This proposal is designed to clarify the contribution of behavioral life stressors and maladaptive coping patterns to the development of hypertension, a major health problem in the U.S. In Study 1, 60 men and women aged 18-45 still at risk for hypertension will undergo laboratory assessments of blood pressure and hemodynamic responses to standardized mental and physical stressors (including tasks where their role alternates between active versus passive coping). These lab assessments will be repeated 3 times: after placebo only, after nonselective beta-blockade, and after beta-blockade plus alpha-1 blockade, in a counterbalanced, double-blind protocol, to verify the role of specific sympathetic activity in mediating responses. Study 1 also includes 24-hour ambulatory blood pressure monitoring, to permit evaluation of the relationship between laboratory and real-life responses. It also includes an assessment of responses to treadmill exercise, and through Doppler echocardiography, comparisons of the relationships of blood pressure responses to physical stressors, lab mental stressors, and ambulatory life events to left ventricular mass index and diastolic dysfunction can be made. In Study 2, 40 men who had undergone ambulatory blood pressure monitoring as college students will undergo a follow-up assessment 3-4 years later as full-time workers including evaluation of responses to standardized stressors and 24- hours ambulatory monitoring. Thus, the predictive utility of ambulatory blood pressure data obtained in early adulthood may be tested. The predictive relationship of a self-focused pattern of coping with stress (self-blame, keep-to-self) will also be tested. In study 3, 80 men formerly studied as college students will undergo a 9-11 year follow-up, including assessment of blood pressure responses to standardized stressors and 24-hour ambulatory monitoring, plus echocardiographic determination of left ventricular mass index and diastolic dysfunction. This study will extend previous observations on the utility of cardiovascular stress responses as predictors of long-term increases in blood pressure and pathogenic changes in myocardial function.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL018976-13
Application #
3335711
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1976-05-01
Project End
1994-03-31
Budget Start
1992-04-01
Budget End
1993-03-31
Support Year
13
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Type
Schools of Medicine
DUNS #
078861598
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Girdler, S S; Light, K C (1994) Hemodynamic stress responses in men and women examined as a function of female menstrual cycle phase. Int J Psychophysiol 17:233-48
Girdler, S S; Pedersen, C A; Stern, R A et al. (1993) Menstrual cycle and premenstrual syndrome: modifiers of cardiovascular reactivity in women. Health Psychol 12:180-92
Stabler, B; Turner, J R; Girdler, S S et al. (1992) Reactivity to stress and psychological adjustment in adults with pituitary insufficiency. Clin Endocrinol (Oxf) 36:467-73
Dolan, C A; Sherwood, A; Light, K C (1992) Cognitive coping strategies and blood pressure responses to real-life stress in healthy young men. Health Psychol 11:233-40
Light, K C; Dolan, C A; Davis, M R et al. (1992) Cardiovascular responses to an active coping challenge as predictors of blood pressure patterns 10 to 15 years later. Psychosom Med 54:217-30
Sherwood, A; Davis, M R; Dolan, C A et al. (1992) Cardiovascular reactivity assessment: effects of choice of difficulty on laboratory task responses. Int J Psychophysiol 12:87-94
Sherwood, A; Turner, J R; Light, K C et al. (1990) Temporal stability of the hemodynamics of cardiovascular reactivity. Int J Psychophysiol 10:95-8
Girdler, S S; Turner, J R; Sherwood, A et al. (1990) Gender differences in blood pressure control during a variety of behavioral stressors. Psychosom Med 52:571-91
Sherwood, A; Dolan, C A; Light, K C (1990) Hemodynamics of blood pressure responses during active and passive coping. Psychophysiology 27:656-68
Turner, J R; Girdler, S S; Sherwood, A et al. (1990) Cardiovascular responses to behavioral stressors: laboratory-field generalization and inter-task consistency. J Psychosom Res 34:581-9

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