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Oddo VM, Mabrouk S, Andrea SB, Ahonen EQ, Winkler MR, Vignola EF, Hajat A. The association between precarious employment and stress among working aged individuals in the United States. Prev Med 2024; 187:108123. [PMID: 39216552 PMCID: PMC11700481 DOI: 10.1016/j.ypmed.2024.108123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Precarious employment is a plausible stressor, which may adversely affect health. We investigated the association between multidimensional precarious employment and perceived and biological stress in the U.S. METHODS We used data from waves 4 (2008-2009) and 5 (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health. Eight indicators were mapped to five dimensions of precarious employment to create a continuous score (PES, range: 0-5): material rewards, working-time arrangements, stability, workers' rights, and interpersonal relationships. Perceived stress was constructed from the four-item Cohen's perceived stress score (PSS; range: 0-16; wave 4). We measured biological stress in waves 4 and 5 via C-reactive protein (CRP). Given variability in CRP collection between waves, we treated wave 4 and 5 as cross-sectional. We employed adjusted linear regression models to estimate whether the PES was associated with the PSS in wave 4 (n = 11,510) and CRP in waves 4 (n = 10,343) and 5 (n = 3452). RESULT Individuals were aged 28 and 37 years on average in wave 4 and 5, respectively. Half were female and most identified as non-Hispanic (NH)-White (∼73 %), followed by NH-Black (∼14 %), Hispanic (∼9 %) and NH-other (∼4 %). Average PES was inversely related to education. The PSS averaged 8.1 (Interquartile Range [IQR] = 7.0,9.0). Average CRP was 4.4 mg/L (IQR = 0.8,5.0) in wave 4 and 3.6 mg/L (IQR = 0.8,4.2) in wave 5. The PES was associated with perceived stress (β=0.06; 95 % CI = 0.01,0.10) and CRP in wave 5 (β=0.34; 95 % CI = 0.07,0.62). CONCLUSIONS Given the deleterious effects of stress on health, policies to reduce precarious employment warrant consideration.
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Affiliation(s)
- Vanessa M Oddo
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
| | - Sherif Mabrouk
- Department of Economics, College of Liberal Arts and Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Sarah B Andrea
- School of Public Health, Oregon Health and Sciences University-Portland State University, Portland, OR, USA
| | - Emily Q Ahonen
- Division of Occupational and Environmental Health, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Megan R Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Emilia F Vignola
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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2
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von Känel R. Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration. Semin Thromb Hemost 2024. [PMID: 38914118 DOI: 10.1055/s-0044-1787660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
By integrating findings from comprehensive reviews, meta-analyses, and cutting-edge genetic studies, this article illuminates the significance of stress-induced hypercoagulability in clinical medicine. In particular, the findings from numerous prospective cohort studies indicate that stress and hemostatic factors of a hypercoagulable state are associated with increased incident risk and poor prognosis for atherosclerotic cardiovascular disease and venous thromboembolism. Mendelian randomization studies suggest that these associations are partially causal. The review synthesizes extensive research on the link between acute and chronic stress and hypercoagulability, outlining a potential pathway from stress to thrombosis risk. Consistent with the allostatic load concept, acute stress-induced hypercoagulability, initially adaptive, can turn maladaptive under chronic stress or excessive acute stress, leading to arterial or venous thrombotic events. Individuals with predisposing factors, including atherosclerosis, thrombophilia, or immobilization, may exhibit an increased risk of thrombotic disease during stress. Contextual sociodemographic characteristics, the stress experience, and coping resources additionally modulate the extent of stress-induced hypercoagulability. Research into the neuroendocrine, cellular, and molecular bases reveals how stress influences platelet activation coagulation and fibrinolysis. The activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, along with vagal withdrawal, and the effects of catecholamines, cortisol, and vasopressin, are the central mechanisms involved. Hemoconcentration, inflammation, endothelial dysfunction, and thrombopoiesis additionally contribute to stress-induced hypercoagulability. Further research is needed to prove a causal link between chronic stress and hypercoagulability. This includes exploring its implications for the prevention and management of thrombotic diseases in stressed individuals, with a focus on developing effective psychosocial and pharmacological interventions.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Miller NE, Steptoe A. Pericardial Fat, Socioeconomic Status, and Biological Responses to Acute Mental Stress. Psychosom Med 2023; 85:280-288. [PMID: 36705572 PMCID: PMC10082067 DOI: 10.1097/psy.0000000000001169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 11/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Central adiposity is associated with impaired biological responses to mental stress, and socioeconomic status (SES) might moderate this relationship. However, evidence for associations between pericardial fat, a fat depot implicated in the pathogenesis of cardiovascular disease (CVD), with cardiovascular and inflammatory responses to mental stress is lacking, and moderation by SES is unknown. METHODS The sample was 473 healthy men and women (mean age = 62.8 years) from the Whitehall II study. Cardiovascular and inflammatory responses to laboratory-induced mental stress, consisting of a 5-minute Stroop task and 5-minute mirror tracing task, were assessed. Pericardial fat volume was measured using electron bean computed tomography and adjusted for body surface area. SES was defined by grade of employment within the British civil service (higher/intermediate/lower). RESULTS Pericardial fat was associated with lower heart rate variability, raised heart rate, plasma interleukin-6, fibrinogen, and C-reactive protein at baseline. Furthermore, greater pericardial fat was associated with lower systolic blood pressure reactivity to mental stress, independent of sociodemographics, smoking status, waist-to-hip ratio, and baseline systolic blood pressure. There were no interactions between pericardial fat and SES for any outcome. CONCLUSIONS Greater pericardial fat was associated with numerous cardiovascular and inflammatory factors implicated in CVD. It was also related to reduced systolic blood pressure reactivity to acute mental stress, independent of central adiposity and baseline systolic blood pressure. This association did not vary by SES. Reduced systolic blood pressure reactivity to mental stress might contribute to the association between greater pericardial fat and CVD.
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Shade RD, Ross JA, Van Bockstaele EJ. Targeting the cannabinoid system to counteract the deleterious effects of stress in Alzheimer’s disease. Front Aging Neurosci 2022; 14:949361. [PMID: 36268196 PMCID: PMC9577232 DOI: 10.3389/fnagi.2022.949361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
Alzheimer’s disease is a progressive neurodegenerative disorder characterized histologically in postmortem human brains by the presence of dense protein accumulations known as amyloid plaques and tau tangles. Plaques and tangles develop over decades of aberrant protein processing, post-translational modification, and misfolding throughout an individual’s lifetime. We present a foundation of evidence from the literature that suggests chronic stress is associated with increased disease severity in Alzheimer’s patient populations. Taken together with preclinical evidence that chronic stress signaling can precipitate cellular distress, we argue that chronic psychological stress renders select circuits more vulnerable to amyloid- and tau- related abnormalities. We discuss the ongoing investigation of systemic and cellular processes that maintain the integrity of protein homeostasis in health and in degenerative conditions such as Alzheimer’s disease that have revealed multiple potential therapeutic avenues. For example, the endogenous cannabinoid system traverses the central and peripheral neural systems while simultaneously exerting anti-inflammatory influence over the immune response in the brain and throughout the body. Moreover, the cannabinoid system converges on several stress-integrative neuronal circuits and critical regions of the hypothalamic-pituitary-adrenal axis, with the capacity to dampen responses to psychological and cellular stress. Targeting the cannabinoid system by influencing endogenous processes or exogenously stimulating cannabinoid receptors with natural or synthetic cannabis compounds has been identified as a promising route for Alzheimer’s Disease intervention. We build on our foundational framework focusing on the significance of chronic psychological and cellular stress on the development of Alzheimer’s neuropathology by integrating literature on cannabinoid function and dysfunction within Alzheimer’s Disease and conclude with remarks on optimal strategies for treatment potential.
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Affiliation(s)
- Ronnie D. Shade
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Jennifer A. Ross
- Department of Pharmacology and Physiology, College of Medicine, Drexel University, Philadelphia, PA, United States
- *Correspondence: Jennifer A. Ross,
| | - Elisabeth J. Van Bockstaele
- Department of Pharmacology and Physiology, College of Medicine, Drexel University, Philadelphia, PA, United States
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Rejer I, Wacewicz D, Schab M, Romanowski B, Łukasiewicz K, Maciaszczyk M. Stressors Length and the Habituation Effect-An EEG Study. SENSORS (BASEL, SWITZERLAND) 2022; 22:6862. [PMID: 36146211 PMCID: PMC9505843 DOI: 10.3390/s22186862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
The research described in this paper aimed to determine whether people respond differently to short and long stimuli and whether stress stimuli repeated over time evoke a habituation effect. To meet this goal, we performed a cognitive experiment with eight subjects. During this experiment, the subjects were presented with two trays of stress-inducing stimuli (different in length) interlaced with the main tasks. The mean beta power calculated from the EEG signal recorded from the two prefrontal electrodes (Fp1 and Fp2) was used as a stress index. The main results are as follows: (i) we confirmed the previous finding that beta power assessed from the EEG signal recorded from prefrontal electrodes is significantly higher for the STRESS condition compared to NON-STRESS condition; (ii) we found a significant difference in beta power between STRESS conditions that differed in length-the beta power was four times higher for short, compared to long, stress-inducing stimuli; (iii) we did not find enough evidence to confirm (or reject) the hypothesis that stress stimuli repeated over time evoke the habituation effect; although the general trends aggregated over subjects and stressors were negative, their slopes were not statistically significant; moreover, there was no agreement among subjects with respect to the slope of individual trends.
