Skip to main content
Log in

Psychosocial Correlates of Atrial Natriuretic Peptide: A Marker of Vascular Health

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Psychosocial factors have been associated with cardiovascular outcomes, but few studies have examined the association between psychosocial function and natriuretic peptides.

Purpose

The purpose of this study is to determine the predictive value of hostility, anger, and social support in relation to atrial natriuretic peptide (ANP), a marker of vascular health, among middle-aged men.

Methods

One hundred twenty-one men (mean age = 39.8 years, SD = 4.1) underwent assessments of ANP and completed the Cook–Medley Hostility Scale, the Spielberger State–Trait Anger Scale, and the Interview Schedule for Social Interaction.

Results

Higher levels of hostility (β = 0.22 [95 % CI 0.04, 0.40], P = 0.032) and trait anger (β = 0.18 [95 % CI 0.01, 0.37], P = 0.044) were associated with greater ANP levels. In contrast, higher perceived social support was also associated with lower ANP levels, (β = −0.19 [95 % CI −0.05, −0.41], P = 0.010).

Conclusions

Psychosocial factors, including hostility, anger, and social support, are associated with varying ANP levels among middle-aged men, independent of cardiovascular and behavioral risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Rosamond W, Flegal K, Friday G, et al. Heart disease and stroke statistics–2007 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2007;115:e69-171.

    Article  PubMed  Google Scholar 

  2. Chida Y, Steptoe A. The association of anger and hostility with future coronary heart disease: A meta-analytic review of prospective evidence. Journal of the American College of Cardiology. 2009;53:936-946.

    Article  PubMed  Google Scholar 

  3. Hemingway H, Marmot M. Evidence based cardiology: Psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ (Clinical Research Ed). 1999;318:1460-1467.

    Article  CAS  Google Scholar 

  4. Hogan BE, Linden W. Anger response styles and blood pressure: At least don't ruminate about it! Ann Behav Med. 2004;27:38-49.

    Article  PubMed  Google Scholar 

  5. Fredrickson BL, Maynard KE, Helms MJ, et al. Hostility predicts magnitude and duration of blood pressure response to anger. Journal of Behavioral Medicine. 2000;23:229-243.

    Article  PubMed  CAS  Google Scholar 

  6. Vella EJ, Kamarck TW, Shiffman S. Hostility moderates the effects of social support and intimacy on blood pressure in daily social interactions. Health Psychology. 2008;27:S155-S162.

    Article  PubMed  Google Scholar 

  7. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99:2192-2217.

    Article  PubMed  CAS  Google Scholar 

  8. Rodriguez CJ, Boden-Albala B, Burg MM, et al. The effect of high social support on ambulatory blood pressure diurnal variation. Circulation. 2006;113:E369-E369.

    Google Scholar 

  9. Rodriguez CJ, Burg MM, Meng J, et al. Effect of social support on nocturnal blood pressure dipping. Psychosomatic Medicine. 2008;70:7-12.

    Article  PubMed  Google Scholar 

  10. Chen YY, Gilligan S, Coups EJ, Contrada RJ. Hostility and perceived social support: Interactive effects on cardiovascular reactivity to laboratory stressors. Annals of Behavioral Medicine. 2005;29:37-43.

    Article  PubMed  Google Scholar 

  11. Hansel A, Hong S, Camara RJ, von Kanel R. Inflammation as a psychophysiological biomarker in chronic psychosocial stress. Neuroscience and Biobehavioral Reviews. 2010;35:115-121.

    Article  PubMed  Google Scholar 

  12. Steptoe A, Hamer M, Chida Y. The effects of acute psychological stress on circulating inflammatory factors in humans: A review and meta-analysis. Brain, Behavior, and Immunity. 2007;21:901-912.

    Article  PubMed  CAS  Google Scholar 

  13. Brydon L, Magid K, Steptoe A. Platelets, coronary heart disease, and stress. Brain, Behavior, and Immunity. 2006;20:113-119.

    Article  PubMed  CAS  Google Scholar 

  14. Lampert R. Anger and ventricular arrhythmias. Current Opinion in Cardiology. 2010;25:46-52.

    Article  PubMed  Google Scholar 

  15. Melo LG, Pang SC, Ackermann U. Atrial natriuretic peptide: Regulator of chronic arterial blood pressure. News in Physiological Sciences. 2000;15:143-149.

