Blood glucose symptom beliefs of diabetic patients: Accuracy and implications.

Tested the accuracy of blood glucose (BG) symptom beliefs in 16 female and 10 male 16–64 yr old insulin-dependent diabetics. A within-Ss, repeated measures design was used to identify symptoms related to low and high BG levels for individual Ss. At the end of a year, Ss reported which symptoms they believed were related to their own low and high BG levels. Across Ss, the frequency of accurate beliefs (hits and correct rejections) was higher than the frequency of inaccurate beliefs (false alarms and misses). Female Ss' symptom beliefs yielded more hits, as well as more false alarms. Males missed more symptoms, especially low BG symptoms, than females. Symptom belief accuracy was greater if symptom–BG relationships remained stable across time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular and emotional responses in women: The role of hostility and harassment.

The relation of hostility and harassment to cardiovascular and emotional responses was examined by having 51 women (aged 18–26 yrs) high and low in hostility complete a task with or without harassment. Harassed high hostile Ss showed greater systolic blood pressure (SBP) increases during task and recovery periods than did harassed low hostile Ss and nonharassed Ss. Harassed low hostile Ss evidenced greater SBP increases during task and recovery periods than did nonharassed Ss. Among high hostile women, cardiovascular elevations during the task were associated with self-reported levels of negative affect. Antagonistic hostility, relative to neurotic hostility, was positively associated with harassment-induced SBP changes. These results support the hypothesis that hostile people exhibit excessive behaviorally induced cardiovascular responses to interpersonally challenging tasks that evoke anger-related emotional states. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in the relation between interview-derived hostility scores and resting blood pressure

We examined the correlations between Structured Interview (SI)-derived hostility scores and resting blood pressure (BP) to see if they would be the same or different for healthy men and women. Standard risk factor information and resting BP measures were obtained from 193 undergraduates (109 men, 84 women), who underwent the SI. Subjects were rated for Potential for Hostility, Hostile Style, Intensity and Content, and completed Antagonism and Neuroticism scales. As expected, SI hostility scores were related to higher resting SBP in men, however; in women, they were related to lower resting SBP and Neuroticism. Regression analyses controlling for standard CHD risk factors indicated that SI-derived hostility predicted resting SBP and hypertensive status in both men and women, though in opposite directions. Thus, SI-derived hostility may assess a different construct in women than in men.     

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)     

Race differences in stress-induced reactivity in young adults.

Studied the cardiovascular response to the stress of mental arithmetic in 121 young Black and White adults. Stress-induced reactivity was studied before and following 14 days of oral sodium loading (10 gm NaCl per day). Marginal hypertensives, both Black and White, had greater systolic blood pressure (SBP) levels and greater diastolic BP levels in response to stress. Whites had a greater SBP level during mental stress than Blacks and greater reactivity. The prevalence of sodium sensitivity was greater in Blacks (37.3%) than in Whites (18.4%). Sodium loading did not augment the BP reactivity to the mental stress in any of the racial or BP groups. Data demonstrate racial variation in the cardiovascular response to centrally medicated adrenergic stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between mood and blood pressure in the natural environment: An adolescent population.

Examined the relation between psychological variables and blood pressure (BP) as 28 male 13–18 yr olds engaged in their customary activities over 24 hrs. During the ambulatory monitoring, Ss monitored mood state, perceptions of the environment, and ambulatory BP at 30-min intervals. Systolic BP (SBP) reactivity to laboratory stressors was significantly correlated with average SBP in the home environment. Ambulatory SBP was positively associated with worried, hostile, depressed, and tense mood ratings. Ambulatory diastolic BP was correlated with hostile, depressed, and upset mood ratings as well as with hostile perceptions of the environment. In general, average ambulatory BP appeared to be associated with negative emotions and perceptions of the environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diurnal blood pressure patterns in normotensive and hypertensive children and adolescents

As abnormalities in diurnal ambulatory blood pressure (BP) have been associated with hypertensive target organ damage in adults, we investigated the diurnal systolic BP (SBP) and diastolic BP (DBP) patterns of 54 normotensive children, age 13.4 +/- 3.0 years, and 45 untreated borderline and mildly hypertensive children, age 14.4 +/- 2.6 years. Subjects wore the SpaceLabs 90207 ambulatory BP monitor for 24 h. BP was measured q 15 min from 08.00-21.00 h then q 30 min from 21.00-08.00 h. Nocturnal BP fall, the night-day ratio and cusum derived measures were calculated from time-weighted daytime and night-time SBP and DBP. The groups were compared using analysis of covariance with adjustment for age, race, gender and body mass index. The influence of age, gender and race on the diurnal BP profile was also examined. Nocturnal SBP fall was greater in hypertensive compared to normotensive subjects (17.1 +/- 6.7 vs 14.6 +/- 7.1 mm Hg; unadjusted mean +/- s.d., P = 0.022). Normotensive and hypertensive groups did not differ in nocturnal DBP fall or SBP or DBP night-day ratio. Race appeared to influence the diurnal BP pattern as black subjects had less nocturnal SBP fall (12.9 +/- 6.9 vs 17.1 +/- 6.5 mm Hg; P < 0.005) and a higher night-day SBP ratio (90.1 +/- 5.3 vs 86.7 +/- 4.6%; P < 0.005) than white subjects. In conclusion, hypertensive children and adolescents have a similar diurnal BP pattern as their normotensive counterparts, except that the entire BP profile is shifted upward with a greater absolute fall in SBP at night. Race also appears to influence the diurnal BP profile of normotensive and hypertensive children and adolescents.     

