Stress Reactivity and Type A Behavior Lane, J. D., Adcock, R. A. and Burnett, R. E. (1992). "Respiratory sinus arrhythmia and cardiovascular responses to stress." Psychophysiology 29(4): 461-70.
The parasympathetic nervous system provides mechanisms that could attenuate sympathetically mediated heart rate stress responses and might have even more general antagonistic actions on stress reactivity. Individuals characterized by higher levels of parasympathetic tone might, through such mechanisms, be less reactive when stimuli elicit sympathetically mediated responses. Respiratory sinus arrhythmia (RSA) is considered to be a noninvasive index of cardiac parasympathetic (vagal) tone. The present study investigated whether individual differences in RSA level at rest could predict variations among individuals in the magnitude of cardiovascular responses to psychological stress. None of the measures of resting respiratory sinus arrhythmia, derived from spectral analysis of beat-to-beat changes in resting heart rate, predicted the observed variations in cardiovascular task reactivity. However, scores reflecting respiratory sinus arrhythmia as the percentage of total heart rate variability (RSAnorm) were negatively correlated with blood pressure levels, both at rest and during the task. Furthermore, subjects with higher scores for RSAnorm demonstrated a faster adaptation of heart rate responses during stress, which suggests the development of parasympathetic antagonism to ongoing sympathetic arousal. Although a simple relationship between respiratory sinus arrhythmia and reactivity was not observed, these results encourage further investigation of RSA measures as psychophysiological indices of individual differences in parasympathetic (vagal) cardiac tone, or perhaps of general parasympathetic/sympathetic balance, which could modulate the expression of potentially pathogenic stress responses.
Fukudo, S., Lane, J. D., Anderson, N. B., Kuhn, C. M., Schanberg, S. M., McCown, N., Muranaka, M., Suzuki, J. and Williams, R. B., Jr. (1992). "Accentuated vagal antagonism of beta-adrenergic effects on ventricular repolarization. Evidence of weaker antagonism in hostile type A men." Circulation 85(6): 2045-53.BACKGROUND. Prior research has suggested a weaker parasympathetic antagonism of sympathetic effects on the heart in type A (coronary-prone) men. To confirm this phenomenon and extend our understanding of it, we investigated the effects of prior muscarinic blockade on the electrocardiogram T wave and other cardiovascular and neuroendocrine responses to isoproterenol in type A and type B (non-coronary-prone) men. METHODS AND RESULTS. Responses to two 5-minute intravenous isoproterenol infusions (0.01 micrograms/kg/min and 0.02 micrograms/kg/min) were evaluated in six type A and six type B men after pretreatment with either dextrose placebo or atropine (1.2 mg). Atropine significantly potentiated T wave attenuation in the recovery period after isoproterenol infusion (0.30 +/- 0.07 mV) compared with placebo (0.54 +/- 0.09 mV, p less than 0.001). Atropine also potentiated the heart rate increase to isoproterenol (39 +/- 3 beats per minute versus 20 +/- 2 beats per minute after placebo). Atropine enhanced decreases in systolic, diastolic, and mean arterial pressures as well as pulse pressure to isoproterenol. Atropine enhancement of many of these responses was increased among subjects with high scores on various hostility/anger scales. Isoproterenol alone produced greater T wave attenuation in type A than in type B men. However, atropine enhancement of T wave attenuation and blood pressure falls by isoproterenol was present only in type B men. CONCLUSIONS. These findings indicate that there is accentuated parasympathetic antagonism of T wave attenuation and blood pressure responses induced by beta-adrenergic stimulation. Relative weakness of this antagonism of sympathetic effects on the heart in hostile type A individuals may contribute to their higher coronary disease risk.
Anderson, N. B., Lane, J. D., Taguchi, F. and Williams, R. B., Jr. (1989). "Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men." Health Psychology 8(5): 525-40.This study investigated cardiovascular responses to two stressors known to elicit either beta-adrenergic (mental arithmetic) or alpha-adrenergic (forehead cold pressor) reactivity in Black and White men. Participants in each group were selected for presence or absence of parental hypertension. Based on previous research, Blacks were expected to show smaller cardiovascular responses to the beta-adrenergic mental arithmetic task and greater responses to the alpha-adrenergic cold pressor relative to the Whites. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, forearm blood flow, and forearm vascular resistance were assessed during a resting baseline, a prestress period, and during and after each experimental procedure. Unlike previous findings, no significant racial differences in cardiovascular responses were found during either task. However, Black participants had significantly higher SBP and DBP levels throughout the cold pressor periods. Parental history did not significantly influence cardiovascular responses in either group. The results are discussed in relation to previous research on racial differences in stress reactivity and their implications for future research.
