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Is spending money on others good for your heart?
Abstract
Objective: Does spending money on others (prosocial spending) improve the cardiovascular health of community-dwelling older adults diagnosed with high blood pressure? Methods: In Study 1, 186 older adults diagnosed with high blood pressure participating in the Midlife in the US Study (MIDUS) were examined. In Study 2, 73 older adults diagnosed with high blood pressure were assigned to spend money on others or to spend money on themselves. Results: In Study 1, the more money people spent on others, the lower their blood pressure was two years later. In Study 2, participants who were assigned to spend money on others for three consecutive weeks subsequently exhibited lower systolic and diastolic blood pressure compared to participants assigned to spend money on themselves. The magnitude of these effects was comparable to the effects of interventions such as antihypertensive medication or exercise. Conclusions: Together, these findings suggest that spending money on others shapes cardiovascular health, thereby providing one pathway by which prosocial behavior improves physical health among at-risk older adults.
Supplementary resource (1)
Data
December 2016
... Prosocial actions take on many familiar forms, like charitable giving, volunteering, donating blood, or the everyday kinds of helping that we focus on in the current research, such as sharing food or offering advice to others (Aknin & Whillans, 2021). Prosociality is a hallmark of a well-functioning society (Bowles & Gintis, 2003;Rand & Nowak, 2013), and performing prosocial acts can provide personal benefits to the helper, including positive reputational rewards (Willer, 2009;Willer et al., 2010), better physical health (Brown et al., 2009;Kushlev et al., 2020;Lyubomirsky et al., 2005;Whillans et al., 2016), and increased emotional well-being and meaning in life (Aknin et al., 2013(Aknin et al., , 2015Van Tongeren et al., 2016). Despite the benefits of prosociality, people sometimes choose not to help others, and research has examined factors that restrict helping behaviors (Latané & Darley, 1970;Piliavin et al., 1981), including gender roles. ...
Although men and women help others, there are systematic gender differences in the type of helping they perform. Consistent with traditional gender roles and stereotypes, men typically help in agentic ways, and women typically help in communal ways. Drawing on the Theory of Planned Behavior, the Gender Roles Inhibiting Prosociality model predicts that gender stereotypes about gender-inconsistent helping create negative attitudes, restrictive subjective norms, and low self-efficacy that undermine helping intentions, which, in turn, reduce engagement in gender-inconsistent helping contexts. Across three studies (N = 1,355), we find empirical support for the hypothesized model: When asked to imagine engaging in a gender-inconsistent (vs. gender-consistent) helping scenario, participants anticipated feeling worse, expected others to judge them more negatively, and reported decreased self-efficacy beliefs, and these factors predicted lower intentions to engage in gender-inconsistent helping. Critically, behavioral intentions explained some of the variance in gender-inconsistent helping during the following month. Internal meta-analyses of the differences between gender-consistent and -inconsistent helping on attitudes, subjective norms, self-efficacy, and behavioral intentions across studies revealed small-to-medium average effect sizes (ds = 0.16—0.47). These results have the potential to inform interventions aimed at increasing helping in all its forms.
... In contrast to receiving support, there is an emerging literature indicating that being a support provider may be beneficial to health (Brown et al. 2003). One recent study found that those randomly assigned to spend money on others as opposed to themselves had lower subsequent blood pressure (Whillans et al. 2016). ...
Background:
Support-giving has emerged as a health-relevant social behavior, such that giving more support is associated with better physical health. However, biological mechanisms by which support-giving and health are linked remain unclear. Whether support-giving uniquely relates to health relative to other psychosocial factors is also an open research question.
Purpose:
Two studies test the hypothesis that support-giving is uniquely (over-and-above other psychosocial factors) related to lower systemic inflammation, a biological correlate of health.
Methods:
Cross-sectional associations of support-giving with markers of systemic inflammation (i.e., interleukin-6 [IL-6], C-reactive protein [CRP]) were examined in two independent samples of midlife adults (Study 1, n = 746; Study 2, n = 350).
Results:
Consistent with hypotheses, giving to more social targets (to family and friends, and also volunteering for various causes), but not receiving support from similar targets, was associated with lower IL-6. In conceptual replication and extension with a different measure of support-giving, higher frequency of support-giving behavior was associated with lower IL-6, even after adjusting for social network size and individual differences in social desirability. There were no associations between support-giving and CRP in either sample.
