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Massengale K, Xu Y, Snieder H, Su S, Wang X. A longitudinal study of blood pressure circadian rhythm from childhood to early adulthood. J Hum Hypertens 2024; 38:437-443. [PMID: 38627604 DOI: 10.1038/s41371-024-00911-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/19/2024] [Accepted: 04/02/2024] [Indexed: 05/09/2024]
Abstract
Altered blood pressure (BP) circadian rhythmicity has been increasingly linked with cardiovascular risk. However, little is known about BP circadian rhythm change with age and its possible sociodemographic, anthropometric, and genetic moderators. Twenty-four-hour ambulatory BP was measured up to 16 times over a 23-year period in 339 European Americans (EAs) and 293 African Americans (AAs), with an average age of 15 years at the initial visit. BP circadian rhythms were indexed by amplitude and percent rhythm (a measure of rhythm integrity) and calculated using Fourier analysis. BP amplitude and percent rhythm increased with age and average BP (BP mesor). AAs were more likely to have lower BP amplitude and percent rhythm than their EA counterparts. BP amplitude and percent rhythm also decreased with adiposity (BMI and waist circumference). The summer season was associated with lower BP amplitude in AAs and lower percent rhythm in both AAs and EAs. Sex, height, socioeconomic status, physical activity, and family history of essential hypertension did not have an independent impact on BP amplitude or percent rhythm. The results of the present study suggest that BP circadian rhythm increases with age and BP mesor from childhood to young adulthood, decreases with adiposity, and that AAs are more likely to have lower circadian rhythm than EAs. Furthermore, we demonstrated that the summer season is associated with lower BP rhythmicity.
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Affiliation(s)
| | - Yanyan Xu
- Department of Biostatistics and Informatics, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Harold Snieder
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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2
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Crosswell AD, Mayer SE, Whitehurst LN, Picard M, Zebarjadian S, Epel ES. Deep rest: An integrative model of how contemplative practices combat stress and enhance the body's restorative capacity. Psychol Rev 2024; 131:247-270. [PMID: 38147050 PMCID: PMC11003855 DOI: 10.1037/rev0000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Engaging in contemplative practice like meditation, yoga, and prayer, is beneficial for psychological and physical well-being. Recent research has identified several underlying psychological and biological pathways that explain these benefits. However, there is not yet consensus on the underlying overlapping physiological mechanisms of contemplative practice benefits. In this article, we integrate divergent scientific literatures on contemplative practice interventions, stress science, and mitochondrial biology, presenting a unified biopsychosocial model of how contemplative practices reduce stress and promote physical health. We argue that engaging in contemplative practice facilitates a restorative state termed "deep rest," largely through safety signaling, during which energetic resources are directed toward cellular optimization and away from energy-demanding stress states. Our model thus presents a framework for how contemplative practices enhance positive psychological and physiological functioning by optimizing cellular energy consumption. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Alexandra D. Crosswell
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Stefanie E. Mayer
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | | | - Martin Picard
- Department of Psychiatry, Division of Behavioral Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center
- Department of Neurology, H. Houston Merritt Center, Columbia Translational Neuroscience Initiative, College of Physicians and Surgeons, Columbia University Irving Medical Center
- New York State Psychiatric Institute
| | | | - Elissa S. Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
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3
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Augustin J, Bei der Kellen R, Behrendt CA, Magnussen C, Terschüren C, Ascone L, Kühn S, Wolf S, Augustin M, Andrees V. Associations between a Subjective Living Environment and Quality of Life among People with Arterial Hypertension-Results from the Hamburg City Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:180. [PMID: 36612502 PMCID: PMC9819795 DOI: 10.3390/ijerph20010180] [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: 11/29/2022] [Revised: 12/16/2022] [Accepted: 12/18/2022] [Indexed: 06/17/2023]
Abstract
Hypertension is a global public health concern and an important contributor to cardiovascular disease. It remains disputed how important life circumstances are for the etiology of hypertension. Thus, the aim of this study is to assess the spatial variation of hypertension within an urban population and to investigate the association with the quality of life of city dwellers and their subjective evaluation of their residential district, as well as their home environment, using the example of Hamburg, Germany. In this cross-sectional study, the first 10,000 participants from the Hamburg City Health Study (HCHS) were analysed. Only participants who had resided at the current address for a minimum of five years were considered. In the descriptive analysis, participants with and without arterial hypertension were compared considering various parameters. The subjective quality of the living environment was obtained using an appropriate subjective living environment index. Quality of life was mapped using the EuroQol Group quality of life questionnaire (EQ-5D) score and the two (mental and physical health) scores of the Short Form Health Questionnaire SF-8. The Gini-coefficient was used to quantify the regional economic variation within Hamburg. Linear and logistic regression analyses were performed. Regional levels were 68 city district clusters in Hamburg. The analysis included n = 8192 participants living at least five years in Hamburg at the time of participation in the HCHS. There was a spatial variation in the prevalence of arterial hypertension within Hamburg. Prevalence rates between city district clusters ranged from 50.0% to 88.5%. The results showed that city district clusters with a worse subjective perception of the living environment were partly associated with an increased prevalence of arterial hypertension. Furthermore, a negative association was observed between arterial hypertension prevalence and the sociodemographic status of participants in the city district clusters. Thus, participants with a high level of education suffered less frequently from arterial hypertension than participants with a rather low level of education. The subjective living environment index and quality of life were significantly related to the occurrence of arterial hypertension; however, more extensive and detailed studies are necessary to derive possible clinical implications.