    PubMed  CAS  Google Scholar 

  16. Levin ER, Gardner DG, Samson WK. Mechanisms of disease—Natriuretic peptides. New England Journal of Medicine. 1998;339:321-328.

    Article  PubMed  CAS  Google Scholar 

  17. Naruse M, Takeyama Y, Tanabe A, et al. Atrial and brain natriuretic peptides in cardiovascular diseases. Hypertension. 1994;23:I231-234.

    Article  PubMed  CAS  Google Scholar 

  18. Ogawa T, Linz W, Stevenson M, et al. Evidence for load-dependent and load-independent determinants of cardiac natriuretic peptide production. Circulation. 1996;93:2059-2067.

    Article  PubMed  CAS  Google Scholar 

  19. Hirata Y, Matsumoto A, Aoyagi T, et al. Measurement of plasma brain natriuretic peptide level as a guide for cardiac overload. Cardiovascular Research. 2001;51:585-591.

    Article  PubMed  CAS  Google Scholar 

  20. Freitag MH, Larson MG, Levy D, et al. Plasma brain natriuretic peptide levels and blood pressure tracking in the Framingham Heart Study. Hypertension. 2003;41:978-983.

    Article  PubMed  CAS  Google Scholar 

  21. Melander O, Newton-Cheh C, Almgren P, et al. Novel and conventional biomarkers for prediction of incident cardiovascular events in the community. Jama-Journal of the American Medical Association. 2009;302:49-57.

    Article  CAS  Google Scholar 

  22. Nishikimi T, Yoshihara F, Morimoto A, et al. Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension. 1996;28:22-30.

    Article  PubMed  CAS  Google Scholar 

  23. de Bold ML K. Atrial natriuretic factor and brain natriuretic peptide gene expression in the spontaneous hypertensive rat during postnatal development. American Journal of Hypertension. 1998;11:1006-1018.

    Article  Google Scholar 

  24. Levy D, Hwang SJ, Kayalar A, et al. Associations of plasma natriuretic peptide, adrenomedullin, and homocysteine levels with alterations in arterial stiffness: The Framingham Heart Study. Circulation. 2007;115:3079-3085.

    Article  PubMed  CAS  Google Scholar 

  25. Sung SH, Chuang SY, Sheu WH, et al. Relation of adiponectin and high-sensitivity C-reactive protein to pulse-wave velocity and N-terminal pro-B-type natriuretic peptide in the general population. Am J Cardiol. 2009;103:1411-1416.

    Article  PubMed  CAS  Google Scholar 

  26. Smith JG, Newton-Cheh C, Almgren P, et al. Assessment of conventional cardiovascular risk factors and multiple biomarkers for the prediction of incident heart failure and atrial fibrillation. Journal of the American College of Cardiology. 2010;56:1713-1719.

    Article  Google Scholar 

  27. Debold AJ. Atrial natriuretic factor—A hormone produced by the heart. Science (New York, N Y ). 1985;230:767-770.

    Article  CAS  Google Scholar 

  28. Rosenzweig A, Seidman CE. Atrial natriuretic factor and related peptide hormones. Annu Rev Biochem. 1991;60:229-255.

    Article  PubMed  CAS  Google Scholar 

  29. Doust JA, Glasziou PP, Pietrzak E, Dobson AJ. A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure. Archives of Internal Medicine. 2004;164:1978-1984.

    Article  PubMed  CAS  Google Scholar 

  30. Rubattu S, Stanzione R, Di Angelantonio E, et al. Atrial natriuretic peptide gene polymorphisms and risk of ischemic stroke in humans. Stroke; a Journal of Cerebral Circulation. 2004;35:814-818.

    Article  PubMed  CAS  Google Scholar 

  31. Costello-Boerrigter LC, Boerrigter G, Redfield MM, et al. Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the general community—Determinants and detection of left ventricular dysfunction. Journal of the American College of Cardiology. 2006;47:345-353.

    Article  PubMed  CAS  Google Scholar 

  32. Khaleghi M, Saleem U, Morgenthaler NG, et al. Plasma midregional pro-atrial natriuretic peptide is associated with blood pressure indices and hypertension severity in adults with hypertension. American Journal of Hypertension. 2009;22:425-431.