Conclusions:
Future research needs to establish causality and directly test mechanistic pathways, but together, findings reaffirm the health-relevance of support-giving behavior and shed light on a promising biological mechanism by which such effects may occur.
A meta-analysis of positive psychology intervention (PPIs) studies was conducted. PPIs were defined as interventions in which the goal of wellbeing enhancement was achieved through pathways consistent with positive psychology theory. Data were extracted from 347 studies involving over 72,000 participants from clinical and non-clinical child and adult populations in 41 countries. The effect of PPIs with an average of ten sessions over six weeks offered in multiple formats and contexts was evaluated. At post-test, PPIs had a significant small to medium effect on wellbeing (g = 0.39), strengths (g = 0.46), QoL (g = 0.48), depression (g = −0.39), anxiety (g = −0.62), and stress (g = −0.58). Gains were maintained at three months follow-up. Individuals in non-western countries with clinical problems, who engaged in longer individual or group therapy programs containing multiple PPIs benefited most. This meta-analysis shows that PPIs have an extensive evidence base supporting their effectiveness.
Planetary life support systems are collapsing due to climate change and the biodiversity crisis. We have a very short time. Within 3040 years, human civilisation may collapse if current trends continue. The rootcause is the existing consumer economy, coupled with profit maximisation based on ecological and social externalities. Trends can be reversed, civilisation may be saved by transforming the profitmaximising consumer economy into an ecologically and socially just economy, which we call "the prosumer economy". Prosumer economy is a macroscale circular economy with minimum negative or positive ecological and social impact, an ecosystem of producers and prosumers, who have synergistic and circular relationships with deepened circular supply chains/networks, where leakage of wealth out of the system is minimised. In a prosumer economy there is no waste, no lasting negative impacts on the ecology and no social exploitation. The prosumer economy is like a lake or a forest, an economic ecosystem that is productive and supportive of the planet.
Planetary life support systems are collapsing due to climate change and the biodiversity crisis. The root cause is the existing consumer economy, coupled with profit maximisation based on ecological and social externalities. Trends can be reversed, civilisation may be saved by transforming the profit maximising consumer economy into an ecologically and socially just economy, which we call the prosumer economy. Prosumer economy is a macro scale circular economy with minimum negative or positive ecological and social impact, an ecosystem of producers and prosumers, who have synergistic and circular relationships with deepened circular supply chains, networks, where leakage of wealth out of the system is minimised. In a prosumer economy there is no waste, no lasting negative impacts on the ecology and no social exploitation. The prosumer economy is like a lake or a forest, an economic ecosystem that is productive and supportive of the planet. We are already planting this forest through Good4Trust.org, started in Turkey. Good4Trust is a community platform bringing together ecologically and socially just producers and prosumers. Prosumers come together around a basic ethical tenet the golden rule and share on the platform their good deeds. The relationship are already deepening and circularity is forming to create a prosumer economy. The platforms software to structure the economy is open source, and is available to be licenced to start Good4Trust anywhere on the planet. Complexity theory tells us that if enough agents in a given system adopt simple rules which they all follow, the system may shift. The shift from a consumer economy to a prosumer economy has already started, the future is either ecologically and socially just or bust.
"By now, it has become a bromide that the U.S. constitution and culture are built on the pursuit of happiness (Myers, 1992). According to this political philosophy, government should allow citizens to strive towards their own conception of happiness, and should assist them as much as possible to reach this goal. In return, citizens ought to make the most of the opportunity, ultimately contributing to the common good of all. The enduring appeal of this American ideal rests on the very plausible assumption that happiness is the fundamental objective of all human effort and activity, in all cultures, whether people are aware of it or not. By taking action, humans aim towards more positive conditions and feelings than they currently experience, or towards more positive future feelings than what they might otherwise experience if they failed to act (Carver & Scheier, 1998). Accordingly, becoming happier is not only a hugely popular topic on the self-help shelves, it is increasingly becoming a stated policy goal of world governments, with the gross national happiness of the country (rather than its gross domestic product) as the primary quantity to be maximized "
The data includes measures collected for the two experiments reported in “False-Positive Psychology” [1] where listening to a randomly assigned song made people feel younger (Study 1) or actually be younger (Study 2). These data are useful because they illustrate inflations of false positive rates due to flexibility in data collection, analysis, and reporting of results. Data are useful for educational purposes.
