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Prolonged stress-related cardiovascular activation: Is there any?

  • Published:
Annals of Behavioral Medicine

Abstract

Background: Prolonged physiological activation before or after stressors has gained recognition as a decisive element in theories that explain the link between stress and disease, specifically cardiovascular (CV) disease. This view is opposed to the conventional reactivity hypothesis that emphasizes responses during stressors.Purpose: Prolonged activity has not often been an explicit research goal of real-life stress studies. Nevertheless, a growing number of these studies have provided evidence for prolonged activity, often as a secondary research goal.Methods: An overview of this evidence is lacking and is provided in this article.Results: The combined data from the reviewed studies suggest that discrete and chronic stress sources, as well as negative emotional episodes and dispositions, are related to prolonged CV activity of various durations, including sleep periods. On the other hand, evidence supporting the assumption that prolonged stress-related activation predicts disease is still very modest.Conclusions: In this article we suggest that future research of prolonged activation should give priority to (a) the establishment of clear beginnings and endings of stressful events, (b) the prediction of disease by prolonged activation, and (c) potential psychological mediators of stress-related prolonged activation. These mediators may include, for example, worry and rumination, or other processes characterized by perseverative cognition, including unconscious processes.

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References

  1. Barefoot JC, Schroll M: Symptoms of depression, acute myocardial infarction, and total mortality in a community sample.Circulation. 1996,93:1976–1980.

    PubMed  CAS  Google Scholar 

  2. 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.

    PubMed  CAS  Google Scholar 

  3. Smith DF: Negative emotions and coronary heart disease: Causally related or merely coexistent? A review.Scandinavian Journal of Psychology. 2001,42:57–69.

    Article  PubMed  CAS  Google Scholar 

  4. Jonas BS, Mussolino ME: Symptoms of depression as a prospective risk factor for stroke.PsychosomaticMedicine. 2000,62:463–471.

    CAS  Google Scholar 

  5. Jonas BS, Lando JF: Negative affect as a prospective risk factor for hypertension.Psychosomatic Medicine. 2000,62:188–196.

    PubMed  CAS  Google Scholar 

  6. Levenstein S, Smith MW, Kaplan GA: Psychosocial predictors of hypertension in men and women.Archives of Internal Medicine.2001,161:1341–1346.

    Article  PubMed  CAS  Google Scholar 

  7. Amerena J, Julius S: Role of the nervous system in human hypertension. In Hollenberg NK, Braunwald E (eds),Hypertension: Mechanisms and Therapy. Philadelphia: Current Medicine, 1995.

    Google Scholar 

  8. Sloan RP, Shapiro PA, Bagiella E, et al.: Cardiac autonomic control buffers blood pressure variability responses to challenge: A psychophysiologic model of coronary artery disease.Psychosomatic Medicine. 1999,61:58–68.

    PubMed  CAS  Google Scholar 

  9. Linden W, Earle TL, Gerin W, Christenfeld N: Physiological stress reactivity and recovery: Conceptual siblings separated at birth?Journal of Psychosomatic Research. 1997,42:117–135.

    Article  PubMed  CAS  Google Scholar 

  10. Schwartz AR, Gerin W, Davidson KW, et al.: Toward a causal model of cardiovascular responses to stress and the development of cardiovascular disease.Psychosomatic Medicine.2003,65:22–35.

    Article  PubMed  Google Scholar 

  11. Manuck SB, Kaplan JR, Clarkson TB: Behaviorally induced heart-rate reactivity and atherosclerosis in cynomolgus monkeys.Psychosomatic Medicine. 1983,45:95–108.

    PubMed  CAS  Google Scholar 

  12. Manuck SB, Kaplan JR, Adams MR, Clarkson TB: Behaviorally elicited heart-rate reactivity and atherosclerosis in female cynomolgus monkeys(Macaca-fascicularis). Psychosomatic Medicine. 1989,51:306–318.

    PubMed  CAS  Google Scholar 

  13. Pickering TG, Gerin W: Area review: Blood pressure reactivity.Annals of Behavioral Medicine. 1990,12:3–16.

    Article  Google Scholar 

  14. Brosschot JF, Thayer JF: Anger inhibition, cardiovascular recovery, and vagal function: A model of the line between hostility and cardiovascular disease.Annals of Behavioral Medicine.1998,20:326–332.