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Kennedy E, Niedzwiedz CL. The association of anxiety and stress-related disorders with C-reactive protein (CRP) within UK Biobank. Brain Behav Immun Health 2022; 19:100410. [PMID: 35028602 PMCID: PMC8741412 DOI: 10.1016/j.bbih.2021.100410] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/29/2022] Open
Abstract
Anxiety and stress-related disorders are both common and disabling psychiatric conditions. There are a number of hypotheses suggesting the underlying pathophysiology of these disorders, however, the exact mechanism is unknown. Inflammation has previously been linked with depression and has more recently been suggested as a possible link to anxiety aetiology. The objectives of this study are to assess the relationship between different anxiety/stress-related disorders and inflammation (measured by C-reactive protein) using the UK Biobank, and also determine whether any relationship between anxiety/stress disorders and inflammation is explained by depressive symptoms and other social and health-related factors. We utilised the UK Biobank for the sample of this study. Our sample included 353,136 participants of which 12,759 (3.61%) had a history of an anxiety (phobic, obsessive-compulsive, or other anxiety disorder including generalised anxiety and panic disorders) or stress-related disorder (including acute stress reaction, post-traumatic stress disorder and adjustment disorders). Four logistic regression models were calculated in which we tested the association between anxiety/stress disorders and C-reactive protein (CRP) >3 mg/L, adjusting for covariates (including age, sex, ethnicity, education level, socioeconomic deprivation, depressive symptoms, body mass index (BMI) and multimorbidity). An association was observed between other anxiety disorders (including panic and generalised anxiety disorders) and CRP (OR: 1.164 [95% CI: 1.096–1.236]). This was attenuated in models after the addition of BMI, multimorbidity and depressive symptoms. Stress/adjustment disorders followed a similar pattern of results (OR: 1.107 [95% CI: 1.040, 1.178]), with the association attenuated with the addition of BMI and multimorbidity). Phobic anxiety disorders (OR: 1.059 [95% CI: 0.896, 1.251]) and obsessive-compulsive disorders (OR: 1.299 [95% CI: 0.973, 1.733]) both showed no statistically significant results in any of the models. Our results support the hypothesis that some anxiety and stress-related disorders may be associated with high levels of inflammatory markers, as measured by CRP. Further studies are required to untangle the potential causal relationships involved.
We explored the association of anxiety and stress-related disorders with C-reactive protein (CRP) using UK Biobank. Several disorders (e.g. generalised anxiety, panic and stress/adjustment) were associated with higher levels of CRP. Associations were attenuated with adjustment for health-related factors, such as multimorbidity and depressive symptoms.
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Huang C, Li P, Martin CR. Simplification or simulation: Power calculation in clinical trials. Contemp Clin Trials 2021; 113:106663. [PMID: 34958933 DOI: 10.1016/j.cct.2021.106663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVES A justifiable sample size is essential at trial design stage. Generally this task is completed by forming the main research question into a statistical procedure and then implementing the published formulae or software packages. When these standard statistical formulae/software packages become unavailable for studies with complex statistical procedures, some statisticians choose to fill this gap by assuming an alternative simplified sample size calculation. Monte Carlo simulations can also be deployed, particularly for complex trials. However, it is still unclear on how to determine the appropriate approach under certain practical scenarios. METHODS We adopted real clinical trials as examples and investigated on simplification and simulation-based sample size calculation approaches. RESULTS Compared to simplified sample size calculation, the simulation approach can better address the non-ignorable impact of baseline/follow-up outcome correlation on study power. For studies with multiple endpoints and multiple co-primary endpoints, the sample sizes calculated by simplification approach should be scrutinized. CONCLUSIONS Directly using the simplification approach for sample size calculation should be restricted. We recommend to utilize the simulation approach, particularly for complex trials, at least as a sensitivity checking and a useful triangulation to the simplification approach outlined.
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Affiliation(s)
- Chao Huang
- Hull York Medical School, University of Hull, UK.
| | - Pute Li
- School of Professional Study, New York University, USA
| | - Colin R Martin
- Institute for Health and Wellbeing, University of Suffolk, UK
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Parsons C, Roberts R, Mills NT. Review: Inflammation and anxiety-based disorders in children and adolescents - a systematic review and meta-analysis. Child Adolesc Ment Health 2021; 26:143-156. [PMID: 33200498 DOI: 10.1111/camh.12434] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Anxiety-based disorders are common and are often chronic with an onset during childhood or adolescence. An emerging literature has examined the role of inflammation in these disorders by measuring blood concentrations of inflammatory markers such as cytokines, C-reactive protein (CRP) and immune markers such as white blood cell counts. However, existing results are inconsistent, with available meta-analyses only including adult populations. We believe this is the first systematic review and meta-analysis to investigate these inconsistencies among the population of children and adolescents. METHODS A systematic search of five electronic databases was conducted to identify studies which compared inflammatory markers between individuals with an anxiety-based disorder and healthy controls. Study quality was assessed, and pooled effect sizes (Hedges' g) were calculated using random-effects meta-analyses. RESULTS Nine independent studies were identified. The combined meta-analysis of 16 cytokines and CRP was approaching significance; however, no significant between-group difference was observed for meta-analyses of individual inflammatory or immune markers. Heterogeneity was high, and quality assessments identified important limitations; primarily, small sample sizes and a lack of control over confounding variables. CONCLUSIONS Although no significant effects were observed, the small number of included studies and limitations in study or reporting quality render these findings provisional. Research in this area has the potential for important clinical implications in relation to therapeutic interventions. Important recommendations for further research are put forth.
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Affiliation(s)
- Chelsea Parsons
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Rachel Roberts
- School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Natalie T Mills
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
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Anxiety and depression predispose individuals to an autoimmune bullous diseases- bullous pemphigoid: A large-scale population-based cohort study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01396-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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van Diemen JJK, van Dijk A, Racca C, Knol T, Bonten TN, Numans ME, Fuijkschot WW, Smulders YM, Thijs A. The viewing of a 'Bloodcurdling' horror movie increases platelet reactivity: A randomized cross-over study in healthy volunteers. Thromb Res 2019; 182:27-32. [PMID: 31442695 DOI: 10.1016/j.thromres.2019.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/12/2019] [Accepted: 07/31/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Epidemiological studies have suggested an increased risk of cardiovascular events (CVE) during acute stressful and/or frightful moments. A possible explanation for this could be an effect of acute stress on hemostasis. A recent study demonstrated an increase in factor VIII after watching a horror movie. Primary hemostasis, however, is thought to play a more prominent role in the etiology of CVE. The objective of this study was therefore to assess the influence of viewing a 'bloodcurdling' horror movie on platelet reactivity in healthy volunteers. METHODS We performed a randomized cross-over study in healthy adults. Subjects were allocated to two movies in random sequence: a horror and a control movie. Blood was drawn at baseline and after 24 min of viewing time. The primary endpoint was the change in Platelet Function Analyzer® Closure Time (Δ PFA-CT) after watching the movie. RESULTS In total, 20 participants, aged 18-30 years, completed the study protocol. The delta PFA-CT was statistically significantly shorter with a mean in the delta difference of -9.7 s (SEM 4.0, 95% C.I. -18.0 to -1.3) during the horror movie versus the control movie. The Light Transmission Aggregometry endpoints were in line with the PFA-CT, albeit only the highest level of Arachidonic Acid agonist demonstrated a statistically significant mean difference in the delta of aggregation of 13.15% (SEM 7.0, 95% C.I. 1.6-27.9). CONCLUSION A 'blood curdling' horror movie increases platelet reactivity. These data are supportive of a role of platelet reactivity in acute stress induced cardiovascular event risk.
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Affiliation(s)
- J J K van Diemen
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands.
| | - A van Dijk
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands
| | - C Racca
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands
| | - T Knol
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands
| | - T N Bonten
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - M E Numans
- Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - W W Fuijkschot
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands
| | - Y M Smulders
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands
| | - A Thijs
- Department of Internal Medicine, Amsterdam University Medical Center, Location VU University Medical Center, Amsterdam, the Netherlands
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Steptoe A, Hiltl TJ, Dowd JB, Hamer M. Socioeconomic status and central adiposity as determinants of stress-related biological responses relevant to cardiovascular disease risk. Brain Behav Immun 2019; 77:16-24. [PMID: 30468859 PMCID: PMC6417991 DOI: 10.1016/j.bbi.2018.11.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/14/2018] [Accepted: 11/19/2018] [Indexed: 12/17/2022] Open
Abstract
Stress-related processes have been implicated in the associations between lower socioeconomic status (SES), central adiposity, and cardiovascular disease risk. This study analysed the impact of SES and central adiposity on cardiovascular, inflammatory and neuroendocrine stress responses, and associations with cytomegalovirus (CMV) infection in a sample of 537 men and women aged 53-76 years (mean 62.89 years). SES was defined by grade of employment (higher, intermediate, and lower categories), and central adiposity was indexed by waist-hip ratio (WHR). Cardiovascular, inflammatory and cortisol responses were monitored during administration of a standardized mental stress testing protocol and salivary cortisol was measured repeatedly over the day. Lower SES was associated with raised systolic and diastolic blood pressure (BP), plasma interleukin (IL-6), fibrinogen, C-reactive protein, and salivary cortisol, and a large WHR accentuated SES differences in fibrinogen, C-reactive protein, and likelihood of CMV seropositivity, independently of general adiposity indexed by body mass index. During mental stress testing, return to resting levels (recovery) following behavioural challenge in systolic and diastolic BP and heart rate was impaired among lower SES participants, particularly those with large WHR. Lower SES participants had greater cortisol concentrations across the day, but this pattern did not vary with WHR. These findings extend the evidence relating lower SES to stress-related biological risk factors for cardiovascular disease, and indicate that central adiposity may augment these effects.
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Affiliation(s)
- Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK.
| | - Tanja-Julia Hiltl
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - Jennifer Beam Dowd
- Department of Global Health and Social Medicine, King's College London, London WC2R 2LS, UK
| | - Mark Hamer
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; School of Sport, Exercise and Health Sciences, Loughborough University, Leicestershire LE11 3TU, UK
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Elfassy T, Swift SL, Glymour MM, Calonico S, Jacobs DR, Mayeda ER, Kershaw KN, Kiefe C, Al Hazzouri AZ. Associations of Income Volatility With Incident Cardiovascular Disease and All-Cause Mortality in a US Cohort. Circulation 2019; 139:850-859. [PMID: 30612448 PMCID: PMC6370510 DOI: 10.1161/circulationaha.118.035521] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 09/11/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Income volatility is on the rise and presents a growing public health problem. Because in many epidemiological studies income is measured at a single point in time, the association of long-term income volatility with incident cardiovascular disease (CVD) and mortality has not been adequately explored. The goal of this study was to examine associations of income volatility from 1990 to 2005 with incident CVD and all-cause mortality in the subsequent 10 years. METHODS The Coronary Artery Risk Development in Young Adults Study is an ongoing prospective cohort study conducted within urban field centers in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA. We studied 3937 black and white participants 23 to 35 years of age in 1990 (our study baseline). Income volatility was defined as the intraindividual SD of the percent change in income across 5 assessments from 1990 to 2005. An income drop was defined as a decrease of ≥25% from the previous visit and less than the participant's average income from 1990 to 2005. CVD events (fatal and nonfatal) and all-cause mortality between 2005 and 2015 were adjudicated with the use of medical records and death certificates. CVD included primarily acute events related to heart disease and stroke. RESULTS A total of 106 CVD events and 164 deaths occurred between 2005 and 2015 (incident rate, 2.76 and 3.66 per 1000 person-years, respectively). From Cox models adjusted for sociodemographic, behavioral, and CVD risk factors, higher income volatility and more income drops were associated with greater CVD risk (high versus low volatility: hazard ratio, 2.07; 95% CI, 1.10-3.90; ≥2 versus 0 income drops: hazard ratio, 2.54; 95% CI, 1.24-5.19) and all-cause mortality (high versus low volatility: hazard ratio, 1.78; 95% CI,1.03-3.09; ≥2 versus 0 income drops: hazard ratio, 1.92; 95% CI, 1.07-3.44). CONCLUSIONS In a cohort of relatively young adults, income volatility and drops during a 15-year period of formative earning years were independently associated with a nearly 2-fold risk of CVD and all-cause mortality.