Altruism, although costly, may promote well-being for people who give. Costly giving by adults has received considerable attention, but less is known about the possible benefits, as well as biological and environmental correlates, of altruism in early childhood. In the current study, we present evidence that children who forgo self-gain to help other people show greater vagal flexibility and higher subsequent vagal tone than children who do not, and children from less wealthy families behave more altruistically than those from wealthier families. These results suggest that (a) altruism should be viewed through a biopsychosocial lens, (b) the influence of privileged contexts on children's willingness to make personal sacrifices for others emerges early, and (c) altruism and healthy vagal functioning may share reciprocal relations in childhood. When children help others at a cost to themselves, they could be playing an active role in promoting their own well-being as well as the well-being of others.
© The Author(s) 2015.
When data analyses produce encouraging but nonsignificant results, researchers often respond by collecting more data. This may transform a disappointing dataset into a publishable study, but it does so at the cost of increasing the Type I error rate. How big of a problem is this, and what can we do about it? To answer the first question, we estimate the Type I error inflation based on the initial sample size, the number of participants used to augment the dataset, the critical value for determining significance (typically .05), and the maximum p value within the initial sample such that the dataset would be augmented. With one round of augmentation, Type I error inflation maximizes at .0975 with typical values from .0564 to .0883. To answer the second question, we review methods of adjusting the critical value to allow augmentation while maintaining p < .05, but we note that such methods must be applied a priori. For the common occurrence of post-hoc dataset augmentation, we develop a new statistic, paugmented , that represents the magnitude of the resulting Type I error inflation. We argue that the disclosure of post-hoc dataset augmentation via paugmented elevates such augmentation from a questionable research practice to an ethical research decision.
© The Author(s) 2014.
Although a great deal of research has shown that people with more money are somewhat happier than are people with less money, our research demonstrates that how people spend their money also matters for their happiness. In particular, both correlational and experimental studies have shown that people who spend money on others report more happiness. The benefits of such prosocial spending emerge among adults around the world, and the warm glow of giving can be detected even in toddlers. These benefits are most likely to emerge when giving satisfies one or more core human needs (relatedness, competence, and autonomy). The rewards of prosocial spending are observable in both the brain and the body and can potentially be harnessed by organizations and governments.
Hypertension is the most common condition seen in primary care and leads to myocardial infarction, stroke, renal failure, and death if not detected early and treated appropriately. Patients want to be assured that blood pressure (BP) treatment will reduce their disease burden, while clinicians want guidance on hypertension management using the best scientific evidence. This report takes a rigorous, evidence-based approach to recommend treatment thresholds, goals, and medications in the management of hypertension in adults. Evidence was drawn from randomized controlled trials, which represent the gold standard for determining efficacy and effectiveness. Evidence quality and recommendations were graded based on their effect on important outcomes. There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion. The same thresholds and goals are recommended for hypertensive adults with diabetes or nondiabetic chronic kidney disease (CKD) as for the general hypertensive population younger than 60 years. There is moderate evidence to support initiating drug treatment with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, calcium channel blocker, or thiazide-type diuretic in the nonblack hypertensive population, including those with diabetes. In the black hypertensive population, including those with diabetes, a calcium channel blocker or thiazide-type diuretic is recommended as initial therapy. There is moderate evidence to support initial or add-on antihypertensive therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in persons with CKD to improve kidney outcomes. Although this guideline provides evidence-based recommendations for the management of high BP and should meet the clinical needs of most patients, these recommendations are not a substitute for clinical judgment, and decisions about care must carefully consider and incorporate the clinical characteristics and circumstances of each individual patient.
