Psychophysiologic sensitization to headlight glare among professional drivers with and without cardiovascular disease.

EEG and cardiovascular (CV) response and recovery to simulated headlight glare (the glare pressor test) were examined in 4 groups of male professional drivers (age 25-52 yrs)—12 with ischemic heart disease (IHD), 12 with hypertension (HTN), 10 with borderline hypertension (BHTN), and 34 who were healthy—and in 23 non-professional driver controls—to assess sensitization to this night driving stressor in relation to degree of CV disease severity. After glare exposure the IHD drivers showed the most pronounced alpha blockade, a rise in diastolic BP (DBP), and, unlike the other groups, a persistent fall in finger pulse volume. The BHTN group reacted initially with DBP rise and finger pulse drop, mainly without CNS arousal. The DBP remained constant in normotensive professional drivers older than 40. The drivers' CV responses to glare were inversely related to reported stressors and subjective experience. Anxiety trait and long work hours were associated with heightened central arousal to glare in professional drivers. Results suggest that there may be progressive degrees of sensitization to glare exposure in these samples, with the least among normotensive professional drivers older than 40, moderate levels in borderline hypertensives, and the most severe in drivers with IHD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models of personality and disease: An interactional approach to Type A behavior and cardiovascular risk.

Describes and critiques models currently guiding research regarding the link between Type A (coronary prone) behavior and coronary heart disease and offers an alternative model. The model offered places this link in an interactional context. Specifically, it is hypothesized that via cognitive and overt behaviors, Type A individuals construct a subjective and objective environment rich in those classes of stimuli known to elicit enhanced physiological reactivity. This approach differs from previous ones by emphasizing that the Type A pattern represents an ongoing process of challenge and demand engendering behavior. That is, Type A persons do not simply respond to challenges and demands; they seek and create them through their cognitions and actions. This constructed environment also elicits and maintains further Type A behavior. The present view of Type A behavior as a challenge and demand engendering style is contrasted with other conceptual approaches, and implications are discussed. (81 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inability to predict cardiovascular disease from hostility scores or MMPI items related to Type A behavior.

[Correction Notice: An erratum for this article was reported in Vol 58(5) of Journal of Consulting and Clinical Psychology (see record 2008-10621-001). In the article, the mean Ho scores are incorrect and some reported information is no longer relevant. The entries have been corrected and are included in the erratum. All other analyses and all conclusions are correct as reported.] Medical and psychological data collected for 30 years on a group of 280 men (mean age in 1947&=&45 years) were evaluated to identify the personality characteristics and attitudes that might be predictive of the later development of coronary heart disease (CHD). Minnesota Multiphasic Personality Inventory (MMPI) Hostility scores did not predict CHD in this population. A 35-item scale derived from MMPI items judged to reflect the Type A construct and from other personality scales did not predict the later incidence of myocardial infarctions or other evidence of CHD. It is therefore possible that personality factors may not be strong predictors of CHD in particular samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior, personality hardiness, and cardiovascular responses to stress.

Type A behavior and hardiness were examined as predictors of cardiovascular responses to stress in 68 male undergraduates. Systolic and diastolic blood pressure (SBP and DBP) and heart rate were monitored while subjects performed a difficult mirror-tracing task. Type A assessments based on the Structured Interview, but not those based on the Jenkins Activity Survey, were associated with significantly enhanced SBP and DBP elevations. Hardiness was associated with significantly reduced DBP responsiveness. In addition, a significant interaction indicated that the Type B-high hardiness group showed the least DBP reactivity. A near-significant interaction (p?=?.06) suggested that Type B-high hardiness subjects also reported the least anger. Further exploration of the data indicated that the challenge component of hardiness accounted for its relationship to DBP reactivity. These results have implications both for the psychophysiologic study of Type A behavior and for understanding the health-promoting effects of hardiness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Task-related arousal of Type A and Type B persons: Level of challenge and response specificity.