Behavioral predictors of blood pressure variation in hypertensives and normotensives.

Examined the relative impact of activity, posture, location, social involvement, and tension on the 24-hr blood pressure (BP) variability of 21 normotensives, 18 borderline hypertensives, and 18 sustained essential hypertensives. Within each diagnostic group, activity accounted for more variance in BP variability than any other behavioral dimension. For each behavioral dimension, the magnitude of the relationship with BP was greater for the normotensives than for both hypertensive groups. Variation due to individuals was a better predictor of BP variability for the 2 hypertensive groups than for the normotensive group. (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)     

Caffeine enhances the physiological response to occupational stress in medical students.

Tested caffeine (3.3 mg/kg) against a placebo in 20 male medical students (aged 19–31 yrs) during periods of low (no exams) vs high (final exams) work stress. On each of 8 test days, heart rate and blood pressure were measured at baseline and over a 40-min postdrug interval; immediately afterward, blood was drawn to test plasma cortisol and serum lipid concentrations. Exams increased heart rate and systolic blood pressure. Caffeine decreased heart rate and increased systolic blood pressure, diastolic blood pressure, plasma cortisol levels, and serum cholesterol levels. Caffeine effects were additive with those of exams, and together they increased the number of Ss showing systolic blood pressures in the borderline hypertensive range. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intra-arterial blood pressure and heart rate reactivity to behavioral stress in normotensive, borderline, and mild hypertensive men

Intra-arterial blood pressure (BP) stress reactivity was studied in newly detected, World Health Organization-classified (1978), age-matched normotensive (NT; n = 33), borderline hypertensive (BHT; n = 30), and hypertensive (HT; n = 32) men recruited through routine health examinations. They underwent a relaxation baseline followed by 8 standardized behavioral challenges. BHT and HT men displayed exaggerated BP reactivity compared with NT men, particularly on perceptual-motor and social tasks, and HT men showed higher reactivity than NT men in the cold pressor test. These results are the first to show reactivity differences between NT men and BHT or HT men in an intra-arterial experiment. Diastolic BP (DBP) discriminated the groups better than systolic BP (SBP) or heart rate (HR). The few differences in SBP compared with DBP among the groups combined with hardly any differences in HR indicate the predominance of vascular factors in middle-aged as opposed to younger men with borderline or mild hypertension.     

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)     

Code Stroke: rapid transport, triage and treatment using rt-PA therapy. The NINDS rt-PA Stroke Study Group

In view of the concern regarding the potential risks and benefits of sodium restriction, the effect on biochemical and orthostatic responses from a moderate reduction in sodium intake in elderly persons that is sufficient to lower systolic blood pressure (SBP) was examined. Seventeen hypertensive subjects aged 65-79 years entered a double-blind randomized placebo controlled cross-over trial of a low sodium diet plus placebo tablets vs a low sodium diet plus sodium tablets (80 mmols/day) each for 5 weeks. At the end of high and low sodium periods, two 24-h urine collections and venous blood samples were undertaken and supine and standing BPs were recorded. On the low compared to the high sodium phase (urinary sodium excretion 95 +/- 36 vs 174 +/- 40 mmols/24-h, respectively), clinic supine SBP fell by 8 mm Hg (95% CI: 1-15 mm Hg, P< 0.05) and diastolic BP (DBP) by 1 mm Hg (CI: -3 to 5 mm Hg); there was no change in total LDL- and HDL-cholesterol and triglyceride levels, serum calcium, phosphate, parathyroid hormone, glucose, creatinine clearance or urinary albumin excretion rate. Serum urate was significantly higher during the low compared to high sodium intake (304 +/- 56 vs 277 +/- 44 micromols/l). Orthostatic BP responses during the high and low sodium intakes were unchanged. In summary, after 5 weeks of moderate sodium restriction no adverse effects other than an increase in serum urate was seen in elderly hypertensive persons.     

Mood changes associated with blood glucose fluctuations in insulin-dependent diabetes mellitus.

Examined relationships between blood glucose (BG) levels and self-reported mood in 34 19–68 yr old insulin-independent diabetes mellitus patients. Four times each day, Ss completed a mood/symptom checklist before a self-measurement of BG until 40 checklists had been completed. Half the items of the checklist described physical symptoms, and half described mood states. Within-S correlations and regressions showed that moods were related to BG for the majority of Ss and that, like physical symptoms, mood–BG relationships were idiosyncratic. Low BG levels were associated with negative mood states; positive mood items were almost always associated with high BG. High BG levels also frequently correlated with negative mood states, although the negative mood items that related to high glucose (anger, sadness) differed from those that tended to relate to low BG. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual behavior in pigeons: Categories, subcategories, and pseudocategories.