    Article  PubMed  CAS  Google Scholar 

  15. Haynes SN, Gannon LR, Orimoto L, O’Brien WH, Brandt M:Psychophysiological assessment of poststress recovery.Psychological Assessment. 1991,3:356–365.

    Article  Google Scholar 

  16. Shetler K, Marcus R, Froelicher VF, et al.: Heart rate recovery: Validation and methodologic issues.Journal of the American College of Cardiology. 2001,38:1980–1987.

    Article  PubMed  CAS  Google Scholar 

  17. Glynn LM, Christenfeld N, Gerin W: The role of rumination in recovery from reactivity: Cardiovascular consequences of emotional states.Psychosomatic Medicine. 2002,64:714–726.

    Article  PubMed  Google Scholar 

  18. Treiber FA, Musante L, Kapuku G, et al.: Cardiovascular (CV) responsivity and recovery to acute stress and future CV functioning in youth with family histories of CV disease: A 4-year longitudinal study.International Journal of Psychophysiology.2001,41:65–74.

    Article  PubMed  CAS  Google Scholar 

  19. Borghi C, Costa FV, Boschi S, Mussi A, Ambrosioni E: Predictors of stable hypertension in young borderline subjects: A five-year follow-up study.Journal of Cardiovascular Pharmacology.1986,8(Suppl. 5):S138-S141.

    PubMed  Google Scholar 

  20. Cole CR, Blackstone EH, Pashkow FJ, Snader CE, Lauer MS:Heart-rate recovery immediately after exercise as a predictor of mortality.New England Journal of Medicine. 1999,341:1351–1357.

    Article  PubMed  CAS  Google Scholar 

  21. Stewart JC, France CR: Cardiovascular recovery from stress predicts longitudinal changes in blood pressure.Biological Psychology. 2001,58:105–120.

    Article  PubMed  CAS  Google Scholar 

  22. Everson SA, Kaplan GA, Goldberg DE, Salonen JT: Anticipatory blood pressure response to exercise predicts future high blood pressure in middle-aged men.Hypertension. 1996,27:1059–1064.

    PubMed  CAS  Google Scholar 

  23. Kamarck TW, Eranen J, Jennings JR, et al.: Anticipatory blood pressure responses to exercise are associated with left ventricular mass in Finnish men—Kuopio Ischemic Heart Disease Risk Factor Study.Circulation. 2000,102:1394–1399.

    PubMed  CAS  Google Scholar 

  24. Gerin W, Pickering TG: Association between delayed recovery of blood-pressure after acute mental stress and parental history of hypertension.Journal of Hypertension. 1995,13:603–610.

    Article  PubMed  CAS  Google Scholar 

  25. Schuler JLH, O’Brien WH: Cardiovascular recovery from stress and hypertension risk factors: A meta-analytic review.Psychophysiology. 1997,34:649–659.

    Article  PubMed  CAS  Google Scholar 

  26. Decesaris R, Ranieri G, Andriani A, Filitti V, Bonfantino MV:Effects of cigarette-smoking on blood-pressure and heart-rate.Journal of Hypertension. 1991,9:S122-S123.

    CAS  Google Scholar 

  27. Lane JD, Manus DC: Persistent cardiovascular effects with repeated caffeine administration.Psychosomatic Medicine. 1989,51:373–380.

    PubMed  CAS  Google Scholar 

  28. Newman AB, Haggerty CL, Kritchevsky SB, Nevitt MC, Simonsick EM: Walking performance and cardiovascular response: Associations with age and morbidity—The health, aging and body composition study.Journals of Gerontology Series A—Biological Sciences and Medical Sciences. 2003,58:715–720.

    Google Scholar 

  29. Selye H:Stress. Montreal, Canada: Acta, Inc., Medical Publishers, 1950.

    Google Scholar 

  30. Ursin H: Personality activation, and somatic health. In Levine S, Ursin H (eds),Coping and Health. New York: Plenum, 1980, 259–279.