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Affiliation(s)
- Tali Elfassy
- Department of Public Health Sciences, School of Medicine, University of Miami, Miami, FL
| | - Samuel L. Swift
- Department of Public Health Sciences, School of Medicine, University of Miami, Miami, FL
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Sebastian Calonico
- Department of Economics, School of Business, Department of Economics, University of Miami, Miami, FL
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Elizabeth R. Mayeda
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL
| | - Catarina Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Adina Zeki Al Hazzouri
- Department of Public Health Sciences, School of Medicine, University of Miami, Miami, FL
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13
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Communication and social interaction anxiety enhance interleukin-1 beta and cortisol reactivity during high-stakes public speaking. Psychoneuroendocrinology 2018; 94:83-90. [PMID: 29775877 DOI: 10.1016/j.psyneuen.2018.05.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/07/2018] [Accepted: 05/07/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Worry or fear related to speaking in front of others, or more broadly, communicating and interacting with others, is common. At elevated levels, however, it may contribute to heightened stress reactivity during acute speaking challenges. The purpose of this study was to examine multi-system physiological stress reactivity in the context of high-stakes public speaking while considering the impact of hypothesized individual difference risk factors. METHODS University student participants (n = 95) delivering speeches as a heavily-weighted component of their final grade had saliva samples collected immediately prior to speaking, immediately after, and 20 min after speech completion. Saliva samples were assayed for alpha amylase (sAA), cortisol, and interleukin-1 beta (IL-1β). Self-reported communication anxiety, social interaction anxiety, rejection sensitivity, and sex were assessed as risk factors for heightened stress reactivity. RESULTS Salivary sAA, cortisol, and IL-1β significantly changed following speech delivery. Multivariate analyses demonstrated that elevated levels of self-reported communication anxiety and social interaction anxiety were independently associated with increased cortisol and IL-1β responses and combined to enhance HPA axis and inflammatory cytokine activity further (i.e., cortisol and IL-1β AUCI). Sex and rejection sensitivity were unrelated to physiological stress reactivity. CONCLUSIONS These findings suggest that individuals with elevated communication and interaction fears may be at increased risk of heightened neuroendocrine and inflammatory responses following exposure to acute social stressors. Both types of anxiety may combine to increase physiological reactivity further, with unknown, though likely insalubrious, health consequences over time.
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Steptoe A, Kivimäki M, Lowe G, Rumley A, Hamer M. Blood Pressure and Fibrinogen Responses to Mental Stress as Predictors of Incident Hypertension over an 8-Year Period. Ann Behav Med 2017; 50:898-906. [PMID: 27401000 PMCID: PMC5126198 DOI: 10.1007/s12160-016-9817-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Heightened blood pressure (BP) responses to mental stress predict raised BP levels over subsequent years, but evidence for associations with incident hypertension is limited, and the significance of inflammatory responses is uncertain. Purpose We investigated the relationship between BP and plasma fibrinogen responses to stress and incident hypertension over an average 8-year follow-up. Method Participants were 636 men and women (mean age 59.1 years) from the Whitehall II epidemiological cohort with no history of cardiovascular disease and hypertension. They performed standardized behavioral tasks (color/word conflict and mirror tracing), and hypertension was defined by clinic measures and medication status. Results Of participants in the highest systolic BP reactivity tertile, 29.3 % became hypertensive over the follow-up period compared with 16.5 % of those in the lowest tertile, with an odds ratio of 2.02 (95 % CI 1.17–3.88, p = 0.012) after adjustment for age, sex, grade of employment, body mass index, smoking, alcohol consumption, physical activity, follow-up time, subjective stress response, perceived task difficulty, perceived task engagement, and baseline BP. Similar associations were observed for diastolic BP reactivity (odds ratio 2.05, 95 % CI 1.23–3.40, p = 0.006) and for impaired systolic BP post-stress recovery (odds ratio 2.06, 95 % CI 1.19–3.57, p = 0.010). Fibrinogen reactions to tasks also predicted future hypertension in women (odds ratio 2.64, 95 % CI 1.11–6.30, p = 0.029) but not men. Conclusions These data suggest that heightened cardiovascular and inflammatory reactivity to mental stress is associated with hypertension risk, and may be a mechanism through which psychosocial factors impact on the development of hypertension.
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Affiliation(s)
- Andrew Steptoe
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Gordon Lowe
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
| | - Ann Rumley
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
| | - Mark Hamer
- National Centre for Sport & Exercise Medicine, Loughborough University, Loughborough, UK
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15
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Hamer M, Malan NT, Scheepers K, Meiring M, Malan L, Känel RV. Procoagulant reactivity to laboratory acute mental stress in Africans and Caucasians, and its relation to depressive symptoms: The SABPA Study. Thromb Haemost 2017; 110:977-86. [DOI: 10.1160/th13-05-0383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 07/20/2013] [Indexed: 11/05/2022]
Abstract
SummaryThe risk of cardiovascular disease is dramatically increasing in Africans (black). The prothrombotic stress response contributes to atherothrombotic disease and is modulated by depressive symptoms. We examined coagulation reactivity to acute mental stress and its relation to psychological well-being in Africans relative to Caucasians (white). A total of 102 African and 165 Caucasian school teachers underwent the Stroop Color-Word Conflict test. Circulating levels of von Willebrand factor (VWF) antigen, fibrinogen, and D-dimer were measured before and after the Stroop. Cardiovascular reactivity measures were also obtained. All participants completed the Patient Health Questionnaire-9 and the General Health Questionnaire-28 for the assessment of depressive symptoms and total psychological distress, respectively. After controlling for covariates, resting levels of VWF, fibrinogen, and D-dimer were higher in Africans than in Caucasians (all p-values ≤0.006). Depressive symptoms and psychological distress were not significantly associated with resting coagulation measures. Stress reactivity in VWF (p<0.001) and fibrinogen (p=0.016), but not in D-dimer (p=0.27), were decreased in Africans relative to Caucasians with Africans showing greater reactivity of total peripheral resistance (p=0.017). Depressive symptoms, but not general psychological distress, were associated with greater VWF increase (p=0.029) and greater fibrinogen decrease (p=0.030) in Africans relative to Caucasians. In conclusion, Africans showed greater hypercoagulability at rest but diminished procoagulant reactivity to acute mental stress when compared with Caucasians. Ethnic differences in the vascular adrenergic stress response might partially explain this finding. Depressive symptoms were associated with exaggerated VWF reactivity in Africans relative to Caucasians. The clinical implications of these findings for Africans need further study.
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Ó Súilleabháin PS, Howard S, Hughes BM. Openness to experience and adapting to change: Cardiovascular stress habituation to change in acute stress exposure. Psychophysiology 2017; 55:e13023. [PMID: 29044555 DOI: 10.1111/psyp.13023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 08/09/2017] [Accepted: 09/25/2017] [Indexed: 11/29/2022]
Abstract
Underlying psychophysiological mechanisms of effect linking openness to experience to health outcomes, and particularly cardiovascular well-being, are unknown. This study examined the role of openness in the context of cardiovascular responsivity to acute psychological stress. Continuous cardiovascular response data were collected for 74 healthy young female adults across an experimental protocol, including differing counterbalanced acute stressors. Openness was measured via self-report questionnaire. Analysis of covariance revealed openness was associated with systolic blood pressure (SBP; p = .016), and diastolic blood pressure (DBP; p = .036) responsivity across the protocol. Openness was also associated with heart rate (HR) responding to the initial stress exposure (p = .044). Examination of cardiovascular adaptation revealed that higher openness was associated with significant SBP (p = .001), DBP (p = .009), and HR (p = .002) habituation in response to the second differing acute stress exposure. Taken together, the findings suggest persons higher in openness are characterized by an adaptive cardiovascular stress response profile within the context of changing acute stress exposures. This study is also the first to demonstrate individual differences in cardiovascular adaptation across a protocol consisting of differing stress exposures. More broadly, this research also suggests that future research may benefit from conceptualizing an adaptive fitness of openness within the context of change. In summary, the present study provides evidence that higher openness stimulates short-term stress responsivity, while ensuring cardiovascular habituation to change in stress across time.