In 3 experiments with a total of 16 Ss, we explored how pigeons learn to classify diverse pictures of cats, flowers, cars, and chairs and later how they accurately categorize brand-new pictures from these classes. Using a 4-key forced-choice procedure, Ss in Exp 1 discriminated individual examples within each of the categories from one another (subcategory training); nevertheless, errors were disproportionately conceptual in nature, with Ss more likely to confuse examples within a given category than between different categories. Ss in Exp 2 trained to classify pictures into human language categories (category training) learned far faster and more completely than Ss trained to sort the same pictures into totally arbitrary groupings (pseudocategory training). Finally, in Exp 3, category-trained and subcategory-trained Ss were tested on normally oriented pictures, on left–right reversals, and on top–bottom reversals. Subcategory-trained Ss responded less accurately on both kinds of reversed pictures and less accurately on top–bottom than on left–right reversals; category-trained Ss were less affected by both types of picture reversals, only top–bottom reversals decrementing their performance. Results suggest that many words in our language denote clusters of related visual stimuli, which pigeons also see as highly similar. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness representations and matching labels with symptoms.

Conducted 3 studies with 251 undergraduates in which Ss were presented with health-relevant information (e.g., blood pressure [BP] or symptoms). Study 1 showed that informing Ss that their BP was elevated affected 2 attributes of illness representation: identity (label and symptoms), and time line or expected chronology of the health threat. In Study 2, Ss used environmental cues to interpret whether familiar, unfamiliar, and ambiguous symptoms were due to illness or to stress. Study 3 showed that the constructive process, initiated by a high-BP reading, is directed by prior beliefs about the time line for developing high BP and by the presence of external cues about the stressfulness of daily life. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Postexercise decrease in arterial blood pressure, total peripheral resistance and in circulatory responses to brief hyperoxia in subjects with mild essential hypertension

The objective of our study was: (1) to compare the influence of moderate exercise on circulatory after-response in mildly hypertensive (n = 8) and normotensive male subjects (n = 9); (2) to examine the circulatory response to 3-min hyperoxic inactivation of arterial chemoreceptors at rest and during postexercise period in both groups. Hypertensive men (HTS) with a systolic blood pressure (SBP) 148 +/- 5 mm Hg, diastolic blood pressure (DBP) 92.4 +/- 4 mm Hg; and normotensive men (NTS), with a SBP 126 +/- 3 mm Hg, DBP 75.6 +/- 1.3 mm Hg, were submitted to 20-min of moderate exercise on a cycloergometer (up to the level of 55% of each subject's resting heart rate reserve). Finger arterial BP was recorded continuously with Finapres, impedance reography was used for recording stroke volume, cardiac output and arm blood flow. In HTS a significant decrease in SBP by 14.5 +/- 3.4 mm Hg, DBP by 8.9 +/- 1.9 mm Hg, total peripheral resistance (TPR) by 0.45 +/- 0.05 TPR u. (33.7 +/- 2.7%), and in arm vascular resistance (AVR) by 11.0 +/- 2.7 PRU u. (35.6 +/- 7%), was observed over a 60-min postexercise period. NTS exhibited insignificant changes in SBP, DBP, AVR except a significant decrease in TPR limited only to 20-min postexercise period. Hyperoxia decreased SBP, DBP and TPR in HTS. This effect was significantly attenuated during the postexercise period. Long-lasting antihypertensive effect of a single dynamic exercise in HTS suggests that moderate exercise may be applied as an effective physiological procedure to reduce elevated arterial BP in mild hypertension. We suggest also that the attenuation of the sympathoexcitatory arterial chemoreceptor reflex may contribute to a postexercise decrease in arterial BP and in TPR in mildly hypertensive subjects.     

Acquisition of conditional associations and operant delayed spatial response alternation: Effects of lesions in the medial prefrontal cortex.

8 male rats received bilateral lesions of the medial prefrontal cortex, another 8 rats were control operated. Three weeks after surgery, they were exposed to an autoshaping procedure in which the insertion of a lever into the experimental chamber (conditioned stimulus) always preceded the delivery of a response-independent food pellet (unconditioned stimulus). Ss with lesions acquired this conditional association faster than control. Ss as evidenced by the fact that they were more likely than control Ss to contact the conditioned stimulus at higher rates. Locomotor activity, observed in a standard open-field preceding autoshaping sessions, decreased for both groups of Ss with repeated exposure to the open-field, whereas differences between groups were not observed. Ss were also exposed to an operant delayed spatial response alternation procedure in which they were required to alternate responding between two levers that were inserted into the experimental chamber after delay intervals of either 5, 10, or 20 s had elapsed. Alternation response accuracy of Ss with lesions and control Ss decreased as a function of the duration of the delay interval, but control-operated Ss responded more accurately at each interval duration. Response accuracy increased with prolonged training for both groups of Ss, but faster for control than for Ss with lesions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)