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Affiliation(s)
- Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Ramona Bei der Kellen
- Epidemiological Study Center, Hamburg City Health Study (HCHS), University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Christian-Alexander Behrendt
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Christina Magnussen
- Department of Cardiology, University Heart & Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
- Population Health Research Department, University Heart & Vascular Center Hamburg, 20251 Hamburg, Germany
- German Centre for Cardiovascular Research (DZHK), DZHK-Geschäftsstelle, 10785 Berlin, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Leonie Ascone
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Simone Kühn
- Clinic and Polyclinic for Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, 14195 Berlin, Germany
| | - Sandra Wolf
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
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4
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Neubert M, Süssenbach P, Euteneuer F. Subjective social status and nocturnal blood pressure dipping. J Psychosom Res 2022; 163:111065. [PMID: 36327531 DOI: 10.1016/j.jpsychores.2022.111065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 10/15/2022] [Accepted: 10/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Low social status has been linked to cardiovascular disease. Subjective social status (SSS), which represents one's perceived position in a social hierarchy, has been suggested to predict health outcomes beyond objective measures of socioeconomic status. The present study examined if lower SSS is related to reduced nocturnal blood pressure (BP) dipping, a risk factor for cardiovascular disease. METHODS In this cross-sectional study, a community sample of 53 healthy adults underwent 24-h ambulatory BP monitoring. All participants provided information on SSS and objective measures of socioeconomic status (i.e., education, occupation, and income). SSS was measured in comparison to others in the country (national SSS) as well as in comparison to one's social environment (local SSS) using the German versions of the MacArthur Scales. RESULTS Analyses found that participants with low local SSS exhibited attenuated nocturnal diastolic blood pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .043) and mean arterial pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .041). These associations remained significant after adjusting for objective socioeconomic status. No significant associations between national SSS and cardiovascular measures were observed. CONCLUSION In conclusion, one's perceived social position in the social environment (i.e., local SSS) is associated with nocturnal BP dipping. Therefore, local SSS may be an important psychosocial factor linking social inequality and cardiovascular health.
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Affiliation(s)
- Marie Neubert
- Department of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany; Department of Clinical Psychology, University of Siegen, Siegen, Germany.