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Affiliation(s)
| | - Siobhán Howard
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Brian M Hughes
- School of Psychology, National University of Ireland, Galway, Galway, Ireland
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17
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Gibson EL, Held I, Khawnekar D, Rutherford P. Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients. Front Psychol 2016; 7:1864. [PMID: 27965605 PMCID: PMC5126042 DOI: 10.3389/fpsyg.2016.01864] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/10/2016] [Indexed: 02/01/2023] Open
Abstract
Patients with chronic kidney disease (CKD) often require regular hemodialysis (HD) to prolong life. However, between HD sessions, patients have to restrict their diets carefully to avoid excess accumulation of potassium, phosphate, sodium, and fluid, which their diseased kidneys can no longer regulate. Failure to adhere to their renal dietary regimes can be fatal; nevertheless, non-adherence is common, and yet little is known about the psychological variables that might predict this dietary behavior. Thus, this study aimed to assess whether dietary adherence might be affected by a variety of psychological factors including stress, personality, and health locus of control, as well as dietary knowledge, in chronic HD patients. Fifty-one patients (30 men; age range 25-85) who had undergone HD for at least 3 months and had been asked to restrict at least one of potassium, phosphate or fluid, were recruited from a hospital renal unit. Measures of adherence to each of potassium, phosphate, and fluid were derived from standard criteria for these physiological indices in renal patients. Knowledge of food/drink sources of these dietary factors, and their medical implications in relation to HD and CKD were assessed by a bespoke questionnaire. Psychological factors including stress, personality and health locus of control beliefs were measured by standardized questionnaires. Having to restrict a particular nutrient was associated with better knowledge of both food sources and medical complications for that nutrient; however, greater dietary knowledge was not linked to adherence, and knowledge of medical complications tended to be associated with poorer adherence to potassium and phosphate levels. Adherence to these two nutrient requirements was also associated with lower reported stress in the past week. Adherence was associated with differences in locus of control: these differences varied across indices although there was a tendency to believe in external loci. For potassium, phosphate, and fluid restriction, adherers were less likely to be sensation seekers but did not differ from non-adherers on impulsivity, anxiety sensitivity, or hopelessness. In conclusion, the links between dietary adherence and stress, locus of control and personality suggests that screening for such psychological factors may assist in managing adherence in HD patients.
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Affiliation(s)
- E Leigh Gibson
- Department of Psychology, Whitelands College, University of Roehampton London, UK
| | - Ines Held
- Renal Unit, Wrexham Maelor Hospital Wrexham, UK
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Luijcks R, Vossen CJ, Roggeveen S, van Os J, Hermens HJ, Lousberg R. Impact of early life adversity on EMG stress reactivity of the trapezius muscle. Medicine (Baltimore) 2016; 95:e4745. [PMID: 27684800 PMCID: PMC5265893 DOI: 10.1097/md.0000000000004745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Human and animal research indicates that exposure to early life adversity increases stress sensitivity later in life. While behavioral markers of adversity-induced stress sensitivity have been suggested, physiological markers remain to be elucidated. It is known that trapezius muscle activity increases during stressful situations. The present study examined to what degree early life adverse events experienced during early childhood (0-11 years) and adolescence (12-17 years) moderate experimentally induced electromyographic (EMG) stress activity of the trapezius muscles, in an experimental setting. In a general population sample (n = 115), an anticipatory stress effect was generated by presenting a single unpredictable and uncontrollable electrical painful stimulus at t = 3 minutes. Subjects were unaware of the precise moment of stimulus delivery and its intensity level. Linear and nonlinear time courses in EMG activity were modeled using multilevel analysis. The study protocol included 2 experimental sessions (t = 0 and t = 6 months) allowing for examination of reliability.Results show that EMG stress reactivity during the stress paradigm was consistently stronger in people with higher levels of early life adverse events; early childhood adversity had a stronger moderating effect than adolescent adversity. The impact of early life adversity on EMG stress reactivity may represent a reliable facet that can be used in both clinical and nonclinical studies.
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Affiliation(s)
- Rosan Luijcks
- Department of Psychology and Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
- Correspondence: Rosan Luijcks, Vijverdalseweg 1, 6226 NB, Maastricht, The Netherlands (e-mail: )
| | - Catherine J. Vossen
- Department of Psychology and Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Suzanne Roggeveen
- Department of Psychology and Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychology and Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
- King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Hermie J. Hermens
- Roessingh Research and Development
- Telemedicine Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Richel Lousberg
- Department of Psychology and Psychiatry, Maastricht University Medical Centre, Maastricht, The Netherlands
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Do Cardiovascular Responses to Active and Passive Coping Tasks predict Future Blood Pressure over a 10-Month Later? SPANISH JOURNAL OF PSYCHOLOGY 2016; 19:E10. [DOI: 10.1017/sjp.2016.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe study examined whether cardiovascular responses to active or passive coping tasks and single or multiple tasks predicted changes in resting blood pressure (BP) over a ten-month period. Heart rate (HR), BP, cardiac output (CO), and total peripheral resistance (TPR) were measured at rest, and during mental stress tests (mental arithmetic, speech, and cold pressor tasks). A total of 104 eligible participants participated in the initial study, and 77 (74.04%) normotensive adult participants’ resting BP were re-evaluated at ten-month follow-up. Regression analyses indicated that after adjustment for baseline BP, initial age, gender, body mass index, family history of cardiovascular disease, and current cigarette smoking, heighted systolic blood pressure (SBP) and HR responses to an active coping task (mental arithmetic) were associated with increased future SBP (ΔR2 = .060, ΔR2 = .045, respectively). Further, aggregated SBP responsivity (over the three tasks) to the predictor models resulted in significant, but smaller increases in ΔR2 accounting for .040 of the variance of follow-up SBP. These findings suggest that cardiovascular responses to active coping tasks predict future SBP. Further, compared with single tasks, the findings revealed that SBP responses to three tasks were less predictive compared to an individual task (i.e., mental arithmetic). Of importance, hemodynamic reactivity (namely CO and TPR) did not predict future BP suggesting that more general psychophysiological processes (e.g., inflammation, platelet aggregation) may be implicated, or that BP, but not hemodynamic reactivity may be a marker of hypertension.
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20
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Heritability and Temporal Stability of Ambulatory Autonomic Stress Reactivity in Unstructured 24-Hour Recordings. Psychosom Med 2015; 77:870-81. [PMID: 26371521 DOI: 10.1097/psy.0000000000000227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Measurements of ambulatory autonomic reactivity can help with our understanding of the long-term health consequences of exposure to psychosocial stress in real-life settings. METHODS In this study, unstructured 24-hour ambulatory recordings of cardiac parasympathetic and sympathetic control were obtained in 1288 twins and siblings, spanning both work time and leisure time. These data were used to define two ambulatory baseline (sleep, leisure) and four stress conditions (wake, work, work_sitting, work_peak) from which six ambulatory stress reactivity measures were derived. The use of twin families allowed for estimation of heritability and testing for the amplification of existing or emergence of new genetic variance during stress compared with baseline conditions. RESULTS Temporal stability of ambulatory reactivity was assessed in 62 participants and was moderate to high over a 3-year period (0.36 < r < 0.91). Depending on the definition of ambulatory reactivity used, significant heritability was found, ranging from 29% to 40% for heart rate, 34% to 47% for cardiac parasympathetic control (indexed as respiratory sinus arrhythmia), and 10% to 19% for cardiac sympathetic control (indexed as the preejection period). Heritability of ambulatory reactivity was largely due to newly emerging genetic variance during stress compared with periods of rest. Interestingly, reactivity to short standardized stressors was poorly correlated with the ambulatory reactivity measures implying poor laboratory-real-life correspondence. CONCLUSIONS Ambulatory autonomic reactivity extracted from an unstructured real-life setting shows reliable, stable, and heritable individual differences. Real-life situations uncover a new and different genetic variation compared with that seen in resting baseline conditions, including sleep.
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21
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Yuenyongchaiwat K, Sheffield D, Baker I, Maratos F. Hemodynamic responses to active and passive coping tasks and the prediction of future blood pressure in Thai participants: A preliminary prospective cohort study. JAPANESE PSYCHOLOGICAL RESEARCH 2015. [DOI: 10.1111/jpr.12089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Wagner EYN, Wagner JT, Glaus J, Vandeleur CL, Castelao E, Strippoli MPF, Vollenweider P, Preisig M, von Känel R. Evidence for chronic low-grade systemic inflammation in individuals with agoraphobia from a population-based prospective study. PLoS One 2015; 10:e0123757. [PMID: 25875094 PMCID: PMC4395271 DOI: 10.1371/journal.pone.0123757] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 02/16/2015] [Indexed: 01/24/2023] Open
Abstract
Background Anxiety disorders have been linked to an increased risk of incident coronary heart disease in which inflammation plays a key pathogenic role. To date, no studies have looked at the association between proinflammatory markers and agoraphobia. Methods In a random Swiss population sample of 2890 persons (35-67 years, 53% women), we diagnosed a total of 124 individuals (4.3%) with agoraphobia using a validated semi-structured psychiatric interview. We also assessed socioeconomic status, traditional cardiovascular risk factors (i.e., body mass index, hypertension, blood glucose levels, total cholesterol/high-density lipoprotein-cholesterol ratio), and health behaviors (i.e., smoking, alcohol consumption, and physical activity), and other major psychiatric diseases (other anxiety disorders, major depressive disorder, drug dependence) which were treated as covariates in linear regression models. Circulating levels of inflammatory markers, statistically controlled for the baseline demographic and health-related measures, were determined at a mean follow-up of 5.5 ± 0.4 years (range 4.7 – 8.5). Results Individuals with agoraphobia had significantly higher follow-up levels of C-reactive protein (p = 0.007) and tumor-necrosis-factor-α (p = 0.042) as well as lower levels of the cardioprotective marker adiponectin (p = 0.032) than their non-agoraphobic counterparts. Follow-up levels of interleukin (IL)-1β and IL-6 did not significantly differ between the two groups. Conclusions Our results suggest an increase in chronic low-grade inflammation in agoraphobia over time. Such a mechanism might link agoraphobia with an increased risk of atherosclerosis and coronary heart disease, and needs to be tested in longitudinal studies.
