Hostility Is Related to Blunted β-Adrenergic Receptor Responsiveness Among Middle-Aged Women

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Psychosomatic Medicine (Impact Factor: 3.47). 07/2004; 66(4):507-13. DOI: 10.1097/01.psy.0000132876.95620.04
Source: PubMed


Based on previous findings in men, the hypothesis that hostility would be associated with blunted responsiveness of cardiovascular beta-adrenergic receptors was tested in a study sample of middle-aged women. The roles of the sympathetic nervous system and of social support in this putative relationship were also evaluated.
Subjects were 80 healthy women (n = 23 African American; n = 57 white), aged 47 to 55 years. Hostility was assessed using the Cook-Medley Hostility Scale and social support was assessed with the Brief Social Support Questionnaire. Intravenous isoproterenol challenge was used to evaluate cardiac and vascular beta-adrenergic receptor responsiveness. Twenty-four-hour urinary catecholamine excretion was used to index sympathetic nervous system activity.
Hostility was related to blunted cardiac (R = 0.33, p <.01) and vascular (R = 0.23, p <.05) beta-adrenergic receptor responsiveness in simple correlation analysis and in hierarchical regression analyses controlling for race, menopausal status, weight, and resting heart rate. Low social support was also related to blunted beta-adrenergic receptor responsiveness (R = 0.3, p <.01). Twenty-four-hour norepinephrine excretion was related both to hostility (R = 0.32, p <.01) and to cardiac (R = 0.25, p <.05) and vascular (R = 0.24, p <.05) beta-adrenergic receptor responsiveness.
These observations replicate and extend previous findings in men by demonstrating that higher levels of hostility and low levels of social support are associated with blunted beta-adrenergic receptor responsiveness in middle-aged women. They also suggest that heightened sympathetic nervous system activity associated with hostility may contribute to beta-adrenergic receptor blunting. Because blunted beta-adrenergic receptor sensitivity is a characteristic feature of a broad range of cardiovascular diseases, these findings may reflect an early preclinical manifestation of pathophysiology accompanying hostility and low social support.

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    • "The mechanisms driving the association between hostility and acute stress responses are unclear. Excessive sympathetic nervous activity has been linked to β-adrenergic receptor (β-AR) down-regulation in animals, and a number of studies have related hostility to blunted cardiac and vascular β-AR sensitivity in humans [37,38]. Since β-AR activation plays a central role in the healthy vasodilatory response of blood vessels to stress, a blunted adrenergic response, promoting vasoconstriction, would result in an increase in total peripheral resistance and elevated BP. "
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    ABSTRACT: Evidence suggests that emotional stress can trigger acute coronary syndromes in patients with advanced coronary artery disease (CAD), although the mechanisms involved remain unclear. Hostility is associated with heightened reactivity to stress in healthy individuals, and with an elevated risk of adverse cardiac events in CAD patients. This study set out to test whether hostile individuals with advanced CAD were also more stress responsive. Thirty-four men (aged 55.9+/-9.3 years) who had recently survived an acute coronary syndrome took part in laboratory testing. Trait hostility was assessed by the Cook Medley Hostility Scale, and cardiovascular activity, salivary cortisol, and plasma concentrations of interleukin-6 were assessed at baseline, during performance of two mental tasks, and during a 2-h recovery. Participants with higher hostility scores had heightened systolic and diastolic blood pressure (BP) reactivity to tasks (both P<.05), as well as a more sustained increase in systolic BP at 2 h post-task (P=.024), independent of age, BMI, smoking status, medication, and baseline BP. Hostility was also associated with elevated plasma interleukin-6 (IL-6) levels at 75 min (P=.023) and 2 h (P=.016) poststress and was negatively correlated with salivary cortisol at 75 min (P=.034). Hostile individuals with advanced cardiovascular disease may be particularly susceptible to stress-induced increases in sympathetic activity and inflammation. These mechanisms may contribute to an elevated risk of emotionally triggered cardiac events in such patients.
    Journal of psychosomatic research 02/2010; 68(2):109-16. DOI:10.1016/j.jpsychores.2009.06.007 · 2.74 Impact Factor
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    • "Only one previous study suggested that urinary NE predicted CD 25 [Sherwood et al., 2004]. "
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    ABSTRACT: The purpose of this study was to examine the relationship between mood states and beta-adrenergic receptor function in a normal population. We also examined if sympathetic nervous system activity is related to mood states or beta-adrenergic receptor function. Sixty-two participants aged 25-50 years were enrolled in this study. Mood states were assessed using the Profile of Mood States (POMS). Beta-adrenergic receptor function was determined using the chronotropic 25 dose isoproterenol infusion test. Level of sympathetic nervous system activity was estimated from 24-hr urine norepinephrine excretion. Higher tension-anxiety, depression-dejection, and anger-hostility were related to decreased beta-adrenergic receptor sensitivity (i.e., higher chronotropic 25 dose values), but tension-anxiety was the only remaining independent predictor of beta-adrenergic receptor function after controlling for age, gender, ethnicity, and body mass index (BMI). Urinary norepinephrine excretion was unrelated to either mood states or beta-adrenergic receptor function. These findings replicate previous reports that anxiety is related to decreased (i.e., desensitized) beta-adrenergic receptor sensitivity, even after controlling for age, gender, ethnicity, and body mass index.
    Depression and Anxiety 07/2008; 25(7):559-64. DOI:10.1002/da.20338 · 4.41 Impact Factor
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    • "In addition, trait hostility is associated with tryptophan (a precursor of the neurotransmitter serotonin) and low brain serotonergic function (for a review, see Williams, 2002). As assessed with the Cook–Medley scale used in the current study, hostility has also been associated with blunted responsiveness of -adrenergic receptors in both women and men (Sherwood et al., 2004), which is related to heightened sympathetic activity (Mills et al., 1997; Wood et al., 1982). Genetic predispositions may also play a causative role in the associations observed in the present study. "
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    ABSTRACT: Chronically elevated systemic inflammation has a dramatic impact on health for older individuals. As stress-related responses, both hostility and pain perception may contribute to inflammation which in turn may maintain negative emotion and pain over time. We used structural equation modeling to examine the degree to which trait hostility and pain were uniquely associated with C-reactive protein (CRP) and serum IL-6 levels over a 6-year span in a sample of older adults. The sample included 113 present or former caregivers of a spouse with dementia and 101 non-caregivers. After accounting for depression, health behaviours, and other risk factors, which were also assessed longitudinally, pain and, to a lesser extent, hostility were uniquely associated with plasma levels of CRP but not IL-6. When examined separately, the association between pain and CRP was significant only for caregivers, while the association between hostility and CRP was comparable for the two groups. These findings suggest that hostility may play a role in a cycle of inflammation among older adults, and that pain may be particularly problematic for those under chronic stress. Our results also shed light on inflammation as a mechanism underlying the effects of hostility on cardiovascular disease morbidity and mortality.
    Brain Behavior and Immunity 08/2006; 20(4):389-400. DOI:10.1016/j.bbi.2005.11.002 · 5.89 Impact Factor
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