| | - Philipp Süssenbach
- Department for Human Resources/Health/Social Sciences, Fachhochschule des Mittelstands (University of Applied Sciences), Bielefeld, Bielefeld, Germany
| | - Frank Euteneuer
- Department of Clinical Psychology and Psychotherapy, Philipps University, Marburg, Germany; Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
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Forshaw PE, Correia ATL, Roden LC, Lambert EV, Rae DE. Sleep characteristics associated with nocturnal blood pressure nondipping in healthy individuals: a systematic review. Blood Press Monit 2022; 27:357-370. [PMID: 36094364 DOI: 10.1097/mbp.0000000000000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The current literature investigating nocturnal blood pressure (BP) nondipping has largely focused on clinical populations, however, conditions such as hypertension, obstructive sleep apnoea and insomnia are recognized confounding factors for BP dipping. The exact mechanisms responsible for BP nondipping remain unclear, therefore, there is a need to investigate BP nondipping in healthy individuals to better understand the underlying mechanisms. This review identifies sleep characteristics that may contribute to BP nondipping in healthy individuals. It is anticipated that an understanding of the sleep characteristics that contribute to BP nondipping may inform future sleep-related behavioral interventions to ultimately reducing the burden of cardiovascular disease. METHODS The PubMed, Scopus and Web of Science databases were searched for relevant, English language, peer-reviewed publications (from inception to March 2022). The search identified 550 studies. After duplicates were removed, the titles and abstracts of the remaining 306 studies were screened. Of these, 250 studies were excluded leaving 56 studies to test for eligibility. Thirty-nine studies were excluded such that 17 studies fully met the inclusion criteria for the review. RESULTS Findings from this review indicate that short sleep duration, more sleep fragmentation, less sleep depth and increased variability in sleep timing may be associated with BP nondipping in healthy individuals. CONCLUSION While there is no evidence-based approach for the treatment of nocturnal BP nondipping, it seems promising that addressing one's sleep health may be an important starting point to reduce the prevalence of BP nondipping and perhaps the progression to cardiovascular disease.
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Affiliation(s)
- Philippa Eileen Forshaw
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arron Taylor Lund Correia
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Laura Catherine Roden
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Centre for Sport, Exercise and Life Sciences, School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, United Kingdom
| | - Estelle Victoria Lambert
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dale Elizabeth Rae
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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6
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van Nieuwenhuizen BP, de Goede P, Tan HL, van den Born BJ, Kunst A. Is there an association between socioeconomic status and the degree of diurnal variation in heart rate? INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2021; 11:200118. [PMID: 34918012 PMCID: PMC8645920 DOI: 10.1016/j.ijcrp.2021.200118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/29/2021] [Accepted: 11/11/2021] [Indexed: 11/12/2022]
Abstract
BACKGROUND Disruption in circadian rhythms is associated with cardiovascular disease and may play a role in socioeconomic differences in cardiovascular disease prevalence. However, it is unclear whether low SES is associated with a lower diurnal rhythm in autonomic activity markers. We investigated the association between SES and the amplitude of the daily fluctuation of heart rate. METHODS We included data of 450 participants of a HELIUS sub-study in Amsterdam, the Netherlands. Participants wore an Actiheart monitor (CamNtech), a chest-worn monitor which measures heart rate every 15 s for several days. Cosinor analysis was performed on the time series of heart rate within each participant. We analyzed the association between the cosinor parameters (amplitude, midline and peak time of the diurnal HR rhythm) and SES indicators (education, occupational class and a proxy of income) in multivariate linear regression models, adjusting for age, sex and ethnicity. RESULTS There was a clear diurnal rhythm in the average heart rates, with a peak between noon and 18:00 and a trough between 04:00 and 06:00. This rhythm was present for all categories of education, occupation and income proxy. The estimates for the cosinor parameters did not differ consistently and significantly between categories of education, occupation or income proxy. CONCLUSIONS We did not find any consistent evidence to support our hypothesis of a diminished amplitude in the diurnal variation of heart rate in individuals with lower SES. Future studies should explore SES differences in the diurnal variation in markers of autonomic activity other than heart rate.
