Individual differences in cardiovascular reactions to stress and cigarette smoking.

Examined the stability of cardiovascular (CDV) reactions to psychological stress and cigarette smoking and the extent to which CDV actions to stress were predictive of CDV reactions to smoking. 26 male Ss were given an initial test involving 2 repetitions of mental arithmetic stress and paced smoking while blood pressure and heart rate were measured. Ss were retested 2 mo later in the same paradigm. Large and stable individual differences were observed in CDV reactivity to both stress and smoking. For systolic and diastolic blood pressure, but not heart rate, reactions to stress were modestly correlated with reactions to cigarette smoking, suggesting that levels of reactivity to cigarette smoking may have significance for coronary heart disease and blood pressure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of social competence in borderline essestial hypertension.

Examined the social competence of 22 male borderline hypertensives (aged 19–45 yrs) in relation to cardiovascular responsivity to a behavioral role-play test (RPT) of assertiveness. Ss were divided into 2 groups: one group experienced large increases in pulse pressure (PP) in response to social challenge (Group 1), while the other group showed small changes in PP (relatively equal rises in systolic and diastolic blood pressure) under the same stimulus condition (Group 2). These differential group patterns of cardiovascular response were specific to interpersonal stressors because the groups did not differ in reactivity to cognitive challenges. Group 2 Ss evidenced unassertive responding on a role-play test of negative assertion and were rated by significant others as the least socially competent as compared to normotensive controls (who received the highest social competence ratings) and Ss in Group 1. Group 1 Ss responded in an inappropriately assertive fashion on the RPT and had shorter response latencies during the RPT than Ss in Group 2, suggesting that Ss in Group 2 had greater levels of interpersonal anxiety. Findings indicate that hostile inappropriate assertiveness and inappropriate submissiveness may be associated with hypertension. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of initial smoking cessation and relapse through the first 2 years of the Lung Health Study.

Analyses were made separately for men and women of the predictors of end-of-treatment (4 months) smoking cessation and subsequent relapse at 12 and 24 months among 3,923 participants enrolled in the Lung Health Study's 12-week cognitive–behavioral group smoking cessation program. Nicotine gum (2 mg) was available to all participants. Men were more likely than women to quit smoking initially, but relapse rates were similar for both genders. Baseline variables associated with initial quitting for both genders included greater education, lower nicotine dependence, and fewer respiratory symptoms. The best predictor of relapse between 4 and 12 months was smoking at least 1 cigarette between quit day and 4 months. Nicotine gum use at 12 months predicted relapse by 24 months for both genders. Greater social and environmental support for quitting smoking were the only factors that predicted both initial quitting and relapse for both genders. Clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Central Adiposity Is Associated With Cardiovascular Reactivity to Stress in Adolescents.

The current study examined the association between central adiposity, measured by waist circumference, and cardiovascular reactivity to stress among 106 White and 105 Black adolescents, approximately 50% of whom were girls. Participants engaged in 4 laboratory tasks while cardiovascular reactivity measures were taken. Independent of body mass index, race, and gender, participants with a greater waist circumference exhibited greater systolic blood pressure reactivity and diastolic blood pressure reactivity (boys only). Race did not affect the results. Results from the present study suggest that central adiposity is associated with blood pressure reactivity early in life, especially in adolescent boys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age-related changes in cardiovascular response as a function of a chronic stressor and social support.

The effects of aging, chronic stress, and social support on cardiovascular functioning were examined using a cross-sectional design. 36 family caregivers of Alzheimer's disease victims and 34 control Ss performed 2 active coping tasks while continuous noninvasive measures of cardiovascular activity were monitored. Results revealed that caregivers high in social support displayed typical age-related decreases in heart-rate reactivity, whereas caregivers low in social support displayed age-related increases in heart-rate reactivity. Analyses further indicated that only Ss with low social support were characterized by age-related increases in systolic blood pressure. These results suggest that social support can moderate age-related changes in cardiovascular functioning, particularly in Ss exposed to a chronic stressor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk factors of stroke incidence and mortality. A 12-year follow-up of the Oslo Study