    Google Scholar 

  31. Ursin H, Eriksen HR: Subjective health complaints, sensitization, and sustained cognitive activation (stress).Journal of Psychosomatic Research. 2004,56:445–448.

    Article  PubMed  Google Scholar 

  32. McEwen BS: Stress, adaptation, and disease—Allostasis and allostatic load.Annals of the New York Academy of Sciences.1998,840:33–44.

    Article  PubMed  CAS  Google Scholar 

  33. Sluiter JK, Frings-Dresen MHW, Meijman TF, van der Beek AJ: Reactivity and recovery from different types of work measured by catecholamines and cortisol: A systematic literature overview.Occupational and Environmental Medicine. 2000,57:298–315.

    Article  PubMed  CAS  Google Scholar 

  34. Megargee E, Hokanson JE:Dynamics of Aggression. New York: Harper & Row, 1970.

    Google Scholar 

  35. Brosschot JF, Thayer JF: Worry, perseverative thinking and health. In Nyklicek I, Temoshok LR, Vingerhoets AJJM (eds),Emotional Expression and Health: Advances in Theory, Assessment and Clinical Applications. London: Taylor & Francis, 2004.

    Google Scholar 

  36. Thayer JF, Siegle GI: Neurovisceral integration in cardiac and emotional regulation.IEEE Engineering in Medicine and Biology Magazine. 2002,21:24–29.

    Article  PubMed  Google Scholar 

  37. Merritt MM, Bennett GG, Williams RB, Sollers JJ, Thayer JF:Low educational attainment, John Henryism, and cardiovascular reactivity to and recovery from personally relevant stress.Psychosomatic Medicine. 2004,66:49–55.

    Article  PubMed  Google Scholar 

  38. Kario K, Matsuo T, Shimada K, Pickering TG: Factors associated with the occurrence and magnitude of earthquake-induced increases in blood pressure.American Journal of Medicine.2001,111:379–384.

    Article  PubMed  CAS  Google Scholar 

  39. Parati G, Antonicelli R, Guazzarotti F, Paciaroni E, Mancia G:Cardiovascular effects of an earthquake—Direct evidence by ambulatory blood pressure monitoring.Hypertension. 2001,38:1093–1095.

    Article  PubMed  CAS  Google Scholar 

  40. Brondolo E, Karlin W, Alexander K, Bobrow A, Schwartz J:Workday communication and ambulatory blood pressure: Implications for the reactivity hypothesis.Psychophysiology.1999,36:86–94.

    Article  PubMed  CAS  Google Scholar 

  41. Brosschot JF, van Dijk E, Thayer JF: Prolonged autonomic activation, perseverative negative cognition, and daily hassles.International Congress Series. 2002,1241:329–336.

    Article  Google Scholar 

  42. Ituarte PH, Kamarck TW, Thompson HS, Bacanu S: Psychosocial mediators of racial differences in nighttime blood pressure dipping among normotensive adults.Health Psychology.1999,18:393–402.

    Article  PubMed  CAS  Google Scholar 

  43. Hall M, Vasko R, Buysse D, et al.: Acute stress affects heart rate variability during sleep.Psychosomatic Medicine. 2004,66:56–62.

    Article  PubMed  Google Scholar 

  44. Karasek RA, Theorell TG, Schwartz J, Pieper C, Alfredsson L:Job, psychological factors and coronary heart disease: Swedish prospective findings and U.S. prevalence findings using a new occupational inference method.Advances in Cardiology. 1982,29:62–67.

    PubMed  CAS  Google Scholar 

  45. Van Egeren LF: The relationship between job strain and blood pressure at work, at home, and during sleep.Psychosomatic Medicine. 1992,54:337–343.

    Google Scholar 

  46. Steptoe A, Cropley M, Joekes K: Job strain, blood pressure and response to uncontrollable stress.Journal of Hypertension.1999,17:193–200.

    Article  PubMed  CAS  Google Scholar 

  47. Schnall PL, Schwartz JE, Landsbergis PA, Warren K, Pickering TG: A longitudinal study of job strain and ambulatory blood pressure: Results from a three-year follow-up.Psychosomatic Medicine. 1998,60:697–706.

