Preliminary evidence suggests that individuals who show excessive cardiovascular responses to psychological challenge (exaggerated """"""""cardiovascular reactivity"""""""") may be at increased risk for the development of atherosclerosis and coronary heart disease (CHD). To the extent that exaggerated reactivity exerts a causal, cumulative influence on disease processes, this effect should be observed primarily among those who are exposed to frequent, ongoing stressors which trigger exaggerated cardiovascular responding. A prospective test of this diathesis-stress theory would require a) a valid method of assessing the daily stressors which evoke cardiovascular activation and b) a strategy for reliably documenting the progression of underlying disease processes (i.e., atherosclerosis) in community samples. """"""""Social support,"""""""" the availability of assistance from others, is a second behavioral factor which has been linked with CHD, with individuals lacking in social support showing a poorer prognosis in a number of studies. As with cardiovascular reactivity, the influence of social support on atherosclerosis may be best characterized in humans by tracking individuals in their daily life circumstances, and following the progression of disease over time. These approaches have not been feasible until now. The proposed study examines the joint influence of cardiovascular reactivity and ongoing psychological stress as they influence the development of carotid atherosclerosis in a sample of middle aged adults; the effects of social support processes on response to psychological stressors and disease progression will be simultaneously explored. The sample will be followed over a three-year period using: a) reliable laboratory measures of cardiovascular reactivity; b) real time ambulatory monitoring assessments of behavioral stressors, social interactions and cardiovascular responses; and c) repeat assessments of subclinical atherosclerosis using carotid ultrasonography. These recent measurement innovations, as employed in the present study, should significantly enhance our current understanding of the role of behavioral processes in coronary heart disease risk.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL056346-04
Application #
6389573
Study Section
Behavioral Medicine Study Section (BEM)
Program Officer
Czajkowski, Susan
Project Start
1998-05-01
Project End
2003-04-30
Budget Start
2001-05-01
Budget End
2002-04-30
Support Year
4
Fiscal Year
2001
Total Cost
$487,273
Indirect Cost
Name
University of Pittsburgh
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Khambaty, Tasneem; Stewart, Jesse C; Muldoon, Matthew F et al. (2014) Depressive symptom clusters as predictors of 6-year increases in insulin resistance: data from the Pittsburgh Healthy Heart Project. Psychosom Med 76:363-9
Kamarck, Thomas W; Shiffman, Saul; Sutton-Tyrrell, Kim et al. (2012) Daily psychological demands are associated with 6-year progression of carotid artery atherosclerosis: the Pittsburgh Healthy Heart Project. Psychosom Med 74:432-9
Beatty, Danielle L; Kamarck, Thomas W; Matthews, Karen A et al. (2011) Childhood socioeconomic status is associated with psychosocial resources in African Americans: the Pittsburgh Healthy Heart Project. Health Psychol 30:472-80
Stewart, Jesse C; Fitzgerald, Griffin J; Kamarck, Thomas W (2010) Hostility now, depression later? Longitudinal associations among emotional risk factors for coronary artery disease. Ann Behav Med 39:258-66
Stewart, Jesse C; Rand, Kevin L; Muldoon, Matthew F et al. (2009) A prospective evaluation of the directionality of the depression-inflammation relationship. Brain Behav Immun 23:936-44
Schott, Laura L; Kamarck, Thomas W; Matthews, Karen A et al. (2009) Is brachial artery flow-mediated dilation associated with negative affect? Int J Behav Med 16:241-7
Stewart, Jesse C; Janicki-Deverts, Denise; Muldoon, Matthew F et al. (2008) Depressive symptoms moderate the influence of hostility on serum interleukin-6 and C-reactive protein. Psychosom Med 70:197-204
Vella, Elizabeth J; Kamarck, Thomas W; Shiffman, Saul (2008) Hostility moderates the effects of social support and intimacy on blood pressure in daily social interactions. Health Psychol 27:S155-62
Kamarck, Thomas W; Muldoon, Matthew F; Shiffman, Saul S et al. (2007) Experiences of demand and control during daily life are predictors of carotid atherosclerotic progression among healthy men. Health Psychol 26:324-32
Stewart, Jesse C; Janicki, Denise L; Muldoon, Matthew F et al. (2007) Negative emotions and 3-year progression of subclinical atherosclerosis. Arch Gen Psychiatry 64:225-33

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