The purpose of the current study was to determine whether volunteerism is prospectively associated with hypertension risk among older adults. Participants provided data during the 2006 and 2010 waves of the Health and Retirement Study, a longitudinal panel survey using a nationally representative sample of community-dwelling older adults (age > 50 years). Volunteerism and blood pressure were measured at baseline and again 4 years later. Analyses excluded individuals hypertensive at baseline and controlled for age, race, sex, education, baseline systolic/diastolic blood pressure, and major chronic illnesses. Those who had volunteered at least 200 hr in the 12 months prior to baseline were less likely to develop hypertension (OR = 0.60; 95% CI [0.40, 0.90]) than nonvolunteers. There was no association between volunteerism and hypertension risk at lower levels of volunteer participation. Volunteering at least 200 hr was also associated with greater increases in psychological well-being (B = 0.99, β = .05, p = .006) and physical activity (B = 0.21, β = .05, p = .04) compared with nonvolunteers; however, these factors did not explain the association of volunteerism with hypertension risk. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
This research provides the first support for a possible psychological universal: Human beings around the world derive emotional benefits from using their financial resources to help others (prosocial spending). In Study 1, survey data from 136 countries were examined and showed that prosocial spending is associated with greater happiness around the world, in poor and rich countries alike. To test for causality, in Studies 2a and 2b, we used experimental methodology, demonstrating that recalling a past instance of prosocial spending has a causal impact on happiness across countries that differ greatly in terms of wealth (Canada, Uganda, and India). Finally, in Study 3, participants in Canada and South Africa randomly assigned to buy items for charity reported higher levels of positive affect than participants assigned to buy the same items for themselves, even when this prosocial spending did not provide an opportunity to build or strengthen social ties. Our findings suggest that the reward experienced from helping others may be deeply ingrained in human nature, emerging in diverse cultural and economic contexts. (PsycINFO Database Record (c) 2013 APA, all rights reserved).
The paper uses household economic panel data from five countries—Australia, Britain, Germany, Hungary and The Netherlands—to
provide a reassessment of the impact of economic well-being on happiness. The main conclusion is that happiness is considerably
more affected by economic circumstances than previously believed. In all five countries wealth affects life satisfaction more
than income. In the countries for which consumption data are available (Britain and Hungary), non-durable consumption expenditures
also prove at least as important to happiness as income.
Prior evidence suggests that caregiving may increase risk of cardiovascular disease (CVD) onset. This association has never been examined in a nationally (USA) representative sample, and prior studies could not fully control for socioeconomic confounders. This paper seeks to estimate the association between spousal caregiving and incident CVD in older Americans.
Married, CVD-free Health and Retirement Study respondents aged 50+ years (n=8472) were followed up to 8 years (1669 new stroke or heart disease diagnoses). Current caregiving exposure was defined as assisting a spouse with basic or instrumental activities of daily living ≥14 h/week according to the care recipients' report in the most recent prior biennial survey; we define providing ≥14 h/week of care at two consecutive biennial surveys as 'long-term caregiving'. Inverse probability weighted discrete-time hazard models with time-updated exposure and covariate information (including socioeconomic and cardiovascular risk factors) were used to estimate the effect of caregiving on incident CVD.
Caregiving significantly predicted CVD incidence (HR=1.35, 95% CI 1.06 to 1.68) in the population overall. Long-term caregiving was associated with double the risk of CVD onset (HR=1.95, 95% CI 1.19 to 3.18). This association for long-term care givers varied significantly by race (p<0.01): caregiving predicted CVD onset for white (HR=2.37, 95% CI 1.43 to 3.92) but not for non-white (HR=0.28, 95% CI 0.06 to 1.28).
Spousal caregiving independently predicted risk of CVD in a large sample of US adults. There was significant evidence that the effect for long-term care givers differs for non-whites and white.
Previous research has shown that spending money on others (prosocial spending) increases happiness. But, do the happiness gains depend on who the money is spent on? Sociologists have distinguished between strong ties with close friends and family and weak ties--relationships characterized by less frequent contact, lower emotional intensity, and limited intimacy. We randomly assigned participants to reflect on a time when they spent money on either a strong social tie or a weak social tie. Participants reported higher levels of positive affect after recalling a time they spent on a strong tie versus a weak tie. The level of intimacy in the relationship was more important than the type of relationship; there was no significant difference in positive affect after recalling spending money on a family member instead of a friend. These results add to the growing literature examining the factors that moderate the link between prosocial behaviour and happiness.
The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.
This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.
Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.
Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).
The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary.
Psychosocial stress has been widely studied as a risk factor for stroke and coronary heart disease (CHD) but little is known about the differential effects of stress on stroke and CHD risk by race and sex. Caregiving for a disabled spouse has been associated with increased mortality and CHD risk, but the association of caregiving strain with stroke and CHD risk across race and sex is unknown.
Participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who were providing in-home caregiving to a disabled spouse reported on caregiving strain (high, some, or none), depressive symptoms, social network, education, and age. Caregiving strain groups were compared on the Framingham Stroke Risk Score (N=716) and Framingham CHD Risk Score (N=607), which estimate the projected 10-year risk of incident stroke and ischemic heart disease, respectively.
High caregiving strain was associated with a 23% higher covariate-adjusted estimated stroke risk (11.06% for caregivers with no strain versus 13.62% risk for high-strain caregivers). This association was stronger in men, particularly African American men with high caregiving strain (26.95% estimated 10-year stroke risk). Caregiving strain was not associated with CHD risk scores.
Caregiving strain is significantly associated with higher estimated stroke risk with greatest effects for men, particularly African American men, providing caregiving to their wives. Male spouse caregivers may need special caregiving support. Prospective longitudinal studies should examine how sex and race may moderate the impact of stress on stroke and CHD risk.
Experience Corps (EC) places older volunteers in public elementary schools in 20 cities across the country. The EC program in Baltimore is a health promotion intervention designed to improve the academic outcomes of children and increase older adult volunteer physical activity. We sought to determine if there were sustained increases in physical activity with participation in EC.
Seventy-one African American women volunteers in the Baltimore EC were compared with 150 African American women in the Women's Health and Aging Studies (WHAS) I and II; all were aged 65-86 years with comparable Social Economic Status, frailty, and self-reported health status. Using a regression model, we evaluated physical activity adjusting for a propensity score and time of follow-up over 3 years.
EC volunteers reported a sustained increase in physical activity as compared with the comparison cohort. Baseline physical activity for individuals with a median propensity score was 420 kcal/wk for both groups. At 36 months, EC volunteers reported 670 kcal/week compared with 410 kcal/week in WHAS (p = .04). Discussion These findings suggest that high-intensity senior service programs that are designed as health promotion interventions could lead to sustained improvements in physical activity in high-risk older adults, while simultaneously addressing important community needs.
This research examines how a focus on time versus money can lead to two distinct mind-sets that affect consumers' willingness to donate to charitable causes. The results of three experiments, conducted both in the lab and in the field, reveal that asking individuals to think about "how much time they would like to donate" (vs. "how much money they would like to donate") to a charity increases the amount that they ultimately donate to the charity. Fueling this effect are differential mind-sets activated by time versus money. Implications for the research on time, money, and emotional well-being are discussed. (c) 2008 by JOURNAL OF CONSUMER RESEARCH, Inc..
Adaptation level theory suggests that both contrast and habituation will operate to prevent the winning of a fortune from elevating happiness as much as might be expected. Contrast with the peak experience of winning should lessen the impact of ordinary pleasures, while habituation should eventually reduce the value of new pleasures made possible by winning. Study 1 compared a sample of 22 major lottery winners with 22 controls and also with a group of 29 paralyzed accident victims who had been interviewed previously. As predicted, lottery winners were not happier than controls and took significantly less pleasure from a series of mundane events. Study 2 indicated that these effects were not due to preexisting differences between people who buy or do not buy lottery tickets or between interviews that made or did not make the lottery salient. Paraplegics also demonstrated a contrast effect, not by enhancing minor pleasures but by idealizing their past, which did not help their present happiness.
Seeman, T. E. (Dept of Epidemiology and Public Health, School of Medicine, Yale U., New Haven, CT 06510), G. A. Kaplan, L Knudsen, R. Cohen, and J. Quratnik. Social network ties and mortality among the ekterty in the Alameda County Study. Am J Epidemiol 1987; 126:714–23.
Seventeen-year mortality data from the Alameda County Study are used to examine the relative importance of social ties as predictors of survival at different ages, ranging from 38–94 years at baseline. Previous analyses of Alameda County data by Berkman and Syme (Am J Epidemiol 1979;109:186–204) have shown that such ties are significant predictors of lower nine-year mortality risk for persons aged less than 70 years at baseline. Proportional hazard analyses indicate that social ties are also significant predictors of lower 17-year mortality risks for those aged 70 and older after adjusting for age, sex, race, baseline health status, perceived health, depression, and health practices (relative hazard = 1.49 for Berkman-Syme Social Network index 95% confidence interval (CI) = 1.09–2.05). Comparisons of the relative importance of four types of social ties reveal an interesting shift across the age groups. Marital status assumes primary importance for those aged less than 60 years at baselIne (relative hazard = 1.6 and 1.4 for those aged 38–49 and 50–59, respectively 95% Cl = 1.12–2.29 and 1.02–1.91, respectively). However, ties with close friends and/or relatives assume greater importance for those aged 60 and older (relative hazard = 1.17 comparing those reporting five or more contacts per month to the more socially isolated who report less than five such contacts per month; 95% Cl = 0.98–1.89).