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Affiliation(s)
| | - Paul de Goede
- Laboratory of Endocrinology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Gastroenterology, Endocrinology, and Metabolism, Amsterdam, the Netherlands
- Hypothalamic Integration Mechanisms Group, Netherlands Institute for Neuroscience (NIN), An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Hanno L. Tan
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Netherlands Heart Institute, Utrecht, the Netherlands
| | - Bert-Jan van den Born
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anton Kunst
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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7
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Ferguson TS, Younger-Coleman NOM, Mullings J, Francis D, Greene LG, Lyew-Ayee P, Wilks R. Neighbourhood socioeconomic characteristics and blood pressure among Jamaican youth: a pooled analysis of data from observational studies. PeerJ 2020; 8:e10058. [PMID: 33083129 PMCID: PMC7546221 DOI: 10.7717/peerj.10058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 09/07/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Neighbourhood characteristics are associated with several diseases, but few studies have investigated the association between neighbourhood and health in Jamaica. We evaluated the relationship between neighbourhood socioeconomic status (SES) and blood pressure (BP) among youth, 15-24 years old, in Jamaica. Methods A pooled analysis was conducted using data from three studies (two national surveys and a birth cohort), conducted between 2005-2008, with individual level BP, anthropometric and demographic data, and household SES. Data on neighbourhood SES were obtained from the Mona Geo-Informatics Institute. Neighbourhood was defined using community boundaries from the Social Development Commission in Jamaica. Community characteristics (poverty, unemployment, dependency ratio, population density, house size, and proportion with tertiary education) were combined into SES scores using principal component analysis (PCA). Multivariable analyses were computed using mixed effects multilevel models. Results Analyses included 2,556 participants (1,446 females; 1,110 males; mean age 17.9 years) from 306 communities. PCA yielded two neighbourhood SES variables; the first, PCA-SES1, loaded highly positive for tertiary education and larger house size (higher value = higher SES); while the second, PCA-SES2, loaded highly positive for unemployment and population density (higher value = lower SES). Among males, PCA-SES1 was inversely associated with systolic BP (β-1.48 [95%CI -2.11, -0.84] mmHg, p < 0.001, for each standard deviation unit increase in PCA-SES1 score) in multivariable model accounting for age, household SES, study, BMI, fasting glucose, physical activity and diet. PCA-SES1 was not significantly associated with systolic BP among females (β -0.48 [-1.62, 0.66], p = 0.410) in a similar model. Associations for PCA-SES2 was assessed using linear splines to account for non-linear effects. The were no significant associations between systolic BP and PCA-SES2 among males. Among females, higher PCA-SES2 (i.e. lower SES) was associated with higher systolic BP at spline 2 [z-score -1 to 0] (β4.09 [1.49, 6.69], p = 0.002), but with lower systolic BP at spline 3 [z-core 0 to 1] (β-2.81 [-5.04, -0.59], p = 0.013). There were no significant associations between diastolic BP and PCA-SES1, but PCA-SES2 showed non-linear associations with diastolic BP particularly among males. Conclusion Higher neighbourhood SES was inversely associated with systolic BP among male Jamaican youth; there were non-linear associations between neighbourhood SES and systolic BP among females and for diastolic BP for both males and females.
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Affiliation(s)
- Trevor S Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Novie O M Younger-Coleman
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Jasneth Mullings
- Health Research Resource Unit, Dean's Office, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Damian Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, United States of America
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Rainford Wilks
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
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Spatz ES, Martinez-Brockman JL, Tessier-Sherman B, Mortazavi B, Roy B, Schwartz JI, Nazario CM, Maharaj R, Nunez M, Adams OP, Burg M, Nunez-Smith M. Phenotypes of Hypertensive Ambulatory Blood Pressure Patterns: Design and Rationale of the ECHORN Hypertension Study. Ethn Dis 2019; 29:535-544. [PMID: 31641320 PMCID: PMC6802166 DOI: 10.18865/ed.29.4.535] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective To describe the rationale and design of a prospective study of ambulatory blood pressure measurement (ABPM) combined with measurement of contextual factors to identify hypertensive phenotypes in a Caribbean population with high rates of HTN and cardiovascular disease. Design Prospective, multi-center sub-study. Setting Eastern Caribbean Health Outcomes Research Network Cohort (ECHORN) Study, with study sites in Puerto Rico, the US Virgin Islands, Trinidad and Tobago, and Barbados. Participants Community-residing adults without a diagnosis of HTN and not taking antihypertensive medication. Intervention Ambulatory BP patterns are assessed using 24-hour ABPM. Contextual factors are assessed with: ecological momentary assessment (7-item survey of experiences, exposures and responses associated with daytime BP measurements); actigraphy (capturing physical activity and sleep quality); and self-report surveys (assessing physical and social health, environmental and social stressors and supports). Main Outcome Measures Phenotypes of contextual factors associated with hypertensive BP patterns (sustained HTN, masked HTN, and nocturnal non-dipping). Methods and Results This study will enroll 500 participants; assessments of blood pressure and contextual factors will be conducted during Waves 2 and 3 of the ECHORN parent study, occurring 2 years apart. In Wave 2, we will assess the association between contextual factors and ABPM patterns. Using advanced analytic clustering methods, we will identify phenotypes of contextual factors associated with hypertensive ABPM patterns. We will then test the stability of these phenotypes and their ability to predict change in ABPM patterns between Waves 2 and 3. Conclusions Assessment of ABPM, and the contextual factors influencing ABPM, can identify unique phenotypes of HTN, which can then be used to develop more precision-based approaches to the prevention, detection and treatment of HTN in high-risk populations.