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Affiliation(s)
- En-Young N. Wagner
- Division of Psychosomatic Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
- * E-mail:
| | - Jan T. Wagner
- Swissmedic, Division Clinical Review, Bern, Switzerland
| | - Jennifer Glaus
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Caroline L. Vandeleur
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Marie-Pierre F. Strippoli
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Center for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Prilly, Switzerland
| | - Roland von Känel
- Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
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Endrighi R, Hamer M, Hackett RA, Carvalho LA, Jackson SE, Wardle J, Steptoe A. Effect of short-term weight loss on mental stress-induced cardiovascular and pro-inflammatory responses in women. Stress 2015; 18:602-6. [PMID: 26181102 PMCID: PMC4732430 DOI: 10.3109/10253890.2015.1064889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Epidemiologic evidence links psychosocial stress with obesity but experimental studies examining the mechanisms that mediates the effect of stress on adiposity are scarce. The aim of this study was to investigate whether changes in adiposity following minimal weight loss affect heightened stress responses in women, and examine the role of the adipokine leptin in driving inflammatory responses. Twenty-three overweight or obese, but otherwise healthy, women (M age = 30.41 ± 8.0 years; BMI = 31.9 ± 4.1 kg/m(2)) completed standardized acute mental stress before and after a 9-week calorie restriction program designed to modify adiposity levels. Cardiovascular (blood pressure and heart rate) and inflammatory cytokines (leptin and interleukin-6; IL-6) responses to mental stress were assessed several times between baseline and a 45-min post-stress recovery period. There were modest changes in adiposity measures while the adipokine leptin was markedly reduced (-27%) after the intervention. Blood pressure reactivity was attenuated (-3.38 ± 1.39 mmHg) and heart rate recovery was improved (2.07 ± 0.96 Bpm) after weight loss. Blood pressure responses were inversely associated with changes in waist to hip ratio post intervention. Decreased levels of circulating leptin following weight loss were inversely associated with the IL-6 inflammatory response to stress (r = -0.47). We offered preliminary evidence suggesting that modest changes in adiposity following a brief caloric restriction program may yield beneficial effect on cardiovascular stress responses. In addition, reductions in basal leptin activity might be important in blunting pro-inflammatory responses. Large randomized trials of the effect of adiposity on autonomic responses are thus warranted.
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Affiliation(s)
- Romano Endrighi
- Department of Medical and Clinical Psychology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences,
Bethesda,
MD,
USA
- Department of Epidemiology and Public Health (Psychobiology Group)
- Correspondence: Romano Endrighi,
USUHS, Bldg. 28 Rm. 113, 4301 Jones Bridge Rd.,
Bethesda,
MD 20814,
USA. Tel: +1 301 295 1530. Fax: +1 301 295 3034. E-mail: ;
| | - Mark Hamer
- Department of Epidemiology and Public Health (Psychobiology Group)
| | - Ruth A. Hackett
- Department of Epidemiology and Public Health (Psychobiology Group)
| | | | - Sarah E. Jackson
- Department of Epidemiology and Public Health (Health Behavior Research Center), Institute of Epidemiology and Health Care, University College London,
London,
UK
| | - Jane Wardle
- Department of Epidemiology and Public Health (Health Behavior Research Center), Institute of Epidemiology and Health Care, University College London,
London,
UK
| | - Andrew Steptoe
- Department of Epidemiology and Public Health (Psychobiology Group)
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Pereira-Figueiredo I, Carro J, Muñoz LJ, Sancho C, Castellano O, Gómez-Nieto R, López DE. Sex Differences in the Effects of Sertraline and Stressors in Rats Previously Exposed to Restraint Stress. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/jbise.2015.87038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hall MH, Lee L, Matthews KA. Sleep duration during the school week is associated with C-reactive protein risk groups in healthy adolescents. Sleep Med 2014; 16:73-8. [PMID: 25468623 DOI: 10.1016/j.sleep.2014.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 09/09/2014] [Accepted: 10/11/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND The prevalence of short sleep duration in adolescence and the relevance of early risk factors to cardiovascular disease in adulthood suggest that adolescence is an opportune time to evaluate links between sleep duration and cardiovascular disease risk. We examined associations among actigraphy-assessed sleep duration and sleep debt with elevated C-reactive protein (CRP), a known risk factor for cardiovascular disease. METHODS Participants were 244 (56% Black, 48% male) healthy high school students, each of whom wore wrist actigraphs for one week and provided a fasting blood draw. CRP was examined as both a continuous and categorical outcome, with CRP >3 mg/L identifying a High Risk Group. RESULTS Sleep duration and sleep debt were significantly associated with CRP High Risk Group in covariate-adjusted analyses. Shorter sleep duration on school nights was associated with a greater likelihood of being in the High Risk CRP Group. Likelihood of being in the High Risk CRP Group was doubled in students who obtained an average of two or more hours of "catch up" sleep on weekend nights. CONCLUSIONS Reduced weekday sleep duration and sleep debt were both associated with CRP Risk Group in adolescence. That these relationships may be observed prior to the onset of clinical disease suggests that adolescence may provide an opportune period for disease prevention.
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Affiliation(s)
- Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
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Malan L, Hamer M, Frasure-Smith N, Steyn HS, Malan NT. Cohort Profile: Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) prospective cohort study. Int J Epidemiol 2014; 44:1814-22. [PMID: 25344943 PMCID: PMC4689997 DOI: 10.1093/ije/dyu199] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2014] [Indexed: 01/20/2023] Open
Abstract
Adapting to an over-demanding stressful urban environment may exhaust the psychophysiological resources to cope with these demands, and lead to sympathetic nervous system dysfunction. The evidence that an urban-dwelling lifestyle may be detrimental to the cardiometabolic health of Africans motivated the design of the Sympathetic activity and Ambulatory Blood Pressure in African Prospective cohort study. We aimed to determine neural mechanistic pathways involved in emotional distress and vascular remodelling. The baseline sample included 409 teachers representing a bi-ethnic sex cohort from South Africa. The study was conducted in 2008–09 and repeated after 3-year follow-up in 2011–12, with an 87.8% successful follow-up rate. Seasonal changes were avoided and extensive clinical assessments were performed in a well-controlled setting. Data collection included sociodemographics, lifestyle habits, psychosocial battery and genetic analysis, mental stress responses mimicking daily life stress (blood pressure and haemostatic, cardiometabolic, endothelial and stress hormones). Target organ damage was assessed in the brain, heart, kidney, blood vessels and retina. A unique highly phenotyped cohort is presented that can address the role of a hyperactive sympathetic nervous system and neural response pathways contributing to the burden of cardiometabolic diseases in Africans.
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Affiliation(s)
- Leoné Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa,
| | - Mark Hamer
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa, Department of Epidemiology and Public Health, University College London, London, UK
| | - Nancy Frasure-Smith
- Department of Psychiatry and School of Nursing, McGill University, Montreal, QC, Canada, Centre Hospitalier de l'Université de Montréal and Montreal Heart Institute Research Center, Montreal, QC, Canada and
| | - Hendrik S Steyn
- Statistical Consultation Services, North-West University, Potchefstroom Campus, South Africa
| | - Nicolaas T Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom Campus, South Africa
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van den Bos E, Westenberg PM. Two-year stability of individual differences in (para)sympathetic and HPA-axis responses to public speaking in childhood and adolescence. Psychophysiology 2014; 52:316-24. [PMID: 25267560 DOI: 10.1111/psyp.12337] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 08/20/2014] [Indexed: 11/28/2022]
Abstract
Long-term stability of individual differences in stress responses has repeatedly been demonstrated in adults, but few studies have investigated the development of stability in adolescence. The present study was the first to investigate the stability of individual differences in heart rate, parasympathetic (RMSSD, pNN50, HF), sympathetic (LF/HF, SC), and HPA-axis (salivary cortisol) responses in a youth sample (8-19 years). Responses to public speaking were measured twice over 2 years. Stability was moderate for absolute responses and task delta responses of HR, RMSSD, pNN50, and HF. Stability was lower for SC and task delta responses of LF/HF and cortisol. Anticipation delta responses showed low stability for HR and cortisol. The latter was moderated by age or puberty, so that individual differences were more stable in more mature individuals. The results support the suggestion that stress responses may be reset during adolescence, but only for the HPA axis.
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Beatty DL, Matthews KA, Bromberger JT, Brown C. Everyday Discrimination Prospectively Predicts Inflammation Across 7-Years in Racially Diverse Midlife Women: Study of Women's Health Across the Nation. THE JOURNAL OF SOCIAL ISSUES 2014; 70:298-314. [PMID: 25342861 PMCID: PMC4203661 DOI: 10.1111/josi.12061] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Self-reported discrimination has emerged as a predictor of negative psychological and physical health outcomes across racial/ethnic groups. The goals of this study were to determine whether C-reactive protein (CRP), a marker of inflammation and risk factor for future cardiovascular disease (CVD) was independently predicted by everyday discrimination or whether race or body mass index (BMI) modified this association over a 7-year period among 2,490 women from racially diverse backgrounds. At baseline, the 10-item Williams' measure of everyday discrimination was administered. Generalized estimating equations were used to assess these associations. Descriptive results showed that Black and Chinese women reported greater discrimination than White, Japanese, and Hispanic women, while Black and Hispanic women had the highest levels of CRP over the 7-year period. There was no main effect of everyday discrimination (B = .003, SE = .005, p = .58) and this association did not differ as a function of race (p's > .05). The everyday discrimination × BMI interaction term significantly predicted higher CRP levels over time in the full sample of women (p = .03). Specifically, in non-obese women (BMI less than 30), higher perceived everyday discrimination was associated with higher CRP levels over the 7-year period. These findings were independent of demographic, negative affect, biomedical, and behavioral factors. The results demonstrate that greater everyday discrimination is associated with increased inflammation over time in non-obese women. These findings highlight the implications of interpersonal sources of social stress for long-term physical health via their impact on intermediary biological pathways, specifically inflammation. Greater emphasis on such linkages is warranted as we work towards ameliorating health disparities exacerbated by individual-level factors.