BACKGROUND AND PURPOSE: The objective of this study was to determine the risk factors of stroke incidence and mortality. METHODS: Our data are based on a prospective cohort study of men aged 40 to 49 years after 12 years of follow-up. RESULTS: In age-adjusted Cox proportional-hazards regression analysis of 14,403 healthy men, diastolic blood pressure was a stronger predictor for stroke incidence and mortality than systolic blood pressure. Smoking was a stronger predictor of mortality than of incidence. However, there was no dose-response relation among smokers by increased cigarette consumption. Total serum cholesterol was a significant (P < .05) risk factor for stroke mortality and of borderline significance (P = .08) for stroke incidence. Increased physical activity at leisure was associated with reduced stroke incidence but not mortality. The myocardial infarction risk score comprising systolic blood pressure, total serum cholesterol, and daily cigarette smoking was a strong predictor of mortality and incidence. Body mass index, triglycerides, blood glucose, and physical activity at work were not found to be risk factors for stroke. CONCLUSIONS: Reduction of blood pressure, cessation of smoking, lowered cholesterol, and increased physical activity at leisure are individual measures to reduce the risk of stroke.     

Social support and smoking cessation and maintenance.

Examined the role of social support in smoking cessation and maintenance in 2 longitudinal, prospective studies with 64 Ss each (mean ages 38.4 yrs and 38.8 yrs). Three kinds of support factors were assessed: support from a partner directly related to quitting, perceptions of the availability of general (i.e., nonsmoking) support resources, and the presence of smokers in Ss' social networks. Ss were smokers in cessation programs. Corroborated smoking status was obtained through 12 mo posttreatment. There was evidence for all 3 support factors, but they operated at different points in the process of cessation and maintenance. High levels of partner support and of the perceived availability of general support were associated with cessation and with short-term (to 3 mo posttreatment) maintenance of abstinence. The presence of smokers in Ss' social networks was a hindrance to maintenance and significantly differentiated between relapsers and long-term (12-mo) abstainers. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Articulated thoughts and endorsement procedures for cognitive assessment in the prediction of smoking relapse.

Hypothesized advantages of the articulated thoughts during simulated situations (ATSS [G. C. Davison et al; see PA, Vol 70:1572]) paradigm for assessment of cognitions were tested in a prospective study of smoking relapse. Cognitions in high-risk situations were assessed shortly after smoking cessation among 100 Ss. Consistent with G. A. Marlatt's (1985) model, Ss who abstained continuously for 3 mo. had shown higher self-efficacy, more use of cognitive coping tactics, and more negative expectations for the effects of smoking. Cognitions did not predict 12-mo abstinence nor recovery from an initial lapse. ATSS appeared effective in priming stress-related cognitions but did not exceed questionnaire measures in predictive validity. Exploratory analysis suggested that the methods could be combined to yield more useful data. The "metatrait" concept is discussed as a framework for research on combining cognitive assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Task difficulty, cardiovascular response, and the magnitude of goal valence.

Studied the impact of expected task difficulty on anticipatory cardiovascular (CV) responsiveness and the anticipatory reactivity under difficult task conditions in 64 female undergraduates. Ss performed an easy, moderately difficult, or extremely difficult memory task to earn a small incentive for good performance. CV and subjective measures were taken immediately prior to task performance. Both systolic blood pressure (SBP) responses and ratings of goal attractiveness were nonmonotonically related to expected task difficulty, with the most pronounced SBP elevations and highest goal attractiveness in the moderately difficult task condition. CV response measures revealed a strong positive association between systolic and diastolic pressure (but not heart rate) change in the easy condition, positive relationships among measures in the moderately difficult condition, and no significant correlations in the extremely difficult condition. Subjective measures of arousal were not affected by task difficulty. Principal findings are discussed in terms of J. W. Brehm's theory that motivation varies as a nonmonotonic function of the difficulty of goal attainment. Intercorrelations among CV response variables are considered in terms of their possible indication of the mechanisms underlying blood pressure changes associated with variations in motivation. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking, caffeine, and stress: Effects on blood pressure and heart rate in male and female college students.

Examined the independent and joint effects of cigarette smoking and caffeine consumption on blood pressure (BP) and heart rate (HR) reactions to stress in 38 male and 38 female college students. Following an initial physiological baseline, Ss received 1 of 4 experimental treatments (paced smoking, caffeine, smoking plus caffeine, or neither) and had BP and HR measured before, during, and after 2 stressful tasks. Compared with the control condition, caffeine ingestion enhanced the magnitude of stress-induced systolic BP and HR reactions. Smoking combined with stress, and the joint effect of smoking and caffeine was no greater than either taken alone. Males and females were generally similar in their responses to smoking, caffeine, and stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cue-Provoked Craving and Nicotine Replacement Therapy in Smoking Cessation.