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Affiliation(s)
- Erica S. Spatz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine; New Haven, CT
- Yale/Yale New Haven Health System Corporation Center for Outcomes Research and Evaluation; New Haven, CT
| | | | | | - Bobak Mortazavi
- Department of Computer Science and Engineering, Texas A & M University College of Engineering; College Station, TX
| | - Brita Roy
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
| | - Jeremy I. Schwartz
- Equity Research and Innovation Center, Yale School of Medicine; New Haven, CT
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
| | - Cruz M. Nazario
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico; San Juan, PR
| | - Rohan Maharaj
- Department of Paraclinical Sciences, University of the West Indies; Saint Augustine, Trinidad
| | - Maxine Nunez
- School of Nursing, University of the Virgin Islands; US Virgin Islands
| | - O. Peter Adams
- Department of Family Medicine, Faculty of Medical Sciences, University of the West Indies; Cave Hill, Barbados
| | - Matthew Burg
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine; New Haven, CT
- Department of Anesthesiology, Yale School of Medicine; New Haven, CT
| | - Marcella Nunez-Smith
- Equity Research and Innovation Center, Yale School of Medicine; New Haven, CT
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
| | - ECHORN Writing Group
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine; New Haven, CT
- Yale/Yale New Haven Health System Corporation Center for Outcomes Research and Evaluation; New Haven, CT
- Equity Research and Innovation Center, Yale School of Medicine; New Haven, CT
- Department of Computer Science and Engineering, Texas A & M University College of Engineering; College Station, TX
- Section of General Internal Medicine, Department of Medicine, Yale School of Medicine; New Haven, CT
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico; San Juan, PR
- Department of Paraclinical Sciences, University of the West Indies; Saint Augustine, Trinidad
- School of Nursing, University of the Virgin Islands; US Virgin Islands
- Department of Family Medicine, Faculty of Medical Sciences, University of the West Indies; Cave Hill, Barbados
- Department of Anesthesiology, Yale School of Medicine; New Haven, CT
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9
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Zhao S, Fu S, Ren J, Luo L. Poor sleep is responsible for the impaired nocturnal blood pressure dipping in elderly hypertensive: A cross-sectional study of elderly. Clin Exp Hypertens 2018; 40:582-588. [PMID: 29420078 DOI: 10.1080/10641963.2017.1411495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study was aimed to assess whether sleep disorder was associated with an increased risk of less nocturnal blood pressure (BP) dipping in elderly patients with hypertension. METHODS Cases were 1006 patients, aged >60 years, who were admitted to hospital with diagnosed hypertension during 2016-2017, and were divided into three groups with the systolic nocturnal BP dipping of 10%, and 0% as the cut-off value. The patients' sleep was evaluated by Pittsburgh sleep quality index (PSQI). RESULTS Compared to non-dipper BP rhythm patients (n = 382) and dipper BP rhythm patients (n = 132), reverse dipper patients (n = 492) exhibited higher PSQI score and had higher scores on six components with the exception of use sleep drug (p < 0.05). Multivariate logistic regression indicated that poor sleep, which was defined as high score of PSQI or its seven components, was associated with prevalence of reverse dipper in elderly hypertensive (odds ratio (OR) = 1.17, (95% confidence interval (CI), 1.13-1.21, p < 0.05) after adjusting for risk factors of hypertension. Multiple linear regression analysis showed that there was a significant negative correlation between PSQI score (include its seven components) and nocturnal BP dipping value after adjusting for risk factors of hypertension (β = -0.584, p < 0.001). CONCLUSIONS In elderly patients with hypertension, poor sleep quality individuals were more prone to reverse dipper BP rhythm. Even adjusting for the effect of known risk factors of hypertension, poor sleep may contribute to attenuated BP dipping in elderly hypertensive.