    Article  PubMed  CAS  Google Scholar 

  33. Herrmann-Lingen C, Binder L, Klinge M, et al. High plasma levels of N-terminal pro-atrial natriuretic peptide associated with low anxiety in severe heart failure. Psychosomatic Medicine. 2003;65:517-522.

    Article  PubMed  CAS  Google Scholar 

  34. Krogh J, Strohle A, Westrin A, et al.: N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls. Psychoneuroendocrinology. 2010.

  35. Boyle SH, Williams RB, Mark DB, et al. Hostility, age, and mortality in a sample of cardiac patients. American Journal of Cardiology. 2005;96:64-66.

    Article  PubMed  Google Scholar 

  36. Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases. Annual Review of Public Health. 2005;26:469-500.

    Article  PubMed  Google Scholar 

  37. Lett HS, Blumenthal JA, Babyak MA, et al. Social support and coronary heart disease: Epidemiologic evidence and implications for treatment. Psychosomatic Medicine. 2005;67:869-878.

    Article  PubMed  Google Scholar 

  38. Suls J, Bunde J. Anger, anxiety, and depression as risk factors for cardiovascular disease: The problems and implications of overlapping affective dispositions. Psychol Bull. 2005;131:260-300.

    Article  PubMed  Google Scholar 

  39. Barth J, Schneider S, von Kanel R. Lack of social support in the etiology and the prognosis of coronary heart disease: A systematic review and meta-analysis. Psychosomatic Medicine. 2010;72:229-238.

    Article  PubMed  Google Scholar 

  40. Brondolo E, Rieppi R, Erickson SA, et al. Hostility, interpersonal interactions, and ambulatory blood pressure. Psychosomatic Medicine. 2003;65:1003-1011.

    Article  PubMed  Google Scholar 

  41. Knox SS, Adelman A, Ellison RC, et al. Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Cardiol. 2000;86:1086-1089.

    Article  PubMed  CAS  Google Scholar 

  42. Smith TW, Glazer K, Ruiz JM, Gallo LC. Hostility, anger, aggressiveness, and coronary heart disease: An interpersonal perspective on personality, emotion, and health. Journal of Personality. 2004;72:1217-1270.

    Article  PubMed  Google Scholar 

  43. Williams JE, Paton CC, Siegler IC, et al. Anger proneness predicts coronary heart disease risk: Prospective analysis from the atherosclerosis risk in communities (ARIC) study. Circulation. 2000;101:2034-2039.

    Article  PubMed  CAS  Google Scholar 

  44. Angerer P, Siebert U, Kothny W, et al. Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis. Journal of the American College of Cardiology. 2000;36:1781-1788.

    Article  PubMed  CAS  Google Scholar 

  45. Brondolo E, Grantham KI, Karlin W, et al. Trait hostility and ambulatory blood pressure among traffic enforcement agents: The effects of stressful social interactions. Journal of Occupational Health Psychology. 2009;14:110-121.

    Article  PubMed  Google Scholar 

  46. Tuomisto MT, Majahalme S, Kahonen M, Fredrikson M, Turjanmaa V. Psychological stress tasks in the prediction of blood pressure level and need for antihypertensive medication: 9–12 years of follow-up. Health Psychology. 2005;24:77-87.

    Article  PubMed  Google Scholar 

  47. Tuomisto M, Turjanmaa V, Ollikainen J, Majahalme S, Uusitalo A. Behavioral influences on daily intra-arterial blood pressure and heart rate in normotension, borderline hypertension, and hypertension. International Journal of Psychophysiology. 1997;25:54-54.

    Article  Google Scholar 

  48. Arterial hypertension. Report of a WHO expert committee. Geneva, Switzerland: World Health Organization, 1978.

  49. Abell LL, Levy BB, Brody BB, Kendall FE. A simplified method for estimation of total cholesterol in serum and demonstration of its specificity. The Journal of Biological Chemistry. 1952;195:357-366.

    CAS  Google Scholar 

  50. Warnick GR, Benderson J, Albers JJ. Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. Clinical chemistry. 1982;28:1379-1388.

    PubMed  CAS  Google Scholar 

  51. Cook WW, Medley DM. Proposed hostility and pharisaic-virtue scales for the MMPI. J Appl Psychol. 1954;38:414-418.

    Article  Google Scholar 

  52. Burell G, Öhman A, Sundin Ö, Ström G, Ramund B, Cullhed I, Thoresen CE. Modification of the type A behavior pattern in post-myocardial infarction patients: A route to cardiac rehabilitation. Int J BehavMed. 1994;1:32-54.