Cue exposure paradigms have been used to examine reactivity to smoking cues. However, it is not known whether cue-provoked craving is associated with smoking cessation outcomes or whether cue reactivity can be attenuated by nicotine replacement therapy (NRT) in clinical samples. Cue-provoked craving ratings and reaction time responses were measured on the 1st day of abstinence among 158 smokers who had been randomized to high-dose nicotine (35 mg) or placebo patch. The nicotine patch reduced overall levels of craving but did not attenuate cue-provoked craving increases or reaction time responses. Cue-provoked craving predicted relapse among participants on the nicotine patch but not among those on placebo. In summary, NRT users could benefit from treatment that attenuates cue-provoked craving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental and physical stress as moderators of the postural response in insulin-dependent diabetic patients.

In 14 insulin-dependent diabetic patients (mean age 31.3 yrs) and in 15 normal controls (mean age 30.9 yrs), continuous measures were taken of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and skin conductance (SC) during postural change under baseline and stressor conditions. Diabetic Ss without symptoms of neuropathy and healthy controls showed generally similar responses to postural change and to stressor conditions (mental arithmetic and isometric handgrip). SBP and DBP were more responsive to mental and physical stressors than were HR or SC, especially after standing. Two diabetics with postural hypotension showed significant increases in overall BP levels and less of a fall in BP during postural change under the stressor conditions, despite minimal HR or SC responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Task demand and cardiovascular response magnitude: Further evidence of the mediating role of success importance.

The interactive effects of success importance and task demand on cardiovascular reactivity were investigated in 2 experiments. In Exp 1, Ss learned that success on an easy or difficult memory task would allow them to avoid a mild or severe noise. As expected, pretask and task elevations in heart rate and systolic blood pressure increased with difficulty only when the noise was to be severe. In Exp 2, Ss listened to a victim, attending either to how she must feel or to technical features of the presentation. Then they were given the chance to earn a donation by succeeding on an easy or difficult memory task. Pretask cardiovascular data accorded with predictions predicated on the assumption that the need to help would be greater among victim perspective Ss. For them, systolic elevations increased with difficulty, whereas for technical perspective Ss systolic elevations were low regardless of task demand. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Combined effects of nicotine and mecamylamine in attenuating smoking satisfaction.

Separate and combined effects of nicotine (NIC) and the nicotinic antagonist mecamylamine (MEC) were studied. 12 smokers rated test cigarettes after administration of MEC vs placebo capsules and NIC vs non-NIC preload. Smoking withdrawal symptoms, task performance, and cardiovascular activity were also measured. MEC attenuated smoking satisfaction, liking, and airway sensations. The NIC preload similarly reduced the enjoyable aspects of subsequent test cigarettes, and this action of the preload was not prevented by MEC. In contrast, MEC blocked NIC-related increases in heart rate and systolic blood pressure. Conversely, NIC counteracted MEC's effects on tapping speed and orthostatic blood pressure response. Although each drug offset potential side effects of the other, they acted in unison to attenuate smoking satisfaction and should be evaluated in combination for smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"I can tell when my blood pressure is up, can't I?"

44 21–61 yr old insurance company employees were measured on blood pressure, mood and symptoms (using self-administered checklists), and predictions of their blood pressures, twice daily for 10 days. 20 Ss had elevated blood pressure, and 24 did not. The measures were correlated within-Ss to determine if blood pressure predictions were associated with moods, symptoms, or blood pressure readings and if moods and symptoms were related to blood pressure. Data show that self-predictions of blood pressure were most strongly associated with reported symptoms, next with reported moods, and least with actual blood pressure. A comparison of Ss who were accurate in predicting their blood pressure with those who were not showed no differences in blood pressure levels, systolic blood pressure variation, self-esteem, or private body-consciousness. Ss' beliefs that they could monitor blood pressure were little influenced by contrary information. Results suggest it would be an error to encourage Ss to believe they can successfully treat blood pressure elevations by monitoring symptoms related to blood pressure change. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular and neurohumoral responses to behavioral challenge as a function of race and sex.