To determine whether different levels of challenge had differential effects on the arousal levels of Type A (coronary prone) and Type B (noncoronary prone) persons, 30 Type A and 30 Type B male undergraduates worked on an intelligence test task (digits backwards recall) that was easy, moderately difficult, or extremely difficult. Arousal was measured in terms of systolic blood pressure, diastolic blood pressure, pulse rate, pulse volume, skin resistance, and subjective arousal. Results indicate that, while working on the extremely difficult task, the Type A's evidenced reliably higher systolic blood pressure than did Type B's and that there were not reliable differences between Ss in systolic blood pressure at other levels of challenge or on other measures of arousal. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postprandial lipoprotein responses in hypertriglyceridemic subjects with and without cardiovascular disease

Three groups of age- and weight-matched men (aged 40 to 70 years) without diabetes were studied: controls (n = 10), plasma triglycerides (TG) less than 180 mg/dL and no cardiovascular disease (CVD); HTG-CVD (n = 11), hypertriglyceridemic (HTG) (TG > 240 mg/dL) without CVD; and HTG+CVD (n = 10), HTG (TG > 240 mg/dL) with documented CVD. HTG+CVD subjects had higher fasting and post-oral glucose tolerance test insulin levels than the other two groups, respectively. Very-low-density lipoprotein (VLDL)+chylomicrons (CMs), intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and three high-density lipoprotein (HDL) subfractions (HDL-L, HDL-M, and HDL-D, from least to most dense) were isolated by gradient ultracentrifugation. Fasting lipoproteins were similar in HTG groups, except for higher VLDL lipid to apolipoprotein (apo) B ratios (P < .04) in the HTG+CVD group. Subjects were fed a high-fat mixed meal, and lipoprotein composition was determined at 3, 6, 9, and 12 hours postprandially. Postprandial responses of the core lipids (TG and cholesterol esters [CE]) in all of the lipoprotein subfractions were similar in the two HTG groups at each time point. However, both controls and HTG-CVD subjects had increases in HDL-M phospholipid (PL) at 9 and 12 hours with no change in HDL-D PL. The HTG+CVD group, on the other hand, had no increase in HDL-M PL and had a substantial reduction in HDL-D PL. These changes resulted in significant increases in HDL-M and HDL-D PL to apo A-I ratios in both controls and HTG-CVD subjects between 6 and 12 hours, whereas there was no increase seen in the HTG+CVD group. The HTG-CVD group also had a significantly greater increase in the VLDL+CM PL to apo B ratio (P = .038) at 3 hours than the HTG+CVD group. This diminished amount of surface lipid per VLDL particle may account for the late decrease in the HDL-D PL to apo A-I ratio seen in HTG+CVD patients. There were no other postprandial lipid or apolipoprotein differences between the two HTG groups. We conclude therefore that the major postprandial lipoprotein abnormality in these HTG+CVD patients was a failure to increase the PL content per particle in VLDL+CM, HDL-M, and HDL-D. This abnormality could prevent the usual increase in reverse cholesterol transport seen in postprandial plasma and therefore contribute to their increased incidence of CVD. The greater insulin resistance seen in these patients also appears to contribute significantly to their CVD.     

Depression and the assessment of Type A behavior in a clinical population.

The Structured Interview (SI) method of assessing Type A behavior pattern (TABP) relies on the S's voice stylistics, whereas the Jenkins Activity Survey (JAS) relies on response content. It was hypothesized that depression would affect SI assessments by masking voice stylistics but would have no impact on JAS assessments. The SI, JAS, and the Zung Self-Rating Depression Scale were administered to 2,066 coronary patients. As predicted, there was a negative relationship between depression and SI-assessed TABP and a modest positive relationship between depression and JAS-assessed TABP. Analysis of Type A components revealed that loudness, explosive speech, and intensity of hostility differed between depressed and nondepressed patients. Affective states that influence expressivity appear to produce misclassifications using SI assessments, especially in clinical samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stimulus specificity of physiological response to stress and the Type A coronary-prone behavior pattern.

