Ambulatory Blood Pressure Reactivity as a Moderator in the Association Between Daily Life Psychosocial Stress and Carotid Artery Atherosclerosis

Objective We examined whether associations between daily psychosocial stressor exposures and carotid artery intima-medial thickness (IMT) may be stronger among those showing larger stress-related cardiovascular reactivity (CVR) during the course of daily living. Methods A total of 474 healthy working adults (ages 30–54 years) collected ambulatory blood pressure and recorded their daily experiences, using electronic diaries, during two 2-day periods for a week. Measures of mean momentary task strain and social conflict were used as indices of stressor exposure, and partial regression coefficients linking momentary strain and conflict with ambulatory blood pressure fluctuations were used as measures of CVR. IMT was assessed in the carotid arteries using B-mode ultrasound. Results After covariate adjustment, associations between mean task strain exposure and IMT were significant among those high in CVR to strain (for systolic blood pressure, p = .006, for diastolic blood pressure, p = .011) but not among those low in strain CVR. Similarly, associations involving mean conflict exposure were significant among those high in CVR to social conflict (p < .001 for systolic blood pressure, p = .001 for diastolic blood pressure) but not among low social conflict reactors. Significant moderation effects were more consistently shown for task strain than for social conflict, but the overall pattern of results was robust across two different types of statistical modeling procedures. Conclusions Individual differences in CVR may moderate the effects of daily psychosocial stress on subclinical CVD among healthy employed adults. Using ecological momentary assessment to measure stress exposure as well as stress reactivity may facilitate our ability to detect these effects.

[1]  C. Brisson,et al.  Double Exposure to Adverse Psychosocial Work Factors and High Family Responsibilities as Related to Ambulatory Blood Pressure at Work: A 5-Year Prospective Study in Women With White-Collar Jobs , 2017, Psychosomatic medicine.

[2]  K. Matthews,et al.  Sleep Duration Partially Accounts for Race Differences in Diurnal Cortisol Dynamics , 2017, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[3]  T. Kamarck,et al.  Early Life Family Conflict, Social Interactions, and Carotid Artery Intima-Media Thickness in Adulthood , 2016, Psychosomatic medicine.

[4]  T. Kamarck,et al.  Daily Marital Interaction Quality and Carotid Artery Intima-Medial Thickness in Healthy Middle-Aged Adults , 2014, Psychosomatic medicine.

[5]  M. Kivimäki,et al.  Cumulative meta-analysis of job strain and CHD. , 2014, Epidemiology.

[6]  D. van Klaveren,et al.  Carotid intima-media thickness for cardiovascular risk assessment: systematic review and meta-analysis. , 2013, Atherosclerosis.

[7]  D. Carroll,et al.  Increased blood pressure reactions to acute mental stress are associated with 16-year cardiovascular disease mortality. , 2012, Psychophysiology.

[8]  Andrew Steptoe,et al.  Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data , 2012, The Lancet.

[9]  T. Kamarck,et al.  Daily Psychological Demands Are Associated With 6-Year Progression of Carotid Artery Atherosclerosis: The Pittsburgh Healthy Heart Project , 2012, Psychosomatic medicine.

[10]  Andrew Steptoe,et al.  Stress and cardiovascular disease , 2012, Nature Reviews Cardiology.

[11]  Timothy W. Smith,et al.  Marital discord and coronary artery disease: a comparison of behaviorally defined discrete groups. , 2012, Journal of consulting and clinical psychology.

[12]  Gregory J Welk,et al.  Accuracy of armband monitors for measuring daily energy expenditure in healthy adults. , 2010, Medicine and science in sports and exercise.

[13]  R. Känel,et al.  Inflammation as a psychophysiological biomarker in chronic psychosocial stress , 2010, Neuroscience & Biobehavioral Reviews.

[14]  B. Mausbach,et al.  Association between chronic caregiving stress and impaired endothelial function in the elderly. , 2010, Journal of the American College of Cardiology.

[15]  A. Steptoe,et al.  Greater Cardiovascular Responses to Laboratory Mental Stress Are Associated With Poor Subsequent Cardiovascular Risk Status: A Meta-Analysis of Prospective Evidence , 2010, Hypertension.

[16]  M. Marmot,et al.  Negative aspects of close relationships and heart disease. , 2007, Archives of internal medicine.