    Article  PubMed  CAS  Google Scholar 

  53. Smith TW. Hostility and health: Current status of a psychosomatic hypothesis. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association. 1992;11:139-150.

    Article  CAS  Google Scholar 

  54. Smith TW, Frohm KD. What's so unhealthy about hostility? Construct validity and psychosocial correlates of the Cook and Medley Ho scale. Health Psychology: Official journal of the Division of Health Psychology, American Psychological Association. 1985;4:503-520.

    Article  CAS  Google Scholar 

  55. Weidner G, Friend R, Ficarrotto TJ, Mendell NR. Hostility and cardiovascular reactivity to stress in women and men. Psychosomatic Medicine. 1989;51:36-45.

    PubMed  CAS  Google Scholar 

  56. Everson SA, Kauhanen J, Kaplan GA, et al. Hostility and increased risk of mortality and acute myocardial infarction: The mediating role of behavioral risk factors. American Journal of Epidemiology. 1997;146:142-152.

    Article  PubMed  CAS  Google Scholar 

  57. Spielberger CD, Jacobs G, Russell S, Crane RS. Assessment of anger: The State-Trait Anger Scale. In: Advances in Personality Assessment. Hillsdale: Lawrence Erlbaum Associates; 1983:161-189.

    Google Scholar 

  58. Henderson S, Duncan-Jones P, Byrne DG, Scott R. Measuring social relationships—the interview schedule for social-interaction. Psychological Medicine. 1980;10:723-734.

    Article  PubMed  CAS  Google Scholar 

  59. Unden AL, Orth-Gomer K. Development of a social support instrument for use in population surveys. Social Science & Medicine. 1989;29:1387-1392.

    Article  CAS  Google Scholar 

  60. Eklund M, Bengtsson-Tops A, Lindstedt H. Construct and discriminant validity and dimensionality of the Interview Schedule for Social Interaction (ISSI) in three psychiatric samples. Nordic Journal of Psychiatry. 2007;61:182-188.

    Article  PubMed  Google Scholar 

  61. DiMatteo MR. Social support and patient adherence to medical treatment: A meta-analysis. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association. 2004;23:207-218.

    Article  Google Scholar 

  62. Smith TW, MacKenzie J. Personality and risk of physical illness. Annu Rev Clin Psychol. 2006;2:435-467.

    Article  PubMed  Google Scholar 

  63. Wang TJ, Larson MG, Levy D, et al. Impact of age and sex on plasma natriuretic peptide levels in healthy adults. Am J Cardiol. 2002;90:254-258.

    Article  PubMed  CAS  Google Scholar 

  64. Lupattelli G, Marchesi S, Siepi D, et al. Natriuretic peptides levels are related to HDL-cholesterol with no influence on endothelium dependent vasodilatation. Vasa. 2006;35:215-220.

    Article  PubMed  CAS  Google Scholar 

  65. Wang TJ, Larson MG, Levy D, et al. Impact of obesity on plasma natriuretic peptide levels. Circulation. 2004;109:594-600.

    Article  PubMed  CAS  Google Scholar 

  66. Alyan O, Kacmaz F, Ozdemir O, et al. Effects of cigarette smoking on heart rate variability and plasma N-terminal pro-B-type natriuretic peptide in healthy subjects: Is there the relationship between both markers? Ann Noninvasive Electrocardiol. 2008;13:137-144.

    Article  PubMed  Google Scholar 

  67. Ohba H, Takada H, Musha H, et al. Effects of prolonged strenuous exercise on plasma levels of atrial natriuretic peptide and brain natriuretic peptide in healthy men. American Heart Journal. 2001;141:751-758.

    Article  PubMed  CAS  Google Scholar 

  68. Djousse L, Hunt SC, Eckfeldt JH, et al. Alcohol consumption and plasma atrial natriuretic peptide (from the HyperGEN study). Am J Cardiol. 2006;98:628-632.

    Article  PubMed  CAS  Google Scholar 

  69. Aiken LS, West SG. Multiple regression: testing and interpreting interactions. Newbury Park: Sage; 1991.

    Google Scholar 

  70. Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173-1182.