Conducted 2 experiments with male undergraduates to determine the influence of stimulus specificity on differences in physiological response to stress of coronary-prone (Type A) and noncoronary-prone (Type B [Jenkins Activity Survey]) individuals. In Exp I, a RT task was presented to 51 Ss with and without stress relevant to the Type A behavior pattern. The physiological responses of Type A Ss were greater in the relevant stress compared to the neutral task condition, but responses of Type B Ss were similar in the 2 conditions. In Exp II, 25 Type A and Type B Ss performed a stressful task that was not theoretically relevant to the Type A behavior pattern. Physiological response elevations were found for both groups, but as predicted, there were no differences between Type A and Type B Ss. Results support the discriminant validity of the Type A construct and provide additional evidence for the role of physiological response differences as mediators of the behavior-pattern–disease relationship. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Magnitude and duration of cardiovascular response to anger in Vietnam veterans with and without posttraumatic stress disorder.

This study investigated the cardiovascular responses to a relived anger task in 118 male Vietnam combat veterans (62 with posttraumatic stress disorder [PTSD] and 56 without PTSD). Participants completed standardized diagnostic measures, hostility measures, and a laboratory session in which they relived a self-chosen anger memory while heart rate (HR), systolic blood pressure, and diastolic blood pressure (DBP) were measured continuously using an Ohmeda Finapres monitor. Compared with veterans without PTSD, PTSD veterans took less time to feel anger, had greater mean HR and DBP response during relived anger, and reported greater anger and anxiety during the task. There was a significant relationship between covert hostility and anger response during and after the anger task only in participants with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immune response to glycated and oxidized LDL in IDDM patients with and without renal disease

OBJECTIVE: To study autoantibodies to oxidized and glycated LDL in IDDM patients with and without diabetic nephropathy and in nephropathy-related macroangiopathy RESEARCH DESIGN AND METHODS: The study included 101 IDDM patients with a long duration of diabetes and 54 healthy subjects. Patients were divided into two groups according to their median urinary albumin excretion rate (AER); the normoalbuminuric group had AER <20 microg/min and the albuminuric group >200 microg/min. The groups were matched for age and BMI, and the two diabetic groups were matched for duration of diabetes and glycemic control. Antibodies against oxidized LDL (using malondialdehyde-modified LDL as the antigen) and against glycated LDL were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean antibody levels against glycated LDL were higher in IDDM patients (0.305 +/- 0.399) than in healthy subjects (0.166 +/- 0.22 optical density [OD]; P = 0.019), but levels did not differ significantly between normoalbuminuric and albuminuric IDDM patients (0.258 +/- 0.354 vs. 0.388 +/- 0.459, respectively). Among the three groups, antibody levels to oxidized LDL did not differ. IDDM patients showed an inverse correlation between antibodies to oxidized LDL and HbA1 (r = -0.211, P = 0.04). The antibody levels to glycated and oxidized LDL did not differ among albuminuric IDDM patients with or without clinical macroangiopathy. CONCLUSIONS: Antibodies to glycated and oxidized LDL do not seem to associate with diabetic nephropathy or nephropathy-related macroangiopathy.     

Control over stress, Type A behavior pattern, and response to stress.

Examined (a) differences in physiological response of Type A and Type B individuals to conditions that varied in both controllability and consistency of controllability over an aversive stimulus and (b) whether Type A relative to Type B individuals use more denial and/or projection in cognitively coping with arousing situations as well as whether they differ in being preoccupied in such situations. 96 male undergraduates were randomly assigned to 1 of 4 conditions: no control over shock, consistent control over shock, intermittent control over shock, and low stress. Type A and B behaviors were assessed with the Activity scale of the Thurstone Temperament Schedule. Results indicated that relative to Type B Ss, Type A's manifested (a) greater pulse rates and systolic and diastolic blood pressure in the consistent control condition, (b) greater systolic blood pressure in the no-control condition, and (c) greater diastolic blood pressure in the intermittent control condition. Type A's also used more denial and projection across the 3 high-stress conditions but did not differ in how preoccupied they were as compared to Type B's. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking behavior in offspring of heart disease patients: A response to cognitive dissonance.

