inverse correlation to age and to clinic and ambulatory SBP and a direct association with the day-night changes in blood pressure. The degree of reduction of heart rate from day to night also had an independent inverse association with total cardiovascular morbidity after adjustment for age, diabetes and left ventricular hypertrophy, but this association did not remain significant when average 24 h SBP and the degree of day-night reduction in SBP were entered into the equation. CONCLUSIONS: A flattened diurnal rhythm of heart rate in uncomplicated subjects with essential hypertension is a marker of risk for subsequent all-cause mortality and this association persists after adjustment for several risk factors. For assessing these subjects, a limited and uniformly distributed period of ambulatory heart rate recording during the 24 h is clinically valuable.     

Diastolic dysfunction coincides with early mild transplant rejection: in situ measurements in a heterotopic rat heart transplant model

BACKGROUND: Diastolic dysfunction seen in early clinical transplant rejection has been difficult to demonstrate in experimental rodent models because of the inability to make sensitive in situ measurements of systolic and diastolic functions. We have developed a heterotopic heart transplant model with Fisher 344 and ACI rats (without immunosuppression), where in situ measurements of diastolic and systolic functions were made sequentially (daily) by use of an implanted left ventricular balloon. METHODS: Syngeneic and allogeneic heterotopic heart transplants were performed. In situ function was determined by varying balloon volume to measure the developed pressure, the rates of pressure rise (+dp/dt) and pressure fall (-dp/dt), diastolic pressure-volume relationship, and the time constant of diastolic relaxation (tau). These results were compared with function measurements in transplanted hearts that were excised and perfused in a Langendorff mode (ex vivo) during the same posttransplantation period. RESULTS: Histologic examination revealed that at day 3 after transplantation, allografts showed mild lymphocytic infiltration indicative of mild or early rejection, and by day 5, there was severe rejection with myocyte necrosis. By day 3, the slope of the diastolic pressure-volume relationship (ie, left ventricular stiffness) was significantly higher in allografts as compared with isografts (436 +/- 96 vs 177 +/- 26 mm Hg/mL, p < .05). Similarly, tau was significantly longer in allografts by day 3 after transplantation. Developed pressure and +dp/dt became significantly lower in allografts beginning on day 6. Function measurements made in the isolated perfused ex vivo hearts yielded the same results at day 3 after transplantation as the in situ group of hearts. CONCLUSION: Using a chronically implanted left ventricular balloon, we have developed a heterotopic heart transplant model where sensitive measurements of systolic and diastolic functions can be made. With this preparation, the early changes in the diastolic dysfunction seen clinically can be reproducibly detected. Thus this model may be useful to study mechanisms and interventions during early transplant rejection.     

The effect of caffeine on ambulatory blood pressure in hypertensive patients

Because the potential impact of habitual caffeine intake on blood pressure is a controversial issue, a study was carried out to explore the relationship between caffeine and various humoral factors that could account for a coffee-induced rise in blood pressure. Twenty-three hypertensive patients who refrained from caffeine for 2 to 3 weeks were given 250 mg oral caffeine powder dissolved in water. Blood pressure was recorded every 15 min by blood pressure monitor. Caffeine blood level, renin and endothelin were measured before and 1, 2, 3, and 6 h after caffeine intake. Urinary electrolytes and catecholamines were measured under caffeine influence (period I), and for the next 6 h (period II). A significant increase in systolic (P = .017) and diastolic blood pressure (P = .023) occurred in 13 subjects who were 58 +/- 10.4 years old. Nonresponders were younger (44.5 +/- 15.8 years). A statistically significant decrease in heart rate was seen during the first hour after caffeine intake in both responders (P = .008) and nonresponders (P = .004). Marked diuresis and natriuresis were observed during period I in both groups. Renin and endothelin levels were unchanged. Although chronic studies point to development of tolerance to long-term caffeine ingestion, acute studies like the one described are essential to obtain data on the immediate effects that can be of practical importance, especially in the elderly.     