Anderson, N. B., Lane, J. D., Taguchi, F., Williams, R. B., Jr. and Houseworth, S. J. (1989). "Race, parental history of hypertension, and patterns of cardiovascular reactivity in women." Psychophysiology 26(1): 39-47.This study examined the interaction of race and parental history of hypertension on patterns of cardiovascular responses among women. Two stressors were used that produce different patterns of cardiovascular reactivity: mental arithmetic, primarily a beta-adrenergic stimulus, and the cold face stimulus, which evokes alpha-adrenergic (i.e. vascular) activity. Systolic and diastolic blood pressure, heart rate, forearm blood flow, and forearm vascular resistance were assessed before, during, and after arithmetic and cold face stimulus. Both tasks produced the expected patterns of cardiovascular adjustment, although no Black-White differences occurred during arithmetic. However, Black subjects did show a slower recovery of diastolic blood pressure following arithmetic. The cold face stimulus produced significantly greater changes in systolic blood pressure in the Black than in the White women. Parental history of hypertension did not relate significantly to reactivity. The results provide limited support for the idea that Black females exhibit a greater pressor response than White females to a stimulus that produces primarily vascular rather than cardiac changes. These findings are discussed in relation to previous findings with males and with respect to their implications for the role of reactivity in Black-White differences in hypertension prevalence.
Anderson, N. B., Lane, J. D., Monou, H., Williams, R. B., Jr. and Houseworth, S. J. (1988). "Racial differences in cardiovascular reactivity to mental arithmetic." International Journal of Psychophysiology 6(2): 161-4.One hypothesized mechanism for the higher rates and greater severity of essential hypertension among blacks is that this group is particularly susceptible to stress-induced beta-adrenergically mediated cardiovascular hyperreactivity. In this study, we compared the cardiovascular responses to mental arithmetic in 20 white and 17 black, young, normotensive males. Contrary to expectations, the black subjects exhibited significantly smaller changes in heart rate, and systolic and diastolic blood pressure. These findings suggest that cardiovascular reactivity to a mental stressor known to produce beta-adrenergically mediated responses may be lower in some normotensive blacks compared to their white counterparts.
Anderson, N. B., Lane, J. D., Muranaka, M., Williams, R. B., Jr. and Houseworth, S. J. (1988). "Racial differences in blood pressure and forearm vascular responses to the cold face stimulus." Psychosomatic Medicine 50(1): 57-63.The mechanisms responsible for the higher incidence of essential hypertension in blacks than in whites are the object of much research attention. One hypothesis is that the development of hypertension in blacks is associated with exaggerated blood pressure reactivity, particularly those responses mediated by vasoconstriction. Racial differences in blood pressure responses to cold stimulation of the forehead, a known alpha-adrenergic vasoconstrictive stimulus, were examined in health, college-age males. Compared to white subjects, black subjects exhibited significantly greater increases in systolic and diastolic blood pressure, as well as increases in forearm vascular resistance, in response to cold stimulation. This preliminary evidence of increased peripheral vascular reactivity in blacks suggests that known racial differences in hypertension prevalence might derive in part from physiological differences in sympathetic nervous system reactivity.
Muranaka, M., Lane, J. D., Suarez, E. C., Anderson, N. B., Suzuki, J. and Williams, R. B., Jr. (1988). "Stimulus-specific patterns of cardiovascular reactivity in type A and B subjects: evidence for enhanced vagal reactivity in type B." Psychophysiology 25(3): 330-8.
Muranaka, M., Monou, H., Suzuki, J., Lane, J. D., Anderson, N. B., Kuhn, C. M., Schanberg, S. M., McCown, N. and Williams, R. B., Jr. (1988). "Physiological responses to catecholamine infusions in type A and type B men." Health Psychology 7(Suppl): 145-63.To determine whether there are basic biological differences between Type A and Type B men, we compared hemodynamic, electrophysiologic and neuroendocrine responses to equipotent doses of isoproterenol (ISO) and norepinephrine (NE) in 10 Type A and 10 Type B men ages 18 to 29. Results showed equal hemodynamic and neuroendocrine responses to graded ISO doses in Type A and Type B individuals. In contrast, Type A men showed a more prolonged decrease in electrocardiographic T-wave amplitude (TWA) than did Type B men. Post hoc analyses of the correlates of TWA recovery during high-dose ISO infusion provide preliminary evidence for a more robust parasympathetic antagonism of sympathetic nervous system effects in Type B men, especially those with low scores on the Cook-Medley Ho scale. These findings suggest that, in addition to cognitively mediated increases in sympathetic nervous system reactivity, Type As may also be placed at increased risk of developing coronary heart disease by reduced levels of parasympathetic antagonism of sympathetic effects.
Williams, R. B., Jr., Lane, J. D., Kuhn, C. M., Knopes, K. and Schanberg, S. M. (1988). "Effects of propranolol on cardiovascular and neuroendocrine responses to mental arithmetic in type A men." Neuropsychopharmacology 1(4): 337-40.beta-Adrenergic hyperreactivity has been proposed as a pathogenic mechanism of increased coronary risk in Type A individuals. This study compared the effects of propranolol, diazepam, and placebo on cardiovascular and neuroendocrine responses to a stressful cognitive task in six young Type A males. Although diazepam did not differ from placebo, propranolol attenuated heart rate and norepinephrine responses and enhanced cortisol responses to the task. Findings suggest that propranolol has reciprocal effects on the norepinephrine and cortisol components of the "fight-flight" response. Possible central nervous system mechanisms are described.
