Links between physical fitness and cardiovascular reactivity and recovery to psychological stressors: A meta-analysis.

A meta-analysis of published studies with adult human participants was conducted to evaluate whether physical fitness attenuates cardiovascular reactivity and improves recovery from acute psychological stressors. Thirty-three studies met selection criteria; 18 were included in recovery analyses. Effect sizes and moderator influences were calculated by using meta-analysis software. A fixed effects model was fit initially; however, between-studies heterogeneity could not be explained even after inclusion of moderators. Therefore, to account for residual heterogeneity, a random effects model was estimated. Under this model, fit individuals showed significantly attenuated heart rate and systolic blood pressure reactivity and a trend toward attenuated diastolic blood pressure reactivity. Fit individuals also showed faster heart rate recovery, but there were no significant differences in systolic blood pressure or diastolic blood pressure recovery. No significant moderators emerged. Results have important implications for elucidating mechanisms underlying effects of fitness on cardiovascular disease and suggest that fitness may be an important confound in studies of stress reactivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age-related differences in ambulatory blood pressure during daily stress: Evidence for greater blood pressure reactivity with age.

Prior research on age and emotions has found that older adults may show better physiological regulation to stressful stimuli than do younger adults. However, the stress reactivity literature has shown that age is associated with higher cardiovascular reactivity to laboratory stress (J. R. Jennings et al., 1997). The authors investigated these conflicting findings further by examining daily ambulatory blood pressure in 428 middle-aged to older adults. Consistent with the age and reactivity literature, relatively old individuals showed significantly greater increases in ambulatory diastolic blood pressure compared with younger individuals when dealing with daily stressors. However, results also revealed that relatively old individuals reported less of an increase in negative affect during daily stress compared with their younger counterparts. The results of this study are consistent with the age-related increase in cardiovascular risk but highlight the complex links between stress and different facets of the aging process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blood pressure reactivity and cognitive function in the Baltimore Longitudinal Study of Aging.

Objective: Several blood pressure indexes of autonomic dysregulation, including stress-induced blood pressure responses (i.e., reactivity), have been associated previously with stroke, silent cerebrovascular disease, and decreased cognitive function. Design: The authors examined the cross-sectional relations among systolic blood pressure (SBP) and diastolic blood pressure (DBP) reactivity and cognitive function in a sample of stroke- and dementia-free older adults (n = 73, 53% male, 72% Caucasian, mean age = 70.14 years) from the Baltimore Longitudinal Study of Aging. Main Outcome Measures: Age, education, baseline, and reactive blood pressure levels were regressed on cognitive test scores measuring the domains of attention, learning and memory, verbal functions/language skills, and perceptuo-motor speed. A Bonferroni correction was employed and results significant at the standard p     

Aging and Cardiovascular Reactivity to Stress: Longitudinal Evidence for Changes in Stress Reactivity.

Although age differences in cardiovascular function are well documented, little research has provided longitudinal evidence for age-related changes in cardiovascular reactivity to stress. In this study, the authors report such data from a follow-up of their prior work (B. N. Uchino, D. Uno, J. Holt-Lunstad, & J. B. Flinders, 1999) with participants between the ages of 30 to 70 (n=108, mean follow-up=10 months, range=7 to 16 months). Results revealed longitudinal evidence for an age-related increase in systolic blood-pressure reactivity and parasympathetic withdrawal to acute stress. The implications of these findings are discussed in light of the increased cardiovascular disease risk with age, as well as the links between aging, emotions, and physiology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Major depressive disorder is associated with attenuated cardiovascular reactivity and impaired recovery among those free of cardiovascular disease.

Objective: To examine cardiovascular reactivity and recovery to laboratory stress among a naturalistic sample of individuals diagnosed with major depressive disorder (MDD) and healthy control participants. Prospective evidence suggests that MDD confers risk for cardiovascular disease equal to or greater than the risk associated with depressed mood. Enhanced cardiovascular reactivity has been proposed as a mechanism explaining increased risk, but data are inconsistent as to whether depressed individuals exhibit enhanced or attenuated reactivity. Further, few studies have examined appraisal and recovery differences. Design: Participants diagnosed with MDD (N = 25) and healthy control participants (N = 25) engaged in a cardiovascular reactivity protocol including 2 tasks, each followed by a brief recovery period. Main outcome measures: Blood pressure, heart rate, pre-ejection period, cardiac output and total peripheral resistance were assessed. Appraisals of tasks were assessed prior to each task. Results: Depressed participants exhibited significantly less systolic blood pressure, heart rate, and cardiac output reactivity during speech, less heart rate reactivity during mirror tracing, and less heart rate recovery after speech and mirror tracing than controls. Depressed participants appraised the tasks as more demanding, threatening, and stressful and reported being less able to cope than controls. Appraisals were related to heart rate reactivity, but appraisals did not mediate the relationship between depression group and reactivity. Conclusion: Impaired recovery rather than exaggerated cardiovascular reactivity may partially explain the increased prospective cardiovascular disease risk in depressed individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social relationships and ambulatory blood pressure: Structural and qualitative predictors of cardiovascular function during everyday social interactions.

