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Testing the cross-stressor hypothesis under real-world conditions: exercise as a moderator of the association between momentary anxiety and cardiovascular responses

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Abstract

The cross-stressor adaptation hypothesis of exercise training has not been investigated under real-life conditions. Using ecological momentary assessment, we tested whether usual exercise level moderates the relationship of self-reported anxiety to concurrent ambulatory heart rate (HR) and systolic/diastolic blood pressure (SBP/DBP). Participants (N = 832) completed 24-h ambulatory monitoring of HR/BP, using a brachial BP cuff that took readings at 28-min intervals. Anxiety levels were concurrently reported on a visual analog scale (VAS) using a Palm Pilot. Usual exercise behavior was assessed by a self-report questionnaire. Random coefficients linear regression models predicting momentary HR/BP readings from time-matched anxiety scores were estimated, yielding the average within-person effect (slope) of anxiety. The interaction of exercise level (i.e., no weekly exercise, 1–149, and ≥ 150 min/week; a between-person factor) with anxiety was added to the model in order to estimate the average anxiety slope for participants in each exercise category. The relationship of HR/BP to anxiety did not differ significantly among exercise categories, hence not providing evidence for the cross-stressor hypothesis. In an exploratory analysis of the difference in HR/BP between occasions when anxiety was in the top versus bottom person-specific quintiles of responses, the difference in HR (but not SBP or DBP) varied significantly by exercise level (F(2,625) = 4.92, p = 0.008). Though our pre-specified analysis did not support the hypothesis, we provide some post hoc evidence supporting the cross-stressor hypothesis of exercise training for the HR response to anxiety.

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Abbreviations

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

HR:

Heart rate

CV:

Cardiovascular

EMA:

Ecological momentary assessment

PA:

Physical activity

TSST:

Trier social stressor test

VAS:

Visual analog scale

BMI:

Body mass index

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Funding

The Masked Hypertension Study was supported by grant P01-HL47540 (PI: T Pickering, 2005–2009; J Schwartz, 2009–2017) from the National Heart, Lung, and Blood Institute (NHLBI). The data collection was also supported by the NIH’s National Center for Advancing Translational Sciences through Grants MO1-RR10710 (Stony Brook University) and UL1-TR000040 (Columbia University). Preparation of this manuscript was further supported by NHLBI Grant K24-HL125704 (D Shimbo).

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  1. Data Science Institute, Columbia University, 475 Riverside Dr, Room 320, New York, NY, 10115, USA

    Ipek Ensari

  2. Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA

    Joseph E. Schwartz, Donald Edmondson, Andrea T. Duran, Daichi Shimbo & Keith M. Diaz

  3. Department of Psychiatry and Behavioral Health, Stony Brook University, Stony Brook, NY, USA

    Joseph E. Schwartz

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Ensari, I., Schwartz, J.E., Edmondson, D. et al. Testing the cross-stressor hypothesis under real-world conditions: exercise as a moderator of the association between momentary anxiety and cardiovascular responses. J Behav Med 43, 989–1001 (2020). https://doi.org/10.1007/s10865-020-00155-0

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