Objective: This study addressed the issue of whether frequent exposure to life events is associated with aggravation or blunting of cardiovascular reactions to acute mental stress. Methods: In a substantial cohort of 585 healthy young... more
Objective: This study addressed the issue of whether frequent exposure to life events is associated with aggravation or blunting of cardiovascular reactions to acute mental stress. Methods: In a substantial cohort of 585 healthy young adults, systolic and diastolic blood pressure and pulse rate were recorded at rest and in response to a mental arithmetic stress task. Participants indicated, from a list of 50 events, those they had experienced in the last year. Results: There was an overall association between life events and blunted cardiovascular reactivity that was driven by variations in the frequency of exposure to desirable events. The total number of events and the number of personal events were negatively associated with systolic blood pressure and pulse rate reactions to acute stress, whereas the number of work-related events was negatively associated with diastolic blood pressure and pulse rate reactivity. The negative association between total events and systolic blood pressure reactivity was stronger for women than men, whereas men exposed to frequent undesirable events showed enhanced diastolic blood pressure reactivity. The blunting of pulse rate reactivity associated with frequent personal life events was evident particularly for those who had a relatively large number of close friends. Conclusion: The nature and extent of the association between life events exposure and stress reactivity in young adults depends on the valence of the events together with the sex of the individual and their social network size.
The presence of supportive others has been associated with attenuated cardiovascular reactivity in the laboratory. The effects of the presence of a spouse and others in a more naturalistic setting have received little attention. Blood... more
The presence of supportive others has been associated with attenuated cardiovascular reactivity in the laboratory. The effects of the presence of a spouse and others in a more naturalistic setting have received little attention. Blood pressure and heart rate reactions to mental stress were recorded at home in 1028 married/partnered individuals. For 112 participants, their spouse/partner was present; for 78, at least one other person was present. Women tested with a spouse/partner present showed lower magnitude systolic blood pressure and heart rate reactivity than those tested without. Individuals tested with at least one nonspousal other present also displayed attenuated reactivity. This extends the results of laboratory studies and indicates that the spontaneous presence of others is associated with a reduction in cardiovascular reactivity in an everyday environment; spouse/partner presence would appear to be especially effective for women.
The relationship between cardiovascular reactions to acute mental challenge in the laboratory and cognitive ability has received scant attention. The present study examined the association between reactivity and future cognitive ability.... more
The relationship between cardiovascular reactions to acute mental challenge in the laboratory and cognitive ability has received scant attention. The present study examined the association between reactivity and future cognitive ability. Heart rate and blood pressure reactions to a mental stress task were measured in 1647 participants comprising three distinct age cohorts. Cognitive ability was assessed using the Alice Heim-4 test of general intelligence and choice reaction time 5 and 12 years later. High heart rate reactivity was related to higher general intelligence scores and faster choice reaction times at both follow-ups. High heart rate reactivity was also associated with a smaller decline in cognitive ability between assessments. These associations were still evident following adjustment for a wide range of potentially confounding variables. The present results are consistent with the notion that high reactivity may not always be a maladaptive response and that low or blunted reactivity may also have negative corollaries.
Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in... more
Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95% CI = 0.73-0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality.
Recent versions of the reactivity hypothesis, which consider it to be the product of stress exposure and exaggerated hemodynamic reactions to stress that confers cardiovascular disease risk, assume that reactivity is independent of the... more
Recent versions of the reactivity hypothesis, which consider it to be the product of stress exposure and exaggerated hemodynamic reactions to stress that confers cardiovascular disease risk, assume that reactivity is independent of the experience of stressful life events. This assumption was tested in two substantial cohorts, one middle-aged and one elderly. Participants had to indicate from a list of major stressful life events up to six they had experienced in the previous 2 years. They were also asked to rate how disruptive and stressful they were, at the time of occurrence and now. Blood pressure and pulse rate were measured at rest and in response to acute mental stress. Those who rated the events as highly disruptive at the time of exposure and now exhibited blunted systolic blood pressure reactions to acute stress. The present results suggest that acute stress reactivity may not be independent of stressful life events experience.
Exaggerated cardiovascular reactions to acute psychological stress may be involved in the etiology of cardiovascular pathology. The present analysis examined the association between the magnitude of systolic and diastolic blood pressure... more
Exaggerated cardiovascular reactions to acute psychological stress may be involved in the etiology of cardiovascular pathology. The present analysis examined the association between the magnitude of systolic and diastolic blood pressure reactions to stress and cardiovascular disease mortality. Participants were 431 (229 women) from the West of Scotland Twenty-07 Study, aged 63 years at the time of stress testing, where blood pressure was measured during resting baseline and mental arithmetic stress. Participants' vital status was tracked for the next 16 years, during which time 38 had died of cardiovascular disease. Both systolic and diastolic blood pressure reactions were positively associated with cardio-vascular disease mortality. This association could reflect the long-term erosive effects of exaggerated reactivity on the vasculature as well as its short-term capacity to trigger acute cardiovascular events.