Cardiovascular and hormonal responses to a structured interview, an electronic video game, a cold pressor test, and exercise on a bicycle ergometer were assessed in 83 normotensive Black and White men and women (aged 25–44 yrs). Black Ss showed significantly greater diastolic blood pressure (DBP) responses than White Ss during the cold pressor test, which were not accounted for by an increase in plasma catecholamines. Exercise produced reliably greater systolic blood pressure (SBP) increases in Black women than in Black men or White women. Men showed significantly greater SBP and DBP changes than women during the video game. The pattern of physiological reactivity elicited by challenge may be related to the Ss' race and sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of smoking relapse: Analyses of temptations and transgressions after initial cessation.

Different types of "relapse crises" and associated coping responses were associated with the resumption of smoking using a prospective design. One hundred and two previously heavy smokers (M?=?23.9 cigarettes a day) who achieved initial abstinence through a smoking cessation program were interviewed by telephone at 1, 2, and 3 months posttreatment. At each assessment, subjects described relapse crises, situations in which they were tempted to smoke or actually smoked but resumed abstinence (lapsed). Prospective analyses indicated that any smoking lapse is strongly related to subsequent relapse. Situational characteristics of relapse crises and the number of cognitive and behavioral coping responses reported during crises were only modestly consistent over time and were unrelated to later relapse. Confidence ratings and situational attributions about the relapse crises were also not prospectively associated with eventual relapse. Subanalyses suggested that lapses associated with urges and emotional (guilt) responses and lapses occurring in frequent situations are more likely to result in relapse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of situation and coping on relapse crisis outcomes after smoking cessation.

Examines the influence of situational characteristics and coping on the outcome of a relapse crisis for 232 Ss followed for 1 month after a self-initiated smoking cessation attempt. Survival of a relapse crisis was most strongly related to the number of coping strategies used. All coping strategies were equally effective; furthermore, combining cognitive and behavioral coping strategies was not more effective than using multiple cognitive or multiple behavioral strategies. During the second half of the follow-up period (Weeks 3 and 4 postcessation), the presence of smokers resulted in a decreased likelihood of coping and an increased likelihood of smoking. In addition, active coping was marginally related to higher baseline levels of motivation to quit. When motivation and the presence of smokers were controlled, however, coping still significantly predicted outcome. Results are discussed with reference to previous relapse studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants and significance of declining blood pressure in old age. A prospective birth cohort study

AIMS: To investigate the changes in blood pressure and their causes in an elderly population. METHODS: Orthostatic blood pressure measurements were performed in randomly in four birth cohorts (years 65-, 75-, 80- and 85, n=773) at 5-year intervals. RESULTS: Both systolic and diastolic blood pressures decreased in both genders and all age groups. The falls in blood pressure related closely to initial blood pressure values and to the thickness of the left ventricular posterior wall of the heart. The changes in supine (r=0.118, P=0.007) and standing systolic blood pressure (r=0.123, P=0.005), as well as supine (r=0.148, P<0.001) and standing diastolic blood pressure (r=0.186, P<0.001) correlated with changes in body weight. Changes in supine diastolic blood pressure also related to changes in serum cholesterol (r=0.207, P=0.002) and triglycerides (r=0.160, P=0.016). Changes in supine and standing systolic and standing diastolic blood pressures also related to changes in dehydroepiandrosterone sulphate (r=0.161, P<0.05; r=0.205, P<0.01; r=0.140, P<0.05, respectively). Changes in blood pressure also correlated with self-estimated poor health after 5 years (r for supine systolic blood pressure= -0.133, P<0.001, for standing systolic blood pressure= -0.135, P<0.001, for supine diastolic blood pressure= -0.111, P<0.002). PATIENTS: who were institutionalized during the follow-up or who had severely impaired performance capacity after 5 years, displayed the most marked decline in blood pressure. Declining systolic blood pressure was also related to impaired survival prognosis. According to the logistic regression analyses the baseline blood pressure, antihypertensive drugs and changes in dehydroepiandrosterone sulphate and cholesterol explained over 30% of the changes in blood pressure. In the logistic models, declining blood pressure was associated with baseline blood pressure, antihypertensive treatment, poor health after 5 years, and decreasing cholesterol and triglycerides. CONCLUSION: Decline in blood pressure in old age is associated with deteriorating health and is only partly explained by the use of antihypertensive drugs.