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Affiliation(s)
- Shaopan Zhao
- a Department of Geriatric Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Shihui Fu
- a Department of Geriatric Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Jiefeng Ren
- a Department of Geriatric Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
| | - Leiming Luo
- a Department of Geriatric Cardiology , Chinese People's Liberation Army General Hospital , Beijing , China
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10
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Krause N, Ironson G, Pargament K, Hill P. Neighborhood conditions, religious coping, and uncontrolled hypertension. SOCIAL SCIENCE RESEARCH 2017; 62:161-174. [PMID: 28126096 DOI: 10.1016/j.ssresearch.2016.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/14/2016] [Accepted: 08/23/2016] [Indexed: 06/06/2023]
Abstract
The purpose of this study is to see whether God-mediated control beliefs moderate the relationship between living in rundown neighborhoods and uncontrolled hypertension. God-mediated control refers to the belief that God will help people handle the stressors that arise in life. Data are provided by a nationwide survey of adults (N = 1919). Three ways of assessing uncontrolled hypertension are examined: a binary format contrasting people with and without uncontrolled hypertension, systolic and diastolic blood pressure scored continuously, and a four ordinal category scheme recommended by the American Heart Association. The data suggest that stronger God-mediated control beliefs moderate the relationship between neighborhood conditions and uncontrolled blood pressure when blood pressure is scored continuously and when the American Heart Association scheme are used as outcomes.
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11
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Mellman TA, Brown TSH, Kobayashi I, Abu-Bader SH, Lavela J, Altaee D, McLaughlin L, Randall OS. Blood Pressure Dipping and Urban Stressors in Young Adult African Americans. Ann Behav Med 2016; 49:622-7. [PMID: 25623895 DOI: 10.1007/s12160-014-9684-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Blunted nocturnal blood pressure (BP) dipping is an early marker of cardiovascular risk that is prevalent among African Americans. PURPOSE We evaluated relationships of BP dipping to neighborhood and posttraumatic stress and sleep in urban residing young adult African Americans. METHODS One hundred thirty-six black, predominately African American, men and women with a mean age of 22.9 years (SD = 4.6) filled out surveys and were interviewed and had two, 24-h ambulatory BP recordings. RESULTS Thirty-eight percent had BP dipping ratios < .10. Wake after sleep onset (WASO), neighborhood disorder and neighborhood poverty rates but not posttraumatic stress symptoms, and other sleep measures correlated significantly with dipping ratios. Models with the neighborhood measures that also included WASO increased the explained variance. CONCLUSIONS Studies elucidating mechanisms underlying effects of neighborhoods on BP dipping and the role of disrupted sleep, and how they can be mitigated are important directions for future research.
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Affiliation(s)
- Thomas A Mellman
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, 520 W St. N.W., Washington, DC, 20059, USA,
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Schedlowski M, Enck P, Rief W, Bingel U. Neuro-Bio-Behavioral Mechanisms of Placebo and Nocebo Responses: Implications for Clinical Trials and Clinical Practice. Pharmacol Rev 2016; 67:697-730. [PMID: 26126649 DOI: 10.1124/pr.114.009423] [Citation(s) in RCA: 197] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The placebo effect has often been considered a nuisance in basic and particularly clinical research. This view has gradually changed in recent years due to deeper insight into the neuro-bio-behavioral mechanisms steering both the placebo and nocebo responses, the evil twin of placebo. For the neuroscientist, placebo and nocebo responses have evolved as indispensable tools to understand brain mechanisms that link cognitive and emotional factors with symptom perception as well as peripheral physiologic systems and end organ functioning. For the clinical investigator, better understanding of the mechanisms driving placebo and nocebo responses allow the control of these responses and thereby help to more precisely define the efficacy of a specific pharmacological intervention. Finally, in the clinical context, the systematic exploitation of these mechanisms will help to maximize placebo responses and minimize nocebo responses for the patient's benefit. In this review, we summarize and critically examine the neuro-bio-behavioral mechanisms underlying placebo and nocebo responses that are currently known in terms of different diseases and physiologic systems. We subsequently elaborate on the consequences of this knowledge for pharmacological treatments of patients and the implications for pharmacological research, the training of healthcare professionals, and for the health care system and future research strategies on placebo and nocebo responses.