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Affiliation(s)
| | - Karen A. Matthews
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA
- University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA
| | - Joyce T. Bromberger
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA
- University of Pittsburgh, Department of Epidemiology, Pittsburgh, PA
| | - Charlotte Brown
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA
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Dragomir AI, Gentile C, Nolan RP, D'Antono B. Three-year stability of cardiovascular and autonomic nervous system responses to psychological stress. Psychophysiology 2014; 51:921-31. [DOI: 10.1111/psyp.12231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 04/09/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Anda I. Dragomir
- Research Center; Montreal Heart Institute; Montreal Quebec Canada
- Psychology Department; Université de Montréal; Montreal Quebec Canada
| | - Christina Gentile
- Research Center; Montreal Heart Institute; Montreal Quebec Canada
- Psychology Department; Université de Montréal; Montreal Quebec Canada
| | - Robert P. Nolan
- Behavioural Cardiology Research Unit; University Health Network; Toronto Ontario Canada
- Faculty of Medicine; University of Toronto; Toronto Ontario Canada
| | - Bianca D'Antono
- Research Center; Montreal Heart Institute; Montreal Quebec Canada
- Psychology Department; Université de Montréal; Montreal Quebec Canada
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30
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Barrington WE, Stafford M, Hamer M, Beresford SAA, Koepsell T, Steptoe A. Neighborhood socioeconomic deprivation, perceived neighborhood factors, and cortisol responses to induced stress among healthy adults. Health Place 2014; 27:120-6. [PMID: 24603009 PMCID: PMC4212220 DOI: 10.1016/j.healthplace.2014.02.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 11/13/2013] [Accepted: 02/03/2014] [Indexed: 11/24/2022]
Abstract
Associations between measures of neighborhood socioeconomic deprivation and health have been identified, yet work is needed to uncover explanatory mechanisms. One hypothesized pathway is through stress, yet the few studies that have evaluated associations between characteristics of deprived neighborhoods and biomarkers of stress are mixed. This study evaluated whether objectively measured neighborhood socioeconomic deprivation and individual perceived neighborhood characteristics (i.e. social control and fear of crime) impacted cortisol responses to an induced stressor among older healthy adults. Data from Heart Scan, a sub-study of the Whitehall II cohort, were used to generate multilevel piecewise growth-curve models of cortisol trajectories after a laboratory stressor accounting for neighborhood and demographic characteristics. Neighborhood socioeconomic deprivation was significantly associated with individual perceptions of social control and fear of crime in the neighborhood while an association with blunted cortisol reactivity was only evidence among women. Social control was significantly associated with greater cortisol reactivity and mediation between neighborhood socioeconomic deprivation and cortisol reactivity was suggested among women. These findings support a gender-dependent role of neighborhood in stress process models of health.
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Affiliation(s)
- Wendy E Barrington
- University of Washington, School of Public Health, Department of Epidemiology, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, USA.
| | - Mai Stafford
- Medical Research Council, Unit for Lifelong Health and Ageing, London, England, UK
| | - Mark Hamer
- University College London, Department of Epidemiology and Public Health, London, England, UK
| | - Shirley A A Beresford
- University of Washington, School of Public Health, Department of Epidemiology, Seattle, WA, USA; Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, USA
| | - Thomas Koepsell
- University of Washington, School of Public Health, Department of Epidemiology, Seattle, WA, USA
| | - Andrew Steptoe
- University College London, Department of Epidemiology and Public Health, London, England, UK
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31
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Pilger A, Haslacher H, Ponocny-Seliger E, Perkmann T, Böhm K, Budinsky A, Girard A, Klien K, Jordakieva G, Pezawas L, Wagner O, Godnic-Cvar J, Winker R. Affective and inflammatory responses among orchestra musicians in performance situation. Brain Behav Immun 2014; 37:23-9. [PMID: 24513877 DOI: 10.1016/j.bbi.2013.10.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 10/08/2013] [Accepted: 10/18/2013] [Indexed: 02/07/2023] Open
Abstract
A number of studies have shown that mental challenge under controlled experimental conditions is associated with elevations in inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP). However, relatively little work has been done on the effects of 'naturalistic' stressors on acute changes in inflammatory markers. The present study examined whether perceived arousal, valence and dominance in musicians are associated with pro-inflammatory and oxidative responses to a concert situation. Blood and salivary samples obtained from 48 members of a symphony orchestra on the day of rehearsal (i.e., control situation) and on the following day of premiere concert (i.e., test situation) were used to determine changes in salivary cortisol, pro-inflammatory markers (plasma myeloperoxidase, serum CRP, plasma IL-6), oxidative stress markers (paraoxonase1 activity and malondialdehyde), and homocysteine, a risk factor for vascular disease. Results of regression analyses showed a significant trend to increased myeloperoxidase (MPO) response in individuals with low valence score. Both affective states, valence and arousal, were identified as significant predictors of cortisol response during concert. In addition, control levels of plasma malondialdehyde were positively correlated with differences in IL-6 levels between premiere and rehearsal (r=.38, p=.012), pointing to higher oxidative stress in individuals with pronounced IL-6 response. Our results indicate that stress of public performance leads to increased concentrations of plasma MPO (20%), IL-6 (27%) and salivary cortisol (44%) in musicians. The decreasing effect of pleasantness on the MPO response was highly pronounced in non-smokers (r=-.60, p<.001), suggesting a significant role of emotional valence in stress-induced secretion of MPO. Additional studies are needed to assess the generalizability of these findings to other 'naturalistic' stress situations.
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Affiliation(s)
- Alexander Pilger
- Institute of Occupational Medicine, Medical University of Vienna, Vienna, Austria.
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Karl Böhm
- Austrian Broadcasting Corporation, Occupational Service, Vienna, Austria
| | - Alexandra Budinsky
- Institute of Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Angelika Girard
- Institute of Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Katharina Klien
- Institute of Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Galateja Jordakieva
- Institute of Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Lukas Pezawas
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Oswald Wagner
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Jasminka Godnic-Cvar
- Institute of Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Robert Winker
- Health and Prevention Center, Sanatorium Hera, Vienna, Austria
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Castonguay AL, Wrosch C, Sabiston CM. Systemic inflammation among breast cancer survivors: the roles of goal disengagement capacities and health-related self-protection. Psychooncology 2014; 23:878-85. [DOI: 10.1002/pon.3489] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 01/02/2014] [Accepted: 01/06/2014] [Indexed: 11/07/2022]
Affiliation(s)
| | - Carsten Wrosch
- Department of Psychology; Concordia University; Montreal QC Canada
| | - Catherine M. Sabiston
- Faculty of Kinesiology and Physical Education; University of Toronto; Toronto ON Canada
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Moldal ER, Kirpensteijn J, Kristensen AT, Haga HA, Nødtvedt A, Eriksen T. Evaluation of inflammatory and hemostatic surgical stress responses in male cats after castration under general anesthesia with or without local anesthesia. Am J Vet Res 2013; 73:1824-31. [PMID: 23106471 DOI: 10.2460/ajvr.73.11.1824] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize acute inflammatory and hemostatic surgical stress responses following castration in cats and to evaluate whether the addition of local anesthesia to the anesthetic protocol attenuates these responses. ANIMALS 39 male cats. PROCEDURES Cats undergoing castration were randomly assigned to 2 groups: both groups underwent surgery with general anesthesia, and 1 group additionally received a local anesthetic (lidocaine [2.0 mg/kg in total, divided intratesticularly and SC]) prior to incision. Blood samples were collected after anesthetic induction (baseline) and 1, 5, and 24 hours later. Thromboelastography and coagulation variables (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) were analyzed; fibrinolysis was assessed with plasma D-dimer concentrations. The acute-phase response was evaluated via measurement of plasma fibrinogen and serum amyloid A (last time point, 28 hours) concentrations. Hematologic variables were analyzed at baseline and 1, 5, and 24 hours later. RESULTS Evidence of hemostatic and inflammatory activation after surgery was detected in both groups. Maximum amplitude and G (global clot strength) were significantly increased at 24 hours, and significant, but not clinically relevant, decreases were detected in aPTT at 5 and 24 hours and in PT at 24 hours, compared with baseline values. Serum amyloid A concentrations were significantly higher at 24 and 28 hours than at baseline, and plasma fibrinogen concentration was significantly increased at 24 hours; WBC and RBC counts and Hct were significantly increased at multiple time points. No differences between groups were detected for any variables. CONCLUSIONS AND CLINICAL RELEVANCE Castration appeared to induce hypercoagulability and an acute-phase inflammatory response in cats. Local anesthesia with lidocaine did not attenuate this response.
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Affiliation(s)
- Elena R Moldal
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, NO-0033 Oslo, Norway.
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34
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Hartwell KJ, Moran-Santa Maria MM, Twal WO, Shaftman S, DeSantis SM, McRae-Clark AL, Brady KT. Association of elevated cytokines with childhood adversity in a sample of healthy adults. J Psychiatr Res 2013; 47:604-10. [PMID: 23415658 PMCID: PMC3594625 DOI: 10.1016/j.jpsychires.2013.01.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 12/08/2012] [Accepted: 01/11/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Childhood trauma has been associated adult stress-related disorders. However, little is known about physiologic alterations in adults with a history of early life trauma that do not have current psychiatric or medical diagnoses. In this study, the relationships between childhood adversity and cytokine and C-reactive protein (CRP) levels in healthy adults were examined. METHOD Participants included men (n = 18) and women (n = 20) who did not meet DSM-IV criteria for Axis I psychiatric disorders or any major medical illness. Cytokine and CRP levels were obtained from baseline blood samples. Subjects completed the Early Trauma Inventory Self Report (ETI-SR). The primary outcomes included serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL1-β), and CRP levels. In addition, the mean numbers of traumatic experiences (sexual, physical, emotional, general, and the summed total) were measured. RESULTS Significant positive associations were found between the total ETI score and IL-6 (p = 0.05), IL1-β (p < 0.05), and TNF-α (p = 0.01). Significant positive correlations were found between the number of general traumas and IL1-β (p < 0.05), TNF-α (p < 0.05), and IL-6 (p < 0.01). Neither the total number of traumas nor any of the trauma subscales were significantly associated with CRP levels. CONCLUSIONS The positive association between childhood trauma and basal cytokine levels supports the extant literature demonstrating the long-term impact of childhood trauma and stress on homeostatic systems. Importantly, this association was found in healthy adults, suggesting that these alterations may precede the development of significant stress-related psychiatric disorder or disease.