The secretion of glucocorticoids (GCs) is a classic endocrine response to stress. Despite that, it remains controversial as to what purpose GCs serve at such times. One view, stretching back to the time of Hans Selye, posits that GCs help mediate the ongoing or pending stress response, either via basal levels of GCs permitting other facets of the stress response to emerge efficaciously, and/or by stress levels of GCs actively stimulating the stress response. In contrast, a revisionist viewpoint posits that GCs suppress the stress response, preventing it from being pathologically overactivated. In this review, we consider recent findings regarding GC action and, based on them, generate criteria for determining whether a particular GC action permits, stimulates, or suppresses an ongoing stress-response or, as an additional category, is preparative for a subsequent stressor. We apply these GC actions to the realms of cardiovascular function, fluid volume and hemorrhage, immunity and inflammation, metabolism, neurobiology, and reproductive physiology. We find that GC actions fall into markedly different categories, depending on the physiological endpoint in question, with evidence for mediating effects in some cases, and suppressive or preparative in others. We then attempt to assimilate these heterogeneous GC actions into a physiological whole.
This study examines the relationship of social ties and support to patterns of cognitive aging in the MacArthur Studies of Successful Aging (see L. F. Berkman et al., 1993), a cohort study of 1,189 initially high-functioning older adults. Baseline and longitudinal data provide information on initial levels as well as changes in cognitive performance over a 7.5-year period. Linear regression analyses revealed that participants receiving more emotional support had better baseline performance, as did those who were unmarried and those reporting greater conflict with network members. Greater baseline emotional support was also a significant predictor of better cognitive function at the 7.5-year follow-up, controlling for baseline cognitive function and known sociodemographic, behavioral, psychological, and health status predictors of cognitive aging. The findings suggest the potential value of further research on the role of the social environment in protecting against cognitive declines at older ages.
"The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure" provides a new guideline for hypertension prevention and management. The following are the key messages(1) In persons older than 50 years, systolic blood pressure (BP) of more than 140 mm Hg is a much more important cardiovascular disease (CVD) risk factor than diastolic BP; (2) The risk of CVD, beginning at 115/75 mm Hg, doubles with each increment of 20/10 mm Hg; individuals who are normotensive at 55 years of age have a 90% lifetime risk for developing hypertension; (3) Individuals with a systolic BP of 120 to 139 mm Hg or a diastolic BP of 80 to 89 mm Hg should be considered as prehypertensive and require health-promoting lifestyle modifications to prevent CVD; (4) Thiazide-type diuretics should be used in drug treatment for most patients with uncomplicated hypertension, either alone or combined with drugs from other classes. Certain high-risk conditions are compelling indications for the initial use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); (5) Most patients with hypertension will require 2 or more antihypertensive medications to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg for patients with diabetes or chronic kidney disease); (6) If BP is more than 20/10 mm Hg above goal BP, consideration should be given to initiating therapy with 2 agents, 1 of which usually should be a thiazide-type diuretic; and (7) The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated. Motivation improves when patients have positive experiences with and trust in the clinician. Empathy builds trust and is a potent motivator. Finally, in presenting these guidelines, the committee recognizes that the responsible physician's judgment remains paramount.
This study examines the relative contributions of giving versus receiving support to longevity in a sample of older married adults. Baseline indicators of giving and receiving support were used to predict mortality status over a 5-year period in the Changing Lives of Older Couples sample. Results from logistic regression analyses indicated that mortality was significantly reduced for individuals who reported providing instrumental support to friends, relatives, and neighbors, and individuals who reported providing emotional support to their spouse. Receiving support had no effect on mortality once giving support was taken into consideration. This pattern of findings was obtained after controlling for demographic, personality, health, mental health, and marital-relationship variables. These results have implications for understanding how social contact influences health and longevity.