[17]  T. Kamarck,et al.  Experiences of demand and control during daily life are predictors of carotid atherosclerotic progression among healthy men. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[18]  Stephen C. Jones,et al.  Validation of the Oscar 2 oscillometric 24-h ambulatory blood pressure monitor according to the British Hypertension Society protocol , 2007, Blood pressure monitoring.

[19]  Timothy W. Smith,et al.  Age-related differences in ambulatory blood pressure during daily stress: evidence for greater blood pressure reactivity with age. , 2006, Psychology and aging.

[20]  A. Steptoe,et al.  Platelets, coronary heart disease, and stress , 2006, Brain, Behavior, and Immunity.

[21]  T. Kamarck,et al.  Application of ecological momentary assessment to the study of marital adjustment and social interactions during daily life. , 2006, Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association.

[22]  T. Kamarck,et al.  Exaggerated Blood Pressure Responses During Mental Stress Are Prospectively Related to Enhanced Carotid Atherosclerosis in Middle-Aged Finnish Men , 2004, Circulation.

[23]  Linda C Gallo,et al.  Job characteristics, occupational status, and ambulatory cardiovascular activity in women , 2004, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[24]  Joseph E Schwartz,et al.  Correspondence between laboratory and ambulatory measures of cardiovascular reactivity: a multilevel modeling approach. , 2003, Psychophysiology.

[25]  J. Thayer,et al.  Toward a Causal Model of Cardiovascular Responses to Stress and the Development of Cardiovascular Disease , 2003, Psychosomatic medicine.

[26]  T. Kamarck,et al.  Cardiovascular Reactivity to Psychological Challenge: Conceptual and Measurement Considerations , 2003, Psychosomatic medicine.

[27]  T. Lakka,et al.  Stress-Induced Blood Pressure Reactivity and Incident Stroke in Middle-Aged Men , 2001, Stroke.

[28]  N. Schneiderman,et al.  Marital stress worsens prognosis in women with coronary heart disease: The Stockholm Female Coronary Risk Study. , 2000, JAMA.

[29]  T. Kamarck,et al.  Enhancing the laboratory-to-life generalizability of cardiovascular reactivity using multiple occasions of measurement. , 2000, Psychophysiology.

[30]  J. Salonen,et al.  Does low socioeconomic status potentiate the effects of heightened cardiovascular responses to stress on the progression of carotid atherosclerosis? , 1998, American journal of public health.

[31]  T. Kamarck,et al.  Exaggerated blood pressure responses during mental stress are associated with enhanced carotid atherosclerosis in middle-aged Finnish men: findings from the Kuopio Ischemic Heart Disease Study. , 1997, Circulation.

[32]  T Gustavsson,et al.  A new automated computerized analyzing system simplifies readings and reduces the variability in ultrasound measurement of intima-media thickness. , 1997, Stroke.

[33]  T. Kamarck,et al.  Aging or disease? Cardiovascular reactivity in Finnish men over the middle years. , 1997, Psychology and aging.

[34]  J. Salonen,et al.  Interaction of workplace demands and cardiovascular reactivity in progression of carotid atherosclerosis: population based study , 1997, BMJ.

[35]  G. Reboldi,et al.  Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension. , 1994, Hypertension.

[36]  J. Schwartz,et al.  Association between ambulatory blood pressure and alternative formulations of job strain. , 1994, Scandinavian journal of work, environment & health.

[37]  B. Morgenstern,et al.  Human blood pressure determination by sphygmomanometry. , 1993, Circulation.

[38]  J. Sinacore.  Multiple regression: Testing and interpreting interactions , 1993 .

[39]  Robert Karasek,et al.  Healthy Work : Stress, Productivity, and the Reconstruction of Working Life , 1990 .

[40]  Philip Bobko,et al.  A solution to some dilemmas when testing hypotheses about ordinal interactions. , 1986 .

[41]  S. Manuck,et al.  Acute psychophysiologic reactivity and risk of cardiovascular disease: a review and methodologic critique. , 1984, Psychological bulletin.

[42]  S. Manuck,et al.  Social Status, Environment, and Atherosclerosisin Cynomolgus Monkeys , 1982, Arteriosclerosis.

[43]  T. Kamarck,et al.  Experiences of demand and control in daily life as correlates of subclinical carotid atherosclerosis in a healthy older sample. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[44]  T. Kamarck,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. , 1998, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.