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Affiliation(s)
- Karen J. Hartwell
- Department of Psychiatry and Behavioral Neurosciences, Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC, 29425,Ralph H Johnson VAMC, Charleston, SC 29401
| | - Megan M. Moran-Santa Maria
- Department of Psychiatry and Behavioral Neurosciences, Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC, 29425
| | - Waleed O. Twal
- Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC, 29425
| | - Stephanie Shaftman
- Department of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC, 29425
| | - Stacia M. DeSantis
- Department of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC, 29425
| | - Aimee L. McRae-Clark
- Department of Psychiatry and Behavioral Neurosciences, Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC, 29425
| | - Kathleen T. Brady
- Department of Psychiatry and Behavioral Neurosciences, Clinical Neuroscience Division, Medical University of South Carolina, Charleston, SC, 29425,Ralph H Johnson VAMC, Charleston, SC 29401
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Abstract
Although anxiety disorders, like depression, are increasingly being associated with metabolic and cardiovascular burden, in contrast with depression, the role of inflammation in anxiety has sparsely been examined. This large cohort study examines the association between anxiety disorders and anxiety characteristics with several inflammatory markers. For this purpose, persons (18-65 years) with a current (N=1273) or remitted (N=459) anxiety disorder (generalized anxiety disorder, social phobia, panic disorder, agoraphobia) according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and healthy controls (N=556) were selected from the Netherlands Study of Depression and Anxiety. In addition, severity, duration, age of onset, anxiety subtype and co-morbid depression were assessed. Inflammatory markers included C-reactive protein (CRP), interleukin (IL)-6 and tumor-necrosis factor (TNF)-α. Results show that after adjustment for sociodemographics, lifestyle and disease, elevated levels of CRP were found in men, but not in women, with a current anxiety disorder compared with controls (1.18 (s.e.=1.05) versus 0.98 (s.e.=1.07) mg l(-1), P=0.04, Cohen's d=0.18). No associations were found with IL-6 or TNF-α. Among persons with a current anxiety disorder, those with social phobia, in particular women, had lower levels of CRP and IL-6, whereas highest CRP levels were found in those with an older age of anxiety disorder onset. Especially in persons with an age of onset after 50 years, CRP levels were increased compared with controls (1.95 (s.e.=1.18) versus 1.27 (s.e.=1.05) mg l(-1), P=0.01, Cohen's d=0.37). In conclusion, elevated inflammation is present in men with current anxiety disorders. Immune dysregulation is especially found in persons with a late-onset anxiety disorder, suggesting the existence of a specific late-onset anxiety subtype with a distinct etiology, which could possibly benefit from alternative treatments.
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36
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Bartholomeusz M, Callister R, Hodgson D. Altered psychophysiological reactivity as a prognostic indicator of early childhood stress in chronic pain. Med Hypotheses 2013; 80:146-9. [DOI: 10.1016/j.mehy.2012.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/02/2012] [Accepted: 11/09/2012] [Indexed: 11/27/2022]
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Koudouovoh-Tripp P, Sperner-Unterweger B. Influence of mental stress on platelet bioactivity. World J Psychiatry 2012; 2:134-47. [PMID: 24175179 PMCID: PMC3782187 DOI: 10.5498/wjp.v2.i6.134] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 10/10/2012] [Accepted: 10/23/2012] [Indexed: 02/05/2023] Open
Abstract
It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to represent a possible link in this respect. The anculeated platelets are the smallest corpuscular elements circulating in the human blood. They display different serotonergic markers which seem to reflect the central nervous serotonin metabolism. They are known as main effectors in haematological processes but recent research highlights their role in the innate and adaptive immune system. Platelets are containing a multitude of pro-inflammatory and immune-modulatory bioactive compounds in their granules and are expressing immune-competent surface markers. Research gives hint that platelets activation and reactivity is increased by mental stress. This leads to enhanced cross talk with the immune system via paracrine secretion, receptor interaction and formation of platelet leucocyte-aggregates. Recently it has been demonstrated that the immune system can have a remarkable impact in the development of psychiatric disorders. Therefore platelets represent an interesting research area in psychiatry and their role as a possible biomarker has been investigated. We review the influence of mental stress on what is termed platelet bioactivity in this article, which subsumes the mainly immune-modulatory activity of platelets in healthy volunteers, elderly persons with chronic care-giving strain, patients with cardiovascular diseases who are prone to psychosocial stress, as well as in patients with posttraumatic stress disorder. Research data suggest that stress enhances platelet activity, reactivity and immune-modulatory capacities.
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Affiliation(s)
- Pia Koudouovoh-Tripp
- Pia Koudouovoh-Tripp, Clinic for Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
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38
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Efficacy of acupressure for non-pharmacological stress reduction in college students. Complement Ther Med 2012; 20:175-82. [DOI: 10.1016/j.ctim.2011.12.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 12/14/2011] [Indexed: 11/18/2022] Open
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Physiological consequences of repeated exposures to conditioned fear. Behav Sci (Basel) 2012; 2:57-78. [PMID: 25379216 PMCID: PMC4217585 DOI: 10.3390/bs2020057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 05/05/2012] [Accepted: 05/14/2012] [Indexed: 11/18/2022] Open
Abstract
Activation of the stress response evokes a cascade of physiological reactions that may be detrimental when repeated or chronic, and when triggered after exposure to psychological/emotional stressors. Investigation of the physiological mechanisms responsible for the health damaging effects requires animal paradigms that repeatedly evoke a response to psychological/emotional stressors. To this end, adult male Sprague Dawley rats were repeatedly exposed (2X per day for 20 days) to a context that they were conditioned to fear (conditioned fear test, CFT). Repeated exposure to CFT produced body weight loss, adrenal hypertrophy, thymic involution, and basal corticosterone elevation. In vivo biotelemetry measures revealed that CFT evokes sympathetic nervous system driven increases in heart rate (HR), mean arterial pressure (MAP), and core body temperature. Extinction of behavioral (freezing) and physiological responses to CFT was prevented using minimal reinstatement footshock. MAP responses to the CFT did not diminish across 20 days of exposure. In contrast, HR and cardiac contractility responses declined by day 15, suggesting a shift toward vascular-dominated MAP (a pre-clinical marker of CV dysfunction). Flattened diurnal rhythms, common to stress-related mood/anxiety disorders, were found for most physiological measures. Thus, repeated CFT produces adaptations indicative of the health damaging effects of psychological/emotional stress.
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40
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Hamer M, Endrighi R, Venuraju SM, Lahiri A, Steptoe A. Cortisol responses to mental stress and the progression of coronary artery calcification in healthy men and women. PLoS One 2012; 7:e31356. [PMID: 22328931 PMCID: PMC3273460 DOI: 10.1371/journal.pone.0031356] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 01/06/2012] [Indexed: 11/19/2022] Open
Abstract
Background Psychosocial stress is a risk factor for coronary heart disease (CHD). The mechanisms are incompletely understood, although dysfunction of the hypothalamic pituitary adrenal (HPA) axis might be involved. We examined the association between cortisol responses to laboratory-induced mental stress and the progression of coronary artery calcification (CAC). Methods and Results Participants were 466 healthy men and women (mean age = 62.7±5.6 yrs), without history or objective signs of CHD, drawn from the Whitehall II epidemiological cohort. At the baseline assessment salivary cortisol was measured in response to mental stressors, consisting of a 5-min Stroop task and a 5-min mirror tracing task. CAC was measured at baseline and at 3 years follow up using electron beam computed tomography. CAC progression was defined as an increase >10 Agatston units between baseline and follow up. 38.2% of the sample demonstrated CAC progression over the 3 years follow up. There was considerable variation in the cortisol stress response, with approximately 40% of the sample responding to the stress tasks with an increase in cortisol of at least 1 mmol/l. There was an association between cortisol stress reactivity (per SD) and CAC progression (odds ratio = 1.27, 95% CI, 1.02–1.60) after adjustments for age, sex, pre-stress cortisol, employment grade, smoking, resting systolic BP, fibrinogen, body mass index, and use of statins. There was no association between systolic blood pressure reactivity and CAC progression (odds ratio per SD increase = 1.03, 95% CI, 0.85–1.24). Other independent predictors of CAC progression included age, male sex, smoking, resting systolic blood pressure, and fibrinogen. Conclusion Results demonstrate an association between heightened cortisol reactivity to stress and CAC progression. These data support the notion that cortisol reactivity, an index of HPA function, is one of the possible mechanisms through which psychosocial stress may influence the risk of CHD.
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Affiliation(s)
- Mark Hamer
- Department of Epidemiology and Public Health, University College London, London, United Kingdom.
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41
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French JA, Smith AS, Gleason AM, Birnie AK, Mustoe A, Korgan A. Stress reactivity in young marmosets (Callithrix geoffroyi): ontogeny, stability, and lack of concordance among co-twins. Horm Behav 2012; 61:196-203. [PMID: 22210196 PMCID: PMC3278562 DOI: 10.1016/j.yhbeh.2011.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 12/09/2011] [Accepted: 12/10/2011] [Indexed: 11/17/2022]
Abstract
Variation in response styles in the hypothalamic-pituitary-adrenal (HPA) axis are known to be predictors of short- and long-term health outcomes. The nature of HPA responses to stressors changes with developmental stage, and some components of the stress response exhibit long-term individual consistency (i.e., are trait-like) while others are transient or variable (i.e., state-like). Here we evaluated the response of marmoset monkeys (Callithrix geoffroyi) to a standardized social stressor (social separation and exposure to a novel environment) at three different stages of development: juvenile, subadult, and young adult. We monitored levels of urinary cortisol (CORT), and derived multiple measures of HPA activity: Baseline CORT, CORT reactivity, CORT Area Under the Curve (AUC), and CORT regulation. Juvenile marmosets exhibited the most dramatic stress response, had higher AUCs, and tended to show poorer regulation. While baseline CORT and CORT regulation were not consistent within an individual across age, CORT reactivity and measures of AUC were highly correlated across time; i.e., individuals with high stress reactivity and AUC as juveniles also had high measures as subadults and adults, and vice-versa. Marmoset co-twins did not exhibit similar patterns of stress reactivity. These data suggest that regardless of the source of variation in stress response styles in marmosets, individually-distinctive patterns are established by six months of age, and persist for at least a year throughout different phases of marmoset life history.
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Affiliation(s)
- Jeffrey A French
- Callitrichid Research Center, Department of Psychology, University of Nebraska at Omaha, Omaha, NE 68182, USA.
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Austin AW, Patterson SM, von Känel R. Hemoconcentration and hemostasis during acute stress: interacting and independent effects. Ann Behav Med 2012; 42:153-73. [PMID: 21562905 DOI: 10.1007/s12160-011-9274-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Acute psychological stress can produce significant hemoconcentration as well as prothrombotic changes in blood, both of which may have potentially harmful effects on the cardiovascular system. It is unclear whether these effects are independent or have influence on each other. PURPOSE This review discusses research investigating the effects of acute psychological stress on hemoconcentration and hemostasis and explores future directions for psychohematology research. Physiology, associations with cardiovascular disease, and relationships between acute psychological stress are discussed independently for hemoconcentration and hemostasis, followed by an examination of the effects of stress-hemoconcentration on hemostasis. CONCLUSIONS Traditional methods of adjusting for stress-hemoconcentration effects (e.g., calculated plasma volume or hematocrit level corrections) may not be appropriate when examining stress-induced changes in hemostasis. The effects of acute stress on hemostasis should be examined in conjunction with hemoconcentration.