Offspring of heart disease patients, with their variety of health concerns, were compared to a control group with respect to cigarette smoking behavior. Contrary to common-sense expectations, a significantly greater proportion of both male and female offspring were current smokers, and smoked to a greater degree (heavy) than control Ss. The MMPI, however, did not discriminate between Ss on the basis of smoking behavior. In accordance with previous research, it was theorized that the differences observed could be attributed to the higher state of cognitive dissonance associated with cigarette smoking in the offspring group. The fact that a relationship existed between quitting and age, for male and female offspring, suggests that more research is required to study the effects of extreme states of cognitive dissonance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior pattern, parental history of hypertension, and cardiovascular reactivity in college males.

Examined 2 risk factors for cardiovascular disorders—parental history of hypertension and the Type A (coronary prone) behavior pattern—with respect to cardiovascular reactivity to challenging situations. 64 college males completed a structured interview (SI), Jenkins Activity Survey (JAS), and family health questionnaire. Ss were monitored for blood pressure (BP), heart rate (HR), and pulse transit time response to 4 tasks. Type As based on SI classification had significantly higher HR levels across all tasks than did Type Bs (noncoronary prone), as well as higher diastolic BP levels in the cold pressor task. No main effects for Type A-B using JAS classification were found. Type A and parental history did interact in a limited way on some tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Type A behavior, family history of hypertension, and cardiovascular responsivity among Black women.

Determined the effects of Type A (coronary-prone) behavior and family history of hypertension on cardiovascular reactivity to mental stress in 50 26–63 yr old employed Black women. Results indicated that Type A behavior was associated with systolic and diastolic blood pressure hyperresponsivity during a structured interview (SI) but not during mental arithmetic. Certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters. Results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominately White samples also hold true for Blacks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressed contractile response to exercise in diabetic patients in the absence of cardiovascular disease: relationship to adrenergic cardiac dysinnervation

In its various forms, tea is one of the most widely consumed beverages in the world. Elucidation of the chemical components of tea has revealed that the beverage is a rich repository of antioxidants. Among these are the polyphenolics, common to green tea, but also found in black teas together with oxidized polymers that in part account, for the darkened color. Consumption of tea on a regular basis has been associated with reduced risk of several forms of cancer in human populations, with the strongest evidence linking green tea use to reduction in cancer risk in parts of Asia. To understand how tea prevents cancer, studies in animal carcinogenesis models have been done with very encouraging results. This review examines the available data from animal studies on the effects of tea in the prevention of cancer.     

Glucose intolerance, physical signs of peripheral artery disease, and risk of cardiovascular events: the Framingham Study

BACKGROUND: Diabetes and peripheral artery disease (PAD) are acknowledged hallmarks of development of atherosclerotic cardiovascular disease (CVD). The prognostic implications of physical indicators of PAD, compared with and in conjunction with glucose intolerance based on population based data, are not well documented. METHODS AND RESULTS: The influence of carotid and femoral bruits and nonpalpable pedal pulses, with and without glucose intolerance, on development of coronary disease (CHD), congestive heart failure (CHF), and stroke (CVA) was investigated in a cohort of 1672 men and 2264 women ages 47 to 99 years participating in the Framingham Study. Cross-sectional pooling yielded 29,063 2-year person-examination units based on the sample of whom 440 men and 484 women had glucose intolerance develop. Over the 26 years of follow-up, 210 men and 199 women had 1 or more of the specified CVD events. Logistic regression analysis was used to estimate age-adjusted odds ratios comparing incidence of CVD events in subjects with glucose intolerance, signs of PAD, or both conditions with those with neither condition. Glucose intolerance was associated with a 2-fold excess occurrence of physical signs of PAD (P< .01 ). Femoral and carotid bruits were generally associated with greater increased risk of CHD, CHF, and CVA than was glucose intolerance alone. Particularly in women, the concomitant presence of bruits augmented the CVD risk of glucose intolerance. Nonpalpable pedal pulses were a stronger risk factor for CVD end points than glucose intolerance; particularly in men and in both sexes, those with both conditions were at substantially greater risk of CVD events than those with either alone. CONCLUSIONS: Physical findings of PAD appear to signify a compromised arterial circulation to the heart and brain as well as the limbs in persons with glucose intolerance. Persons with the combination are candidates at high risk for CHD, CHF, and CVA.     