    Article  PubMed  CAS  Google Scholar 

  71. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods. 2008;40:879-891.

    Article  PubMed  Google Scholar 

  72. Myrtek M. Meta-analyses of prospective studies on coronary heart disease, type A personality, and hostility. International Journal of Cardiology. 2001;79:245-251.

    Article  PubMed  CAS  Google Scholar 

  73. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychological Bulletin. 1985;98:310-357.

    Article  PubMed  CAS  Google Scholar 

  74. Wann BP, Audet MC, Anisman H. Impact of acute and chronic stressor experiences on heart atrial and brain natriuretic peptides in response to a subsequent stressor. Hormones and Behavior. 2010;58:907-916.

    Article  PubMed  CAS  Google Scholar 

  75. Wann BP, Audet MC, Gibb J, Anisman H. Anhedonia and altered cardiac atrial natriuretic peptide following chronic stressor and endotoxin treatment in mice. Psychoneuroendocrinology. 2010;35:233-240.

    Article  PubMed  CAS  Google Scholar 

  76. Chida Y, Hamer M. Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: A quantitative review of 30 years of investigations. Psychological Bulletin. 2008;134:829-885.

    Article  PubMed  Google Scholar 

  77. Hardy JD, Smith TW. Cynical hostility and vulnerability to disease: Social support, life stress, and physiological response to conflict. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association. 1988;7:447-459.

    Article  CAS  Google Scholar 

  78. Cao C, Han JH, Kim SZ, Cho KW, Kim SH. Diverse regulation of atrial natriuretic peptide secretion by serotonin receptor subtypes. Cardiovascular Research. 2003;59:360-368.

    Article  PubMed  CAS  Google Scholar 

  79. Scharhag J, Herrmann M, Urhausen A, et al. Independent elevations of N-terminal pro-brain natriuretic peptide and cardiac troponins in endurance athletes after prolonged strenuous exercise. Am Heart J. 2005;150:1128-1134.

    Article  PubMed  CAS  Google Scholar 

  80. Kiemer AK, Vollmar AM. The atrial natriuretic peptide regulates the production of inflammatory mediators in macrophages. Annals of the Rheumatic Diseases. 2001;60:Iii68-Iii70.

    PubMed  CAS  Google Scholar 

  81. Vollmar AM. The role of atrial natriuretic peptide in the immune system. Peptides. 2005;26:1086-1094.

    Article  PubMed  CAS  Google Scholar 

  82. Houng AK, McNamee RA, Kerner A, et al. Atrial natriuretic peptide increases inflammation, infarct size, and mortality after experimental coronary occlusion. American Journal of Physiology Heart and Circulatory Physiology. 2009;296:H655-661.

    Article  PubMed  CAS  Google Scholar 

  83. Tracey KJ. The inflammatory reflex. Nature. 2002;420:853-859.

    Article  PubMed  CAS  Google Scholar 

  84. Boyle SH, Williams RB, Mark DB, et al. Hostility as a predictor of survival in patients with coronary artery disease. Psychosomatic Medicine. 2004;66:629-632.

    Article  PubMed  Google Scholar 

  85. Sagnella GA, Markandu ND, Shore AC, MacGregor GA. Effects of changes in dietary sodium intake and saline infusion on immunoreactive atrial natriuretic peptide in human plasma. Lancet. 1985;2:1208-1211.

    Article  PubMed  CAS  Google Scholar 

  86. Miller SB, Friese M, Dolgoy L, et al. Hostility, sodium consumption, and cardiovascular response to interpersonal stress. Psychosomatic Medicine. 1998;60:71-77.

    PubMed  CAS  Google Scholar 

  87. Blumenthal JA, Barefoot J, Burg MM, Williams RB Jr. Psychological correlates of hostility among patients undergoing coronary angiography. The British Journal of Medical Psychology. 1987;60(Pt 4):349-355.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Patrick Smith Ph.D..

About this article

Cite this article

Smith, P., Tuomisto, M.T., Blumenthal, J. et al. Psychosocial Correlates of Atrial Natriuretic Peptide: A Marker of Vascular Health. ann. behav. med. 45, 99–109 (2013). https://doi.org/10.1007/s12160-012-9414-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-012-9414-1

Keywords

Navigation