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Seldenrijk A, Hamer M, Lahiri A, Penninx BWJH, Steptoe A. Psychological distress, cortisol stress response and subclinical coronary calcification. Psychoneuroendocrinology 2012; 37:48-55. [PMID: 21621333 DOI: 10.1016/j.psyneuen.2011.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 05/04/2011] [Accepted: 05/04/2011] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Poor mental health has been associated with coronary heart disease (CHD). One hypothesized underlying mechanism is hypothalamus pituitary adrenal axis dysfunction. We examined the associations between psychological distress, cortisol response to laboratory-induced mental stress and subclinical coronary artery calcification (CAC). PARTICIPANTS 527 volunteers free of CHD (mean age=63.0 ± 5.7 years), drawn from the Whitehall II cohort. MEASURES CAC was measured using electron beam computed tomography. Current distress at time of the heart scan was indicated by a Short Form-36 mental health score, whereas long-term distress was based on the averaged scores of six assessments over the 15 preceding years. Salivary cortisol was measured in response to mental stressors (Stroop, mirror tracing). RESULTS Detectable CAC was found in 56.4% (mild/moderate: 46.9%; severe: 9.5%) of the sample. After adjustment for sociodemographics and conventional risk factors, long-term but not current psychological distress was associated with a higher risk of severe CAC (OR per SD increase=1.49, 95%CI=1.03-2.16). Psychological distress was not significantly associated with cortisol stress response. A trend for interaction (p=.09) indicated that individuals with long-term poor mental health and high cortisol reactivity showed the highest odds for severe CAC. CONCLUSIONS Long-term but not current psychological distress is associated with severe CAC in healthy older subjects. Although psychological distress generally was not associated with cortisol stress responses, participants with both long-term distress and increased cortisol response were especially at risk for severe calcification.
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Affiliation(s)
- Adrie Seldenrijk
- VUMC, Department of Psychiatry, AJ Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
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Egger G, Dixon J. Non-nutrient causes of low-grade, systemic inflammation: support for a 'canary in the mineshaft' view of obesity in chronic disease. Obes Rev 2011; 12:339-45. [PMID: 20701689 DOI: 10.1111/j.1467-789x.2010.00795.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A form of low-grade, systemic inflammation ('metaflammation') is linked to many types of chronic disease. Initially, this was thought to be causally related to weight gain and obesity and a possible explanation of the link between obesity and disease. However, several lifestyle-related inducers of such inflammation, some of which are associated with obesity, but some of which are not, have now been identified. The most common of these have been nutritive related, suggesting that there could still be a relationship, either directly or indirectly, with obesity. Here we provide evidence for non-nutritive inflammatory inducers, providing further support for an earlier suggestion that while obesity, beyond a point, may have a direct link with disease, this may be neither necessary nor sufficient to explain the current epidemic of chronic disease. A more ubiquitous cause encompassing all inflammatory inducers is the modern, post-industrial environment and lifestyles emanating from this. Obesity may thus be more of 'a canary in the mineshaft', warning of bigger global problems, than just a single pathway to modern environmentally driven disease.
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Affiliation(s)
- G Egger
- Health & Human Sciences, Southern Cross University, Lismore, Australia, and Centre for Health Promotion and Research, Sydney, NSW, Australia.
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Shivpuri S, Gallo LC, Crouse JR, Allison MA. The association between chronic stress type and C-reactive protein in the multi-ethnic study of atherosclerosis: does gender make a difference? J Behav Med 2011; 35:74-85. [PMID: 21503709 DOI: 10.1007/s10865-011-9345-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2010] [Accepted: 04/05/2011] [Indexed: 01/24/2023]
Abstract
The objective of this study is to examine how chronic stress in major life domains [relationship, work, sympathetic-caregiving, financial] relates to CVD risk, operationalized using the inflammatory marker C-Reactive Protein (CRP), and whether gender differences exist. Participants were 6,583 individuals aged 45-84 years, recruited as part of the Multi-Ethnic Study of Atherosclerosis. Demographic and behavioral factors, health history, and chronic stress were self-reported. CRP was obtained through venous blood draw. In aggregate, gender by chronic stress interaction effects accounted for a significant, albeit small, amount of variance in CRP (P < .01). The sympathetic-caregiving stress by gender interaction was significant (P < .01); the work stress by gender effect approached significance (P = .05). Women with sympathetic-caregiving stress had higher CRP than those without, whereas no difference in CRP by stress group was observed for men. Findings underscore the importance of considering gender as an effect modifier in analyses of stress-CVD risk relationships.
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Affiliation(s)
- Smriti Shivpuri
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California-San Diego, 9245 Sky Park Ct., San Diego, CA 92123, USA.
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Kotlyar M, Drone D, Thuras P, Hatsukami DK, Brauer L, Adson DE, al'Absi M. Effect of stress and bupropion on craving, withdrawal symptoms, and mood in smokers. Nicotine Tob Res 2011; 13:492-7. [PMID: 21378081 DOI: 10.1093/ntr/ntr011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Studies suggest that in smokers attempting to quit smoking, the occurrence of stressful events is associated with smoking relapse. The purpose of this study was to determine the effect of bupropion (an agent known to increase smoking cessation rates) on the craving, withdrawal, and mood response to stressful tasks administered in a laboratory setting. METHODS Response to three tasks (a speech, math, and cold pressor task) was measured in 65 smokers during ad libitum smoking. Smokers were then randomized to either bupropion or placebo. Fourteen days after starting medication, 43 subjects (28 receiving bupropion and 15 receiving placebo) quit smoking and laboratory procedures were repeated on the third day of abstinence. RESULTS Prior to cessation, stressors presented in a laboratory setting increased craving, nicotine withdrawal symptoms, and subjective distress but decreased positive affect. Thirty minutes of relaxation after the stressors did not result in these measures returning to prestress levels. During the nicotine withdrawal period, stress-induced responses were generally smaller than during the precessation period. Bupropion (relative to placebo) reduced overall levels of craving and withdrawal symptoms but did not have significant effects on response to stress during the nicotine withdrawal period. CONCLUSIONS This study demonstrates that stress results in sustained increases in craving and withdrawal symptoms and changes in mood symptoms and that bupropion affects overall levels of these symptoms. Further research is needed to determine if modifying response to stress is predictive of an effective treatment for facilitating smoking cessation.
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Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 7-170 Weaver Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, USA.
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47
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Psychophysiological risk markers of cardiovascular disease. Neurosci Biobehav Rev 2010; 35:76-83. [DOI: 10.1016/j.neubiorev.2009.11.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 10/30/2009] [Accepted: 11/04/2009] [Indexed: 11/22/2022]
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Plasma renin responses to mental stress and carotid intima-media thickness in black Africans: the SABPA study. J Hum Hypertens 2010; 25:437-43. [PMID: 20686501 DOI: 10.1038/jhh.2010.82] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The renin-angiotensin-aldosterone system can be activated by sympathetic nervous input and is thought to have an important role in the prevalence of hypertension and cardiovascular risk in black Africans. We examined (1) the association between plasma renin responses to mental stress and a marker of sub-clinical atherosclerosis; and (2) associations between resting renin and 24-h ambulatory blood pressure. Participants were 143 urbanized black African men and women (43.1 ± 7.7 years) drawn from a study of Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA). After an overnight fast, participants completed the Stroop mental stress task. Blood samples were drawn during baseline and 10 min after the task to assess the concentration of active renin in plasma. Blood pressure assessments included continuous Finometer measures during the stress testing and 24-h ambulatory monitoring. Carotid intima-media thickness (CIMT) was measured using high-resolution ultrasound. Approximately 50% of the sample responded to the task with an increase in renin concentration. Multiple linear regression analysis revealed an association between the renin stress response and CIMT (β = 0.024, 95% confidence interval, 0.004-0.043), after adjustment for conventional risk factors, blood pressure stress responses and basal levels of renin activity (R(2) for model = 0.37). In addition, resting renin was inversely associated with ambulatory blood pressure. In summary, heightened release of renin during a laboratory mental stressor was associated with a marker of sub-clinical atherosclerosis; thus, it may be a potential mechanism in explaining the increased burden of cardiovascular disease in urbanized black Africans.
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Repeated amphetamine administration in rats revealed consistency across days and a complete dissociation between locomotor and hypothalamic-pituitary-adrenal axis effects of the drug. Psychopharmacology (Berl) 2009; 207:447-59. [PMID: 19809808 DOI: 10.1007/s00213-009-1676-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 09/11/2009] [Indexed: 12/23/2022]
Abstract
RATIONALE Most drugs of abuse stimulate both locomotor activity and the hypothalamic-pituitary-adrenal (HPA) axis, but the relationship between the two responses within the same subjects and their reliabilities has been scarcely studied. Our objectives were to study: (1) the consistency and stability across time of locomotor and HPA activation induced by repeated d-amphetamine (AMPH); (2) the relationship between locomotor and hormonal responses to AMPH; and (3) the relationship between novelty-induced activity and both types of responses to the drug. METHODS Male adult rats were exposed to a novel environment to study the locomotor response. Later, they were injected with AMPH (2 mg/kg, sc) for 5 days. In Experiment 1, Plasma adrenocorticotropin (ACTH) and corticosterone levels in response to AMPH were studied on days 1, 3, and 5, and locomotor response on days 2 and 4. In Experiment 2, ACTH and corticosterone responses were studied on days 2 and 4, and locomotor response on days 1, 3, and 5. RESULTS Across days, both locomotor and HPA responses to the drug were consistent, but independent measures, unrelated to the reactivity to novelty. As measured by the area under the curve, the HPA response to AMPH desensitized with the repeated injection, whereas the initial locomotor response to the drug increased. CONCLUSIONS Dissociation exists between HPA and locomotor activation induced by AMPH, which seemed to be both reliable individual traits. Locomotor reactivity to novelty was related neither to HPA nor to locomotor responses to AMPH.
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Hamer M, O'Donnell K, Lahiri A, Steptoe A. Salivary cortisol responses to mental stress are associated with coronary artery calcification in healthy men and women. Eur Heart J 2009; 31:424-9. [DOI: 10.1093/eurheartj/ehp386] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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