Depression and exaggerated cardiovascular reactivity are considered risk factors for cardiovascular disease, possibly as a result of common antecedents, such as altered autonomic nervous system function. We examined the association... more
Depression and exaggerated cardiovascular reactivity are considered risk factors for cardiovascular disease, possibly as a result of common antecedents, such as altered autonomic nervous system function. We examined the association between depressive symptomatology and cardiovascular reactions to psychological stress in 1608 adults (875 women) comprising 3 distinct age cohorts: 24-, 44-, and 63-year olds. Depression was assessed using the Hospital Anxiety and Depression Scale. Blood pressure and heart rate were measured at baseline and during the paced auditory serial arithmetic test. Depression scores were negatively associated with systolic blood pressure and heart rate reactions, after adjustment for likely confounders such as sex, cohort, occupational status, body mass index, stress task performance score, baseline cardiovascular activity, antidepressant, and antihypertensive medication. The direction of association was opposite to that which would be expected if excessive reactivity were to mediate the association between depression and cardiovascular disease outcomes or if they shared common antecedents. #
Few studies have explored the relationship between individual and combined multiple indicators of socioeconomic status across the life course and the metabolic syndrome, or attempted to understand the mechanisms underlying any... more
Few studies have explored the relationship between individual and combined multiple indicators of socioeconomic status across the life course and the metabolic syndrome, or attempted to understand the mechanisms underlying any associations. The present study examined the associations between 4 indicators of socioeconomic status, individually and in combination, and metabolic syndrome risk in a study of male US veterans and examined the influence of health behaviors, intelligence, and psychologic distress on these associations. Participants (N = 4253) were drawn from the Vietnam Experience Study. From military service files, telephone interviews, and a medical examination, occupational, sociodemographic, health behavior, intelligence, psychologic, and health data were collected. The 4 indices of socioeconomic status were as follows: education achieved, early adulthood income, household income in midlife, and occupational prestige in midlife. Metabolic syndrome was diagnosed from the following: body mass index, fasting blood glucose or a diagnosis of diabetes, blood pressure-a diagnosis of hypertension or taking antihypertensives, high-density lipoprotein cholesterol, and triglyceride levels. In models that adjusted for age, men in the lower 2 groups on the combined measure of socioeconomic status experienced a higher risk of metabolic syndrome. This association was accounted for mainly by education achieved, household income in midlife, and occupational prestige in midlife. Intelligence appeared to explain much of this association. Combined socioeconomic status measures across the life course were related to metabolic syndrome but in a threshold rather than dose-response manner. Intelligence appeared to mediate this relationship.
Objectives: The aim of these analyses was to examine the association of cortisol, dehydroepi-androsterone sulphate (DHEAS), and the cortisol:DHEAS ratio with the diagnoses of major depressive disorder (MDD), generalised anxiety disorder... more
Objectives: The aim of these analyses was to examine the association of cortisol, dehydroepi-androsterone sulphate (DHEAS), and the cortisol:DHEAS ratio with the diagnoses of major depressive disorder (MDD), generalised anxiety disorder (GAD), and their comorbidity. Design: This was a cross-sectional study. Methods: Participants were 4256 Vietnam era US army veterans. From military service files, telephone interviews, and a medical examination, occupational, socio-demographic, and health data were collected. One-year prevalence of MDD and GAD was determined through a diagnostic interview schedule based on the DSM-IV criteria. Contemporary morning fasted cortisol and DHEAS concentrations were determined. Analyses of covariance were run, first with adjustment for age and then additionally adjusting for a range of candidate confounders. Results: In fully adjusted analyses, there was evidence of lower basal cortisol levels in individuals with MDD and co-morbid MDD and GAD than those with GAD alone or no diagnosis. Conclusion: This suggests that MDD and its comorbidity can also be characterised by low as well as high cortisol levels. A profitable line of future research might be to examine cortisol and DHEAS levels in more representative samples including older participants and women with and without MDD, GAD, and other psychiatric diagnoses. #
Introduction The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in... more
Introduction The EXERDIET-HTA study was a multi-arm parallel, a randomized, single-blind controlled experimental trial comparing the effects of 16 weeks of different aerobic exercise programs two days per week, and dietary intervention in a hypertensive, overweight/obese and non-physically active population. Aim To evaluate the influence of diet and aerobic exercise program intervention on cardiovascular risk (CVR) factors and predicted CVR and vascular age (VA) profiles in overweight/obese people with primary hypertension (HTN), and to analyze the potential sex differences in the ability to predict VA and CVR via different methods. Methods The CVR and VA determined (n = 167, 53.7 ± 7.8 years) using the Framingham Risk Score (FRS) and the new equation for the prediction of 10-year atherosclerotic cardiovascular disease (ASCVD) risk, before and after the 16-week intervention period (different aerobic exercise programs + hypocaloric diet). The sex-specific risk factors considered were age, high-density lipoprotein cholesterol (HDL-C), total cholesterol, systolic blood pressure (SBP), diabetes mellitus (DM) and smoking status. Results From baseline to follow-up, participants reduced (p ≤ 0.001) FRS-CVR score and VA, and SBP. Total cholesterol decreased significantly, but specifically in men (p ≤ 0.001), and antihypertensive medication (%) in women (p = 0.047). No significant differences over time were observed for HDL-C, smoking, DM overall for either sex. For ASCVD-CVR there was no overall change or for either sex. After the intervention, women had a lower CVR score than men (p ≤ 0.001), irrespective of the calculation method. Conclusions The improvement in CVR factors after 16-week lifestyle changes reduced the risk of suffering a cardiovascular event in overweight/obese adults with HTN through the FRS estimation tool, but not with the ASCVD score. The risk score algorithms could underestimate CVR in women. In contrast, VA could be a useful and easier tool in the management of individuals with CVR factors.