Immunologic response to the dual murine anti-Id vaccine Melimmune-1 and Melimmune-2 in patients with high-risk melanoma without evidence of systemic disease

Medical imaging is now giving access not only to anatomy but also to functions of organs in the human body. Functional imaging may yield a direct appreciation of the function of a given organ, as is the case when measuring ejection fraction of heart with SPECT. Alternately the approach is indirect. This is the case of cerebral functional imaging, either with PET or NMR, where the perfusion increase induced by neuronal activity is detected. Recent developments of NMR, combining imaging and spectroscopy, allow now to detect modification of physiological parameters induced by muscular activity. Indirect detection of muscle activity is very rich in information alternately requiring invasive techniques. Water shifts resulting from intense exercise are detected either from muscle volume increase or water signal modifications, using simple NMR sequences. Then it is easy to identify which muscle is involved in a given protocol. These water shifts, studied in various muscles and several types of exercise protocols, reflect the perfusion increase induced by exercise, and the contribution of metabolic products such as lactate. In some patients with metabolic myopathies a decreased adaptation of perfusion has been detected. Perfusion measurements, previously performed by using venous occlusion plethysmography or radioactive tracers, now benefit from recently developed MR techniques. Oxygenation of muscle may be measured either by spectroscopy of myoglobin, allowing a time resolution of 1 second, or by spectroscopic imaging allowing a spatial resolution of 1-2 cm in a few minutes. Muscle temperature may be non invasively monitored by diffusion-weighted MR. Direct detection of muscle activity is useful only in those muscles that cannot be directly observed. Ultrafast MR imaging may be used to study vocal cords or oculomotor muscles. More interesting is the measurement of contractility, either in myocardium or skeletal muscle, allowed by MR with spin-tagging. Another contribution of MR to muscle studies is the possibility to quantify muscle cross section and muscle volume, in order to normalize strength or metabolism measurements. Sequences using T1 or T2 differences between muscular and adipose tissue allow to quantify the true muscular volume in patients with neuromuscular disorders. Protocols combining several of these parameters by interleaved NMR measurements of perfusion, phosphorylated metabolites, lactate, myoglobin, now open the way to many comprehensive non-invasive pathophysiological studies.     

Postexercise systolic blood pressure response: clinical application to the assessment of ischemic heart disease

Stress test parameters indicating the presence and extent of coronary artery disease have traditionally included such variables as exercise duration, and the blood pressure and ST-segment responses to exercise. The three-minute systolic blood pressure ratio, another important indicator of significant coronary artery disease, is a useful and readily obtainable measure that can be applied in all patients who are undergoing stress testing for the evaluation of known or suspected ischemic heart disease. The ratio is calculated by dividing the systolic blood pressure three minutes into the recovery phase of a treadmill exercise test by the systolic blood pressure at peak exercise. A three-minute systolic blood pressure ratio greater than 0.90 is considered abnormal and has a diagnostic accuracy of approximately 75 percent for the detection of coronary artery disease (i.e., an accuracy comparable to that of ST-segment depression). Higher values for the ratio are associated with more extensive coronary artery disease, as well as an adverse prognosis after myocardial infarction. Thus, the three-minute systolic blood pressure ratio provides information that is complementary to the traditional exercise test parameters for identifying high-risk ischemic heart disease.