Physiological and neuropsychological correlates of hostility

This experiment tested two hypotheses linking right cerebral arousal to hostility and physiological arousal. A replication of previous research supporting heightened physiological (systolic blood pressure, diastolic blood pressure and heart rate) reactivity among high-hostility subjects was partially successful. Hemispheric lateralization of cerebral activity in response to stress was also measured. Low- and high-hostility subjects were identified using the Cook-Medley Hostility Scale (CMHS). Physiological measures (systolic blood pressure, diastolic blood pressure and heart rate) were recorded and dichotic listening procedures were administered before and after administration of the cold-pressor paradigm. The primary finding of this research was greater right cerebral activation to stress among high-hostility subjects, as indicated by their enhanced ability to identify syllables presented to the left ear. Data further supported previous findings of heightened physiological reactivity to stress among high-hostility subjects and suggest a positive relationship between right cerebral activity and cardiovascular arousal.     

Hemodynamic characteristics of young men at risk for hypertension at rest and during laboratory stressors.

Examined hemodynamic activity at rest and during arithmetic and cold pressor in 105 male medical students varying in risk for hypertension. Classification into low-, moderate-, and high-risk groups was based on resting systolic blood pressure (SBP) and parental history of essential hypertension (PH). Dependent variables were SBP, diastolic BP (DBP), heart rate, and rate-pressure product (RPP). Progressively greater hemodynamic activity was seen across risk groups at rest and during the tasks. Risk groups differed significantly in SBP, DBP, and RPP at baseline and in size of response to mental arithmetic but not cold pressor. These relationships were either absent or weaker when using either risk factor alone to form risk groups. Hemodynamic reactivity to mental stress appears to be predicted better by a combination of resting SBP and hypertension than by either risk factor alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

T4 DNA ligase reduces chromosome damage and enhances cell survival in CHO cells treated with bleomycin

OBJECTIVE: Recent clinical studies suggest that the reflex increase in sympathetic nervous activity accompanying a reduction in blood pressure may contribute to the untoward effects of dihydropyridine calcium antagonists. The aim of this study was to examine whether plasma noradrenaline levels and renin activity are increased with the reduction of blood pressure during the initial phase of administration of the long-acting dihydropyridine calcium antagonist amlodipine. METHODS: The effects of amlodipine on ambulatory blood pressure and on diurnal variations in plasma noradrenaline and renin activity were examined 1, 4, and 7 days after the start of amlodipine administration in eight inpatients with essential hypertension. RESULTS: The 24-h mean systolic and diastolic blood pressure on day 7 was significantly lower than it was 1 day before the start of treatment. There was no change in the mean heart rate. The mean trough to peak ratios of systolic and diastolic blood pressure of seven patients were 61% and 71%, respectively. Diurnal patterns of plasma noradrenaline levels and renin activity 1, 4, and 7 days after the start of amlodipine administration were unchanged. CONCLUSION: The antihypertensive effects of amlodipine were of slow onset and long duration and were not accompanied by an increase in sympathetic activity or activation of the renin-angiotensin system.     

Effects of task strain, social conflict, and emotional activation on ambulatory cardiovascular activity: Daily life consequences of recurring stress in a multiethnic adult sample.

Ambulatory blood pressure (ABP) may be an independent predictor of cardiovascular endpoints, but little is known about its psychosocial determinants. The acute effects of psychosocial processes on cardiovascular activity during daily life were examined by random-effects regression. Healthy adults (N?=?120) were monitored over a 6-day period with ABP monitors and computer-assisted self-report assessments. Task strain, social conflict, and emotional activation were rated following each ABP measurement, as were activity, posture, and other covariates. Results show that blood pressure) (BP) and heart rate (HR) were elevated during periods of emotional activation (high negative affect or high arousal). Diastolic BP was lower during periods involving high decisional control, and HR was lower during high-control, low-demand activities. There were substantial individual differences in the effects of psychosocial influences on ambulatory cardiovascular activity. Psychological factors are reliable determinants of ABP, which may account for the unique predictive value of ABP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychophysiological stress responses, muscle tension, and neck and shoulder pain among supermarket cashiers.