    PubMed  CAS  Google Scholar 

  48. O’Connor DB, O’Connor BL, White BL, Bundred PE: Job strain and ambulatory blood pressure in British general practitioners: A preliminary study.Psychology, Health & Medicine.2000,5:241–250.

    Article  Google Scholar 

  49. Fauvel JP, Quelin P, Ducher M, Rakotomalala H, Laville M:Perceived job stress but not individual cardiovascular reactivity to stress is related to higher blood pressure at work.Hypertension.2001,38:71–75.

    PubMed  CAS  Google Scholar 

  50. Steptoe A, Roy MP, Evans O, Snashall D: Cardiovascular stress reactivity and job strain as determinants of ambulatory blood pressure at work.Journal of Hypertension. 1995,13:201–210.

    Article  PubMed  CAS  Google Scholar 

  51. Goldstein IB, Shapiro D, Chicz-DeMet A, Guthrie D: Ambulatory blood pressure, heart rate, and neuroendocrine responses in women nurses during work and off work days.Psychosomatic Medicine. 1999,61:387–396.

    PubMed  CAS  Google Scholar 

  52. Steptoe A: Stress, social support and cardiovascular activity over the working day.International Journal of Psychophysiology.2000,37:299–308.

    Article  PubMed  CAS  Google Scholar 

  53. Siegrist J: Psychosocial work environment and the risk of coronary heart disease.International Archives of Occupational and Environmental Health. 2000,73(Suppl.):S41-S45.

    Google Scholar 

  54. Vrijkotte TGM, van Doornen LJP, de Geus EJC: Effects of work stress on ambulatory blood pressure, heart rate, and heart rate variability.Hypertension. 2000,35:880–886.

    PubMed  CAS  Google Scholar 

  55. Hanson EKS, Godaert GLR, Maas CJM, Meijman TF: Vagal cardiac control throughout the day: The relative importance of effort-reward imbalance and within-day measurements of mood, demand and satisfaction.Biological Psychology. 2001,56:23–44.

    Article  PubMed  CAS  Google Scholar 

  56. O’Connor DB, O’Connor RC, White BL, Bundred PE: Are occupational stress levels predictive of ambulatory blood pressure in British GPs? An exploratory study.Family Practice. 2001,18:92–94.

    Article  PubMed  CAS  Google Scholar 

  57. Unden A, Orth-Gomer K, Elofsson S: Cardiovascular effects of social support in the work place; twenty-four-hour ECG monitoring of men and women.Psychosomatic Medicine. 1991,53:50–60.

    PubMed  CAS  Google Scholar 

  58. Carels RA, Sherwood A, Szczepanski R, Blumenthal JA: Ambulatory blood pressure and marital distress in employed women.Behavioral Medicine. 2000,26:80–85.

    Article  PubMed  CAS  Google Scholar 

  59. King AC, Oka RK, Young DR: Ambulatory blood-pressure and heart-rate responses to the stress of work and caregiving in olderwomen.Journals of Gerontology. 1994,49:M239-M245.

    PubMed  CAS  Google Scholar 

  60. Schulz R, Beach SR: Caregiving as a risk factor for mortality: The Caregiver Health Effects Study.Journal of the American Medical Association. 1999,282:2215–2219.

    Article  PubMed  CAS  Google Scholar 

  61. Steffen PR, McNeilly M, Anderson N, Sherwood A: Effects of perceived racism and anger inhibition on ambulatory blood pressure in African Americans.Psychosomatic Medicine. 2003,65:746–750.

    Article  PubMed  Google Scholar 

  62. Brisson C, Laflamme N, Moisan J, et al.: Effect of family responsibilities and job strain on ambulatory blood pressure among white-collar women.Psychosomatic Medicine. 1999,61:205–213.

    PubMed  CAS  Google Scholar 

  63. Kamarck TW, Shiffman SM, Smithline L, et al.: Effects of task strain, social conflict, and emotional activation on ambulatory cardiovascular activity: Daily life consequences of recurring stress in a multiethnic adult sample.Health Psychology. 1998,17:17–29.