Anderson, N. B., Williams, R. B., Jr., Lane, J. D., Houseworth, S. and Muranaka, M. (1987). "Parental history of hypertension and cardiovascular responses to behavioral stress in young black women." Journal of Psychosomatic Research 31(6): 723-9.Beta-adrenergic sympathetic nervous system (SNS) hyperresponsivity to behavioral stress may play a role in the onset of sustained high blood pressure--particularly in persons with a parental history of hypertension. Although hypertension is extremely prevalent among blacks, the association between parental history of hypertension and cardiovascular hyperresponsivity has not been explored in this group. The present study examined the influence of parental history of hypertension on cardiovascular stress reactivity in a group of young black females. Contrary to previous findings with whites, black subjects with a parental history of hypertension exhibited significantly smaller systolic blood pressure and forearm blood flow increases, and moderately smaller diastolic blood pressure increases to the task. Parental history subjects also exhibited slower heart rates throughout each experimental condition. The results suggest that blacks at risk from hypertension may not exhibit the beta-adrenergic hyperresponsivity to behavioral stress observed in whites. These results may suggest that beta-adrenergically mediated hyperresponsivity may be less involved in the development of hypertension among blacks.
Anderson, N. B., Williams, R. B., Jr., Lane, J. D., Haney, T., Simpson, S. and Houseworth, S. J. (1986). "Type A behavior, family history of hypertension, and cardiovascular responsivity among black women." Health Psychology 5(4): 393-406.The purpose of this study was to determine the effects of Type A behavior and family history of hypertension on cardiovascular reactivity to mental stress in a group of employed black women. Measures of heart rate and of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken at rest, during a mental arithmetic task, and during the Type A Structured Interview (SI). Results indicated that the Type A behavior pattern was associated with SBP and DBP hyperresponsivity during the SI but not during mental arithmetic. Additionally, certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters either alone or in combination with Type A behavior. The results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominantly white samples also hold true for blacks. Replication of these findings with other subgroups of blacks, such as young females and middle-aged males, will help document the generality of these findings within the black population.
Blumenthal, J. A., Lane, J. D. and Williams, R. B., Jr. (1985). "The inhibited power motive, type A behavior, and patterns of cardiovascular response during the structured interview and Thematic Apperception Test." Journal of Human Stress 11(2): 82-92.The Type A behavior pattern and the inhibited power motive have been implicated in the development of coronary heart disease (CHD). Since it is widely believed that enhanced cardiovascular responsivity may be one mechanism by which individuals develop CHD, the present study examined the relationship of Type A behavior and the inhibited power motive to different patterns of cardiovascular response during two behavioral tasks. Forty-one (24 Type A's, 17 Type B's) male undergraduates underwent the Type A structured interview (SI) and the Thematic Apperception Test (TAT) while a broad range of cardiovascular functions were simultaneously recorded. Different patterns of cardiovascular response were observed during the SI and TAT, and Type A's showed a greater tendency than Type B's to exhibit increased heart rate (HR), systolic blood pressure (SBP), and forearm blood flow (FBF) during the SI and the preparatory phase (but not the story-telling phase) of the TAT. The inhibited power motive was not related to enhanced cardiovascular responsivity during the SI or TAT. The implications of these findings for the development of CHD are discussed.
Lane, J. D., White, A. D. and Williams, R. B., Jr. (1984). "Cardiovascular effects of mental arithmetic in Type A and Type B females." Psychophysiology 21(1): 39-46.
Blumenthal, J. A., Lane, J. D., Williams, R. B., Jr., McKee, D. C., Haney, T. and White, A. (1983). "Effects of task incentive on cardiovascular response in type A and type B individuals." Psychophysiology 20(1): 63-70.
Williams, R. B., Jr., Lane, J. D., Kuhn, C. M., Melosh, W., White, A. D. and Schanberg, S. M. (1982). "Type A behavior and elevated physiological and neuroendocrine responses to cognitive tasks." Science 218(4571): 483-5.Qualitatively distinct patterns of cardiovascular and neuroendocrine responses were observed in male college students during mental work and during sensory intake task performance. During mental work, Type A (coronary-prone) subjects showed greater muscle vasodilatation and more enhanced secretion of norepinephrine, epinephrine, and cortisol than Type B subjects. During sensory intake, Type A hyperresponsivity was found for testosterone and, among those subjects with a positive family history of hypertension, for cortisol. As a demonstration of combined cardiovascular, sympathetic nervous system, and neuroendocrine hyperresponsivity to specific cognitive tasks in Type A subjects, this study breaks ground in the search for mechanisms mediating the increased coronary disease risk among Type A persons.
Back to First Page