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Affiliation(s)
- Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology (M.S.) and Department of Neurology (U.B.), University Clinic Essen, Essen, Germany; Department of Internal Medicine VI, Psychosomatic Medicine, University Hospital Tübingen, Tübingen, Germany (P.E.); and Department of Psychology, University of Marburg, Marburg, Germany (W.R.)
| | - Paul Enck
- Institute of Medical Psychology and Behavioral Immunobiology (M.S.) and Department of Neurology (U.B.), University Clinic Essen, Essen, Germany; Department of Internal Medicine VI, Psychosomatic Medicine, University Hospital Tübingen, Tübingen, Germany (P.E.); and Department of Psychology, University of Marburg, Marburg, Germany (W.R.)
| | - Winfried Rief
- Institute of Medical Psychology and Behavioral Immunobiology (M.S.) and Department of Neurology (U.B.), University Clinic Essen, Essen, Germany; Department of Internal Medicine VI, Psychosomatic Medicine, University Hospital Tübingen, Tübingen, Germany (P.E.); and Department of Psychology, University of Marburg, Marburg, Germany (W.R.)
| | - Ulrike Bingel
- Institute of Medical Psychology and Behavioral Immunobiology (M.S.) and Department of Neurology (U.B.), University Clinic Essen, Essen, Germany; Department of Internal Medicine VI, Psychosomatic Medicine, University Hospital Tübingen, Tübingen, Germany (P.E.); and Department of Psychology, University of Marburg, Marburg, Germany (W.R.)
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Ritvo P, Stefanyk LE, Azargive S, Stojanovic S, Stollon F, Habot J, Khaykin Y, Fair T, Pirbaglou M. Functional capacity and heart rate response: associations with nocturnal hypertension. BMC Cardiovasc Disord 2015. [PMID: 26197812 PMCID: PMC4511245 DOI: 10.1186/s12872-015-0064-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Absences of normative, 10–20 % declines in blood pressure (BP) at night, termed nocturnal non-dipping, are linked to increased cardiovascular mortality risks. Current literature has linked these absences to psychological states, hormonal imbalance, and disorders involving hyper-arousal. This study focuses on evaluating associations between nocturnal non-dipping and indices of functional cardiac capacity and fitness. Methods The current study was a cross-sectional evaluation of the associations between physical capacity variables e.g. Metabolic Equivalent (MET) and Maximum Heart Rate (MHR), Heart rate reserve (HRR), and degree of reduction in nocturnal systolic blood pressure (SBP) or diastolic blood pressure (DBP), also known as ‘dipping’. The study sample included 96 cardiac patient participants assessed for physical capacity and ambulatory blood pressure monitoring. In addition to evaluating differences between groups on nocturnal BP ‘dipping’, physical capacity, diagnoses, and medications, linear regression analyses were used to evaluate potential associations between nocturnal SBP and DBP ‘dipping’, and physical capacity indices. Results 45 males and 14 females or 61.5 % of 96 consented participants met criteria as non-dippers (<10 % drop in nocturnal BP). Although non-dippers were older (p = .01) and had a lower maximum heart rate during the Bruce stress test (p = .05), dipping was only significantly associated with Type 2 Diabetes co-morbidity and was not associated with type of medication. Within separate linear regression models controlling for participant sex, MHR (β = 0.26, p = .01, R2 = .06), HRR (β = 0. 19, p = .05, R2 = .05), and METs (β = 0.21, p = .04, R2 = .04) emerged as significant but small predictors of degree of nighttime SBP dipping. Similar relationships were not observed for DBP. Conclusions Since the variables reflecting basic heart function and fitness (MHR and METs), did not account for appreciable variances in nighttime BP, nocturnal hypertension appears to be a complex, multi-faceted phenomena.
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Affiliation(s)
- Paul Ritvo
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada. .,Department of Psychology, York University, Toronto, ON, Canada. .,Research, Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, Canada. .,Department of Community and Family Medicine, University of Toronto, Toronto, ON, Canada.
| | - Leslie E Stefanyk
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - Saam Azargive
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - Slobodan Stojanovic
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - Faye Stollon
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
| | - Juda Habot
- Division of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada.
| | - Yaariv Khaykin
- Division of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada. .,Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Terry Fair
- Division of Cardiology, Southlake Regional Health Centre, Newmarket, ON, Canada.
| | - Meysam Pirbaglou
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada.
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