Healthy normotensive men and women (N=102) underwent a 3-day ambulatory blood pressure (BP) assessment in which a BP reading was taken 5 min into each social interaction. After each interaction, participants completed a diary that included structural categorization of the relationship and ratings of the quality of the relationship with the interaction partner. Random regression analyses revealed that interactions with family members and spouses were associated with lower ambulatory BP. Interactions with ambivalent network members (characterized by both positive and negative feelings) were associated with the highest ambulatory systolic BP, an effect that was independent of the familial effects on BP. Although there were psychological correlates associated with both structural and functional aspects of relationships, no evidence was found that these mediated the primary findings involving ambulatory BP. These data highlight the influence of both structural and qualitative aspects of relationships on ambulatory BP and possibly health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dating couples' attachment styles and patterns of cortisol reactivity and recovery in response to a relationship conflict.

This study investigated theoretically predicted links between attachment style and a physiological indicator of stress, salivary cortisol levels, in 124 heterosexual dating couples. Cortisol was assessed at 7 points before and after an experimental conflict negotiation task, creating a trajectory of stress reactivity and recovery for each participant. Growth modeling of cortisol data tested hypotheses that (a) insecurely attached individuals show patterns of greater physiological stress reactions to interpersonal conflict than do securely attached individuals and (b) people with insecurely attached partners show patterns of greater stress in reaction to relationship conflict than those with securely attached partners. Hypothesis 1 was supported, but men and women differed in the type of insecure attachment that predicted stress trajectories. Hypothesis 2 was supported for men, but not for women. The discussion emphasizes the role of gender role norms and partner characteristics in understanding connections between adult attachment and patterns of cortisol responses to interpersonal stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trait hostility and ambulatory blood pressure among traffic enforcement agents: The effects of stressful social interactions.

This study investigated the hypothesis that trait hostility is associated with heightened cardiovascular reactivity to potentially stressful social interactions but not to nonsocial activities in the workplace. Participants were 73 (39 women) New York City traffic enforcement agents (TEAs) who patrol the streets and issue summonses for vehicular and parking violations. During their patrols, TEAs face potentially stressful interactions when they encounter motorists and pedestrians who may be angry about receiving summonses. Mood and ambulatory blood pressure were initially measured when TEAs were recently hired and attending classes at the training academy (Time 1), and were subsequently assessed again once the TEAs began independently patrolling the city streets (Time 2). Random effects regression models yielded a significant interaction of hostility and work activity on ambulatory systolic blood pressure at Time 2. For those high in hostility, but not for those low in hostility, systolic blood pressure levels were higher while interacting with members of the public than during nonsocial work activities. The findings support the notion that situational factors affect the association of hostility to cardiovascular reactivity, and that interpersonal stressors in the workplace elicit cardiovascular activation among those high in hostility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of early life stress and psychological functioning to blood pressure in the CARDIA study.

[Correction Notice: An erratum for this article was reported in Vol 28(4) of Health Psychology (see record 2009-10284-005). A URL for supplemental materials was included due to a production error. There are no supplemental materials for this article.] Objective: Low childhood socioeconomic status (CSES) and a harsh early family environment have been linked with health disorders in adulthood. In this study, the authors present a model to help explain these links and relate the model to blood pressure change over a 10-year period in the Coronary Artery Risk Development in Young Adults sample. Design: Participants (N = 2,738) completed measures of childhood family environment, parental education, health behavior, and adult negative emotionality. Main Outcome Measures: These variables were used to predict initial systolic and diastolic blood pressure (SBP and DBP, respectively) and the rate of blood pressure change over 10 years. Results: Structural equation modeling indicated that family environment was related to negative emotions, which in turn predicted baseline DBP and SBP and change in SBP. Parental education directly predicted change in SBP. Although African American participants had higher SBP and DBP and steeper increases over time, multiple group comparisons indicated that the strength of most pathways was similar across race and gender. Conclusion: Low CSES and harsh family environments help to explain variability in cardiovascular risk. Low CSES predicted increased blood pressure over time directly and also indirectly through associations with childhood family environment, negative emotionality, and health behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, change, and psychological health in the 21st century.