This study examined psychological and physiological stress, as well as muscle tension and musculoskeletal symptoms, among 72 female supermarket cashiers. Stress levels were found to be significantly elevated at work, as reflected in the catecholamines, blood pressure, heart rate, electromyographic (EMG) activity, and self-reports. Fifty cashiers (70%) suffering from neck-shoulder pain (trapezius myalgia) were found to have higher EMG activity at work and reported more tension after work. Women who kept a diary for 1 week and reported more musculoskeletal pain (above the median) were older, had higher blood pressure, and reported more work stress and psychosomatic symptoms. The elevated stress levels at work are consistent with data from workers involved in other types of repetitive tasks and can be important for the high prevalence of neck and shoulder symptoms among the cashiers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cholinergic receptor-mediated responses in the arteriolar and venous vascular beds of the human forearm

Different antihypertensive treatment regimes were studied in rats during long-term inhibition of nitric oxide synthesis. Male Munich Wistar rats (weight 150-200 g) were put on oral L-nitro-arginine methyl ester (L-NAME, 50 mg/l drinking water) for 12 weeks. The control group (n = 16) received only tap water. Six weeks after starting L-NAME administration rats were divided into 7 groups (n = 13 in each group: group 1, no treatment; group 2, l-arginine 1 g/l drinking water; group 3, doxazosin 30 mg/kg/day; group 4, felodipine 25-30 mg/kg/day; group 5, losartan 40 mg/kg/day; group 6, metoprolol 300-350 mg/kg/day, and group 7, ramipril 1 mg/kg/day. Systolic blood pressure (sBP) was measured in the conscious rat 1, 6, and 12 weeks after study begin. After a treatment period of 6 weeks albuminuria, glomerular filtration rate (GFR) and renal plasma flow (RPF; inulin and p-aminohippuric acid clearance) were analyzed. All rats showed a significant increase in sBP under 6 weeks of L-NAME administration. Control rats remained normotensive during the whole study period. Rats receiving L-NAME without antihypertensive treatment showed a further increase in sBP after 12 weeks. Blood pressure was lowered in all treated animals, except in rats receiving l-arginine. Values for GFR were lowest in the placebo group, the l-arginine group and in rats receiving felodipine (p < 0.05 compared to the control group). RPF was lowest in the placebo group, the l-arginine group, the felodipine group and the ramipril group (p < 0.05 compared to the control group).(ABSTRACT TRUNCATED AT 250 WORDS)     

Oxytocin causes a long-term decrease of blood pressure in female and male rats

The aim of the present study was to investigate the long-term effects of oxytocin (OXY) on blood pressure (BP) and heart rate (HR) in conscious female and male rats. For this purpose, subcutaneous (SC) (0.01, 0.1, and 1 mg/kg) or intracerebroventricular (ICV) (1 microgram/kg) injections of OXY were given during 5-day periods. BP and HR were measured daily. A significant decrease in BP, without affecting HR, compared to saline-treated controls was seen in response to 0.1 (males: p < 0.01, females: p < 0.001) and 1 mg/kg (p < 0.001) of OXY given SC. BP gradually returned to preexperimental levels within 10 days after the last injection in male rats but, in females, the significant lowering of BP remained unchanged during this period. Also OXY ICV (1 microgram/kg) decreased BP (p < 0.05 after one day, p < 0.001 after 5 days of injections). This effect was still present 8 days after the last injection (p < 0.05). These results indicate that OXY may induce a long-term lowering of BP.     

Stress, reactivity, and immune function in healthy men.