    Article  PubMed  CAS  Google Scholar 

  64. Brosschot JF, Thayer JF: Heart rate response is longer after negative emotions than after positive emotions.International Journal of Psychophysiology. 2003,50:181–187.

    Article  PubMed  Google Scholar 

  65. Shapiro D, Jamner LD, Goldstein IB: Daily mood states and ambulatory blood pressure.Psychophysiology. 1997,34:399–405.

    Article  PubMed  CAS  Google Scholar 

  66. Kawachi I, Sparrow D, Vokonas PS, Weiss ST: Symptoms of anxiety and risk of coronary heart disease: The Normative Aging Study.Circulation. 1994,90:2225–2229.

    PubMed  CAS  Google Scholar 

  67. Scheier MF, Bridges MW: Person variables and health: Personality predispositions and acute psychological states as shared determinants for disease.Psychosomatic Medicine.1995,57:255–268.

    PubMed  CAS  Google Scholar 

  68. Thayer JF, Friedman BH, Borkovec TD: Autonomic characteristics of generalized anxiety disorder and worry.Biological Psychiatry. 1996,39:255–266.

    Article  PubMed  CAS  Google Scholar 

  69. Wulsin LR, Vaillant GE, Wells VE: A systematic review of the mortality of depression.Psychosomatic Medicine. 1999,61:6–17.

    PubMed  CAS  Google Scholar 

  70. Raikkonen K, Matthews KA, Flory JD, Owens JF: Effects of hostility on ambulatory blood pressure and mood during daily living in healthy adults.Health Psychology. 1999,18:44–53.

    Article  PubMed  CAS  Google Scholar 

  71. Jamner LD, Shapiro D, Goldstein IB, Hug R: Ambulatory blood-pressure and heart-rate in paramedics—Effects of cynical hostility and defensiveness.Psychosomatic Medicine. 1991,53:393–406.

    PubMed  CAS  Google Scholar 

  72. Pasic J, Shapiro D, Motivala S, Hui KK: Blood pressure morning surge and hostility.American Journal of Hypertension.1998,11:245–250.

    Article  PubMed  CAS  Google Scholar 

  73. Shapiro D, Goldstein IB, Jamner LD: Effects of cynical hostility, anger out, anxiety, and defensiveness on ambulatory blood pressure in Black and White college students.Psychosomatic Medicine. 1996,58:354–364.

    PubMed  CAS  Google Scholar 

  74. Kario K, Schwartz JE, Davidson KW, Pickering TG: Gender differences in associations of diurnal blood pressure variation, awake physical activity, and sleep quality with negative affect: The work site blood pressure study.Hypertension. 2001,38:997–1002.

    Article  PubMed  CAS  Google Scholar 

  75. Schneider RH, Julius S, Karunas R: Ambulatory blood pressure monitoring and laboratory reactivity in Type A behavior and components.Psychosomatic Medicine. 1989,51:290–305.

    PubMed  CAS  Google Scholar 

  76. Van Egeren LF, Sparrow AW: Ambulatory monitoring to assess real-life cardiovascular reactivity in Type A and Type B subjects.Psychosomatic Medicine. 1990,52:297–306.

    Google Scholar 

  77. Davey GCL, Tallis F:Worrying: Perspectives on Theory, Assessment and Treatment. West Sussex, England: Wiley, 1994.

    Google Scholar 

  78. Smyth J, Ockenfels MC, Porter L, et al.: Stressors and mood measured on a momentary basis are associated with salivary cortisol secretion.Psychoneuroendocrinology. 1998,23:353–370.

    Article  PubMed  CAS  Google Scholar 

  79. Lacey K, Zaharia MD, Griffiths J, et al.: A prospective study of neuroendocrine and immune alterations associated with the stress of an oral academic examination among graduate students.Psychoneuroendocrinology. 2000,25:339–356.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Suzanne Pieper MSc..

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This study was financially supported by a grant of the Netherlands Organization for Scientific Research (NWO).

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Pieper, S., Brosschot, J.F. Prolonged stress-related cardiovascular activation: Is there any?. ann. behav. med. 30, 91–103 (2005). https://doi.org/10.1207/s15324796abm3002_1

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