The National High Blood Pressure Education Program presents the complete Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Like its predecessors, the purpose is to provide an evidence-based approach to the prevention and management of hypertension. The key messages of this report are these: in those older than age 50, systolic blood pressure (BP) of greater than 140 mm Hg is a more important cardiovascular disease (CVD) risk factor than diastolic BP; beginning at 115/75 mm Hg, CVD risk doubles for each increment of 20/10 mm Hg; those who are normotensive at 55 years of age will have a 90% lifetime risk of developing hypertension; prehypertensive individuals (systolic BP 120-139 mm Hg or diastolic BP 80-89 mm Hg) require health-promoting lifestyle modifications to prevent the progressive rise in blood pressure and CVD; for uncomplicated hypertension, thiazide diuretic should be used in drug treatment for most, either alone or combined with drugs from other classes; this report delineates specific high-risk conditions that are compelling indications for the use of other antihypertensive drug classes (angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers); two or more antihypertensive medications will be required to achieve goal BP (<140/90 mm Hg, or <130/80 mm Hg) for patients with diabetes and chronic kidney disease; for patients whose BP is more than 20 mm Hg above the systolic BP goal or more than 10 mm Hg above the diastolic BP goal, initiation of therapy using two agents, one of which usually will be a thiazide diuretic, should be considered; regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan. Positive experiences, trust in the clinician, and empathy improve patient motivation and satisfaction. This report serves as a guide, and the committee continues to recognize that the responsible physician's judgment remains paramount.
This report evaluates whether a program for older volunteers, designed for both generativity and health promotion, leads to short-term improvements in multiple behavioral risk factors and positive effects on intermediary risk factors for disability and other morbidities. The Experience Corps(R) places older volunteers in public elementary schools in roles designed to meet schools' needs and increase the social, physical, and cognitive activity of the volunteers. This article reports on a pilot randomized trial in Baltimore, Maryland. The 128 volunteers were 60-86 years old; 95% were African American. At follow-up of 4-8 months, physical activity, strength, people one could turn to for help, and cognitive activity increased significantly, and walking speed decreased significantly less, in participants compared to controls. In this pilot trial, physical, cognitive, and social activity increased, suggesting the potential for the Experience Corps to improve health for an aging population and simultaneously improve educational outcomes for children.
The authors demonstrate that people discount delayed outcomes as a result of perceived changes over time in supplies of slack. Slack is the perceived surplus of a given resource available to complete a focal task. The present research shows that, in general, people expect slack for time to be greater in the future than in the present. Typically, this expectation of growth of slack in the future is more pronounced for time than for money. In 7 experiments, the authors demonstrate that systematic temporal shifts of perceived slack determine the extent and the pattern of delay discounting, including hyperbolic discounting. They use this framework to explain differential propensity to delay investments and receipts of time and money.
The existing literature indicates links between aspects of social network functioning and health outcomes. It is generally believed that networks that are larger or provide greater instrumental and emotional support contribute to improved health and, perhaps, greater longevity. Recently, it has been suggested that giving as well as receiving social support may be of benefit. On the basis of evolutionary theories of emotion and altruism, the current study sought to test this thesis in a large, ethnically diverse sample of community-dwelling older adults. As expected, levels of social support given were associated with lower morbidity, whereas levels of receiving were not. It is important that these relations held even when (a) socioeconomic status, education, marital status, age, gender, ethnicity, and (b) absolute network size and activity limitation were controlled for. Results are discussed in terms of their implications for theory regarding the relations among social exchanges, giving, and later life adaptation among older adults.
How do the trade-offs that we make about two of our most valuable resources—time and money—shape happiness? While past research has documented the immediate consequences of thinking about time and money, research has not yet examined whether people’s general orientations to prioritize time over money are associated with greater happiness. In the current research, we develop the Resource Orientation Measure (ROM) to assess people’s stable preferences to prioritize time over money. Next, using data from students, adults recruited from the community, and a representative sample of employed Americans, we show that the ROM is associated with greater well-being. These findings could not be explained by materialism, material striving, current feelings of time or material affluence, or demographic characteristics such as income or marital status. Across six studies (N=4,690), we provide the first empirical evidence that prioritizing time over money is a stable preference related to greater subjective well-being.