The impact of stressful life events on health has been the object of inquiry for decades. Health care professionals have studied how stressful life events may precipitate or contribute to the onset of illness. Traumatic events and experiences can profoundly affect physical and psychological well-being, which in turn may predispose an individual to greater resilience or greater vulnerability to life stresses. Examined herein is the relationship between life stresses--including social stressors, political stressors, and environmental stressors--and the critical health related issues that psychologists need to prepare for in both the science and the practice of psychology over the next decade and during the 21st century. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic stress influences cardiovascular and neuroendocrine responses during acute stress and recovery, especially in men.

This study tests the influence of chronic stress on cardiovascular and neuroendocrine responses to and recovery from acute stressors and whether the effects are gender specific. Sixty-two healthy, middle-aged persons (50% women) performed mental-arithmetic and public-speaking tasks and relaxed thereafter for 1 hr while their cardiovascular and neuroendocrine functions were measured. Participants with higher levels of chronic stress showed lower systolic blood pressure (SBP) and epinephrine (E; men only) and marginally lower levels of norepinephrine (NE) responses to the tasks and showed lower levels of cortisol and marginally lower NE responses during recovery. Relative to women, men had high diastolic blood pressure (DBP) responses to the tasks and high SBP, DBP, and E responses during recovery. Gender differences in cardiovascular disease in midlife may be due to gender differences in inability to recover quickly, in addition to enhanced acute-stress response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discrimination and unfair treatment: Relationship to cardiovascular reactivity among African American and European American women.

This study examined the relationship of cardiovascular reactivity to both interpersonal mistreatment and discrimination in a community-based sample of African American and European American women (N?=?363) in midlife. Subtle mistreatment related positively to diastolic blood pressure (DBP) reactivity for African American participants but not their European American counterparts. Moreover, among the African American participants, those who attributed mistreatment to racial discrimination exhibited greater average DBP reactivity. In particular, these women demonstrated greater DBP reactivity to the speech task, which bore similarities to an encounter with racial prejudice but not to a nonsocial mirror tracing task. These findings are consistent with the hypothesis that racial discrimination is a chronic stressor that can negatively impact the cardiovascular health of African Americans through pathogenic processes associated with physiologic reactivity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiac autonomic reactivity and recovery in predicting carotid atherosclerosis: The cardiovascular risk in young finns study.

The present study examined the association of cardiac autonomic task-induced reactivity and recovery to preclinical atherosclerosis. Thirty-three men and 33 women aged 24-39 years participated in the ongoing epidemiological Cardiovascular Risk in Young Finns study. The authors measured heart rate (HR), respiratory sinus arrhythmia (RSA), and preejection period (PEP) during the mental arithmetic and speech tasks in 1999. Carotid atherosclerosis was assessed by measuring the thickness of the common carotid artery intima-media complex (IMT) with ultrasound in 2001. Higher HR, RSA, and PEP reactivity were associated with lower IMT values even after adjusting for cardiovascular risk factors (lipid levels, obesity, and blood pressure). In addition, better HR recovery after the mental arithmetic task was associated with lower IMT values, and this association persisted after all adjustments. Thus, higher task-induced cardiac autonomic reactivity and better HR recovery were related to less preclinical atherosclerosis. The authors concluded that cardiac pattern of reactivity and quick recovery may be associated with better cardiovascular health, and therefore all reactivity occurring in challenging situations should not automatically be considered as potentially pathological. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological Stress Tasks in the Prediction of Blood Pressure Level and Need for Antihypertensive Medication: 9-12 Years of Follow-Up.

Increased blood pressure (BP) reactivity to subtypes of psychological stimuli may differentially predict the development of future BP elevation or hypertension. The authors present the 9-12-year follow-up results of 82 (86%) of 95 male participants with different BP levels. They were healthy, untreated, and age-matched volunteers from a routine health checkup carried out on all 35-, 40-, and 45-year-olds from a medium-sized city. Intra-arterial systolic blood pressure (SBP) during the psychological tasks improved the prediction of future casual SBP and noninvasive 24-hr ambulatory SBP compared with predictions from casual diagnostic measurements. Diastolic blood pressure (DBP) was very useful when added to casual DBP in predicting the need for antihypertensive medication. Reactivity to active tasks especially predicts the need for antihypertensive medication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflict and collaboration in middle-aged and older couples: II. Cardiovascular reactivity during marital interaction.