Examined the effects of acute psychological stress on lymphocyte proliferation and circulating levels of interleukin-1 and -2. 20 healthy men were exposed to 2 viewings of a gruesome surgery film and were asked to recall details of the film twice during a 20-min period. These Ss were compared to a nonstress control group of 9 Ss. Lymphocyte proliferation to the mitogen concanavalin-A was decreased during and after exposure to the stressor when compared to the control group. This decrease was more pronounced in Ss exhibiting greater blood pressure reactivity while viewing the film than in Ss showing smaller blood pressure responses. None of the other immunological measures was significantly affected by the stressor. Cortisol was not correlated with lymphocyte responsiveness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes of plasma osmotic pressure during lactation in rats

It is known that blood and plasma volume increase during lactation. The present paper examines whether an increase in plasma volume is accompanied by the change in plasma composition or attributed to hydro-dilution. Six dam-nursed pups and six dam-removed pups housed individually were designated as lactating rats and control rats, respectively. The plasma osmotic pressure and hematocrit value (Ht) were measured in the rats on days 3, 5, 7, 10, 13 and 18 of lactation. The total plasma protein (TP) and serum sodium concentration were also measured as they are factors affecting the plasma osmotic pressure. In addition, milk yield was estimated by the Morag technique. On day 5 and after day 10, the osmotic pressure of the lactating rats was found to be significantly lower than that of the control rats. The serum sodium concentration (days 5 and after day 10) and Tp values (days 3, 10 and 18) of the lactating rats were significantly lower than those of the control rats. Except on day 5, the Ht values of the lactating rats were significantly lower than those of the controls. During the period between days 3 and 10, milk yield was increased and it become steady (18 g/12 hr) on days 10 and 18. On and after day 10 when rats secreted a large amount of milk, it is considered that a decrease in the plasma osmotic pressure was mainly attributed to the reduction of sodium concentration by hydro-dilution. The Ht values indicate that an increase in blood volume is mainly through plasma volume rather than blood cell volume in lactating rats.     

"Ambulatory blood pressure and heart rate in healthy male paramedics during a workday and a nonworkday": Erratum.

Reports an error in "Ambulatory blood pressure and heart rate in healthy male paramedics during a workday and a nonworkday" by Iris B. Goldstein, Larry D. Jamner and David Shapiro (Health Psychology, 1992, Vol 11[1], 48-54). On page 52, the sentence "For example, the paramedics stood 16.44 times more while home than while at the station" should read "For example, the paramedics stood more while home than while at the station." (The following abstract of the original article appeared in record 1992-29445-001.) Compared ambulatory blood pressure (BP) and heart rate (HR) in 30 White male paramedics (aged 20-43 yrs) during a 24-hr workday and a 24-hr nonworkday. During the 24-hr period as a whole, there were no BP differences between the workday and the nonworkday, but HR was higher during the nonworkday than during the workday. Systolic BP (SBP) recorded in the ambulance on the workday was elevated 9.8 mm Hg, compared with SBP recorded in a car on the nonworkday; it was also 7.2 mm Hg higher at the scene of an accident and at the hospital than during nonworkday activities. Ratings of moods in diaries indicated that paramedics felt more unhappiness, stress, and sadness and less feelings of pleasantness at work than at home. Rather than being elevated for the entire 24-hr period, work BP seemed to reflect the relatively high stress associated with specific situations in the work of a paramedic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood, blood pressure, and heart rate at work: An experience-sampling study.

We describe a study that examined the distinctiveness of momentary positive and negative affect (PA and NA) and their relationships with blood pressure and heart rate at work in a sample of 67 full-time employees who provided psychological and physiological measurements multiple times a day, over 10 working days. These employees recorded their subjective ratings on personal digital assistant devices programmed specifically for this study, and assessed their blood pressure and heart rate using automatic recording devices, at each measurement period. Results support the distinctiveness of PA and NA. First, within-individual factor analyses confirmed the existence of two underlying factors in the momentary affect ratings. Second, the within-individual correlations between PA and NA scores (?.14), and among the two latent constructs (?.13) were both low in magnitude. Finally, as predicted by theory, NA was significantly related to blood pressure within individuals, whereas PA and blood pressure were unrelated (both PA and NA were related to heart rate within individuals, as predicted). (PsycINFO Database Record (c) 2010 APA, all rights reserved)