Marital strain confers risk of cardiovascular disease (CVD), perhaps though cardiovascular reactivity (CVR) to stressful marital interactions. CVR to marital stressors may differ between middle-age and older adults, and types of marital interactions that evoke CVR may also differ across these age groups, as relationship contexts and stressors differ with age. The authors examined cardiovascular responses to a marital conflict discussion and collaborative problem solving in 300 middle-aged and older married couples. Marital conflict evoked greater increases in blood pressure, cardiac output, and cardiac sympathetic activation than did collaboration. Older couples displayed smaller heart rate responses to conflict than did middle-aged couples but larger blood pressure responses to collaboration—especially in older men. These effects were maintained during a posttask recovery period. Women did not display greater CVR than men on any measure or in either interaction context, though they did display greater parasympathetic withdrawal. CVR to marital conflict could contribute to the association of marital strain with CVD for middle-aged and older men and women, but other age-related marital contexts (e.g., collaboration among older couples) may also contribute to this mechanism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blood lead (Pb) levels: A potential environmental mechanism explaining the relation between socioeconomic status and cardiovascular reactivity in children.

Objective: A number of studies have shown an association between socioeconomic status (SES) and cardiovascular reactivity to acute stress. In addition, the authors recently reported that higher early childhood blood lead (Pb) levels are associated with significantly greater total peripheral (vascular) resistance (TPR) responses to acute stress. It is not known whether the SES-TPR association is mediated by underlying differences in blood lead levels. Design: Participants were 9.5-year-old children (N = 122) with established early childhood blood lead levels. Main Outcome Measures: Family SES was measured using the Hollingshead Index, blood lead levels were abstracted from pediatrician and state records, and children's cardiovascular responses to acute stressors were measured in the laboratory with impedance cardiography and an automated blood pressure monitor. Results: Lower family SES was shown to be associated with significantly higher blood lead levels as well as significantly heightened systolic blood pressure, diastolic blood pressure, and TPR responses to acute stress tasks. A mediational analysis confirmed that Pb was a significant mediator of the SES-TPR reactivity association; some evidence also suggested moderation. Conclusion: These results suggest the importance of considering the chemical environment as well as social and psychological environment when evaluating cardiovascular effects of low SES. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do behavioral responses mediate or moderate the relation between cardiovascular reactivity to stress and parental history of hypertension?

To examine whether differences in behavioral responses to stress mediated or moderated the relation between cardiovascular response to stress and parental history of hypertension, 64 healthy undergraduates--16 men with hypertensive parents (PH+), 16 men without hypertensive parents (PH-), 16 PH+ women, and 16 PH- women--participated in a mental arithmetic task, mirror tracing task, and 2 interpersonal role plays. PH+ participants exhibited higher resting heart rates than PH - participants and higher resting systolic blood pressures (SBPs) than PH- women. PH+ participants exhibited greater SBP responses to tasks and engaged in more negative verbal and nonverbal behavior across tasks than PH- counterparts. Differences in behavioral responding neither mediated nor moderated the observed relation between parental history status and SBP response to stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fibromyalgia: The role of sleep in affect and in negative event reactivity and recovery.

Objective: Fibromyalgia (FM) syndrome is a chronic pain condition characterized by diffuse muscle pain, increased negative mood, and sleep disturbance. Until recently, sleep disturbance in persons with FM has been modeled as the result of the disease process or its associated pain. The current study examined sleep disturbance (i.e., sleep duration and sleep quality) as a predictor of daily affect, stress reactivity, and stress recovery. Design and Measures: A hybrid of daily diary and ecological momentary assessment methodology was used to evaluate the psychosocial functioning of 89 women with FM. Participants recorded numeric ratings of pain, fatigue, and positive and negative affect 3 times throughout the day for 30 consecutive days. At the end of each day, participants completed daily diary records of positive and negative life events. In addition, participants reported on their sleep duration and sleep quality each morning. Results: After accounting for the effects of positive events, negative events, and pain on daily affect scores, it was found that sleep duration and quality were prospectively related to affect and fatigue. Furthermore, the effects of inadequate sleep on negative affect were cumulative. In addition, an inadequate amount of sleep prevented affective recovery from days with a high number of negative events. Conclusions: These results lend support to the hypothesis that sleep is a component of allostatic load and has an upstream role in daily functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults.

Loneliness is a prevalent social problem with serious physiological and health implications. However, much of the research to date is based on cross-sectional data, including our own earlier finding that loneliness was associated with elevated blood pressure (Hawkley, Masi, Berry & Cacioppo, 2006). In this study, we tested the hypothesis that the effect of loneliness accumulates to produce greater increases in systolic blood pressure (SBP) over a 4-year period than are observed in less lonely individuals. A population-based sample of 229 50- to 68-year-old White, Black, and Hispanic men and women in the Chicago Health, Aging, and Social Relations Study was tested annually for each of 5 consecutive years. Cross-lagged panel analyses revealed that loneliness at study onset predicted increases in SBP 2, 3, and 4 years later (B = 0.152, SE = 0.091, p