When does giving lead to happiness? Here, we present two studies demonstrating that the emotional benefits of spending money on others (prosocial spending) are unleashed when givers are aware of their positive impact. In Study 1, an experiment using real charitable appeals, giving more money to charity led to higher levels of happiness only when participants gave to causes that explained how these funds are used to make a difference in the life of a recipient. In Study 2, participants were asked to reflect upon a time they spent money on themselves or on others in a way that either had a positive impact or had no impact. Participants who recalled a time they spent on others that had a positive impact were happiest. Together, these results suggest that highlighting the impact of prosocial spending can increase the emotional rewards of giving.
We construct an integrated theory of formal and informal volunteer work based on the premises that volunteer work is (1) productive work that requires human capital, (2) collective behavior that requires social capital, and (3) ethically guided work that requires cultural capital. Using education, income, and functional health to measure human capital, number of children in the household and informal social interaction to measure social capital, and religiosity to measure cultural capital, we estimate a model in which formal volunteering and informal helping are reciprocally related but connected in different ways to different forms of capital. Using two-wave data from the Americans' Changing Lives panel study, we find that formal volunteering is positively related to human capital, number of children in the household, informal social interaction, and religiosity. Informal helping, such as helping a neighbor, is primarily determined by gender, age, and health. Estimation of reciprocal effects reveals that formal volunteering has a positive effect on helping, but helping does not affect formal volunteering.
Background: Hypertension is a leading risk factor for cardiovascular disease and a significant cause of morbidity and mortality. This report uses data from the National Health and Nutrition Examination Survey (NHANES) to examine awareness and pharmacologic treatment of uncontrolled hypertension among U.S. adults with hypertension and focuses on three groups: those who are unaware of their hypertension, those who are aware but not treated with medication, and those who are aware and pharmacologically treated with medication but still have uncontrolled hypertension. Methods: CDC analyzed data from the NHANES 2003-2010 to estimate the prevalence of hypertension awareness and treatment among adults with uncontrolled hypertension. Hypertension was defined as an average systolic blood pressure (SBP) ≥140 mmHg or an average diastolic blood pressure (DBP) ≥90 mmHg, or currently using blood pressure (BP)-lowering medication. Uncontrolled hypertension was defined as an average SBP ≥140 mmHg or an average DBP ≥90 mmHg, among those with hypertension. Results: The overall prevalence of hypertension among U.S. adults aged ≥18 years in 2003-2010 was 30.4% or an estimated 66.9 million. Among those with hypertension, an estimated 35.8 million (53.5%) did not have their hypertension controlled. Among these, an estimated 14.1 million (39.4%) were not aware of their hypertension, an estimated 5.7 million (15.8%) were aware of their hypertension but were not receiving pharmacologic treatment, and an estimated 16.0 million (44.8%) were aware of their hypertension and were being treated with medication. Of the 35.8 million U.S. adults with uncontrolled hypertension, 89.4% reported having a usual source of health care, and 85.2% reported having health insurance. Implications for Public Health Practice: Nearly 90% of U.S. adults with uncontrolled hypertension have a usual source of health care and insurance, representing a missed opportunity for hypertension control. Improved hypertension control will require an expanded effort and an increased focus on BP from health-care syste, clinicians, and individuals.
Objectives:
We sought to test the hypothesis that providing help to others predicts a reduced association between stress and mortality.
Methods:
We examined data from participants (n = 846) in a study in the Detroit, Michigan, area. Participants completed baseline interviews that assessed past-year stressful events and whether the participant had provided tangible assistance to friends or family members. Participant mortality and time to death was monitored for 5 years by way of newspaper obituaries and monthly state death-record tapes.
Results:
When we adjusted for age, baseline health and functioning, and key psychosocial variables, Cox proportional hazard models for mortality revealed a significant interaction between helping behavior and stressful events (hazard ratio [HR] = 0.58; P < .05; 95% confidence interval [CI] = 0.35, 0.98). Specifically, stress did not predict mortality risk among individuals who provided help to others in the past year (HR = 0.96; 95% CI = 0.79, 1.18), but stress did predict mortality among those who did not provide help to others (HR = 1.30; P < .05; 95% CI = 1.05, 1.62).
Conclusions:
Helping others predicted reduced mortality specifically by buffering the association between stress and mortality.
Although accumulated research findings point to both short- and long-term salutary effects of time volunteering on older adults' physical and mental health, little research has been done on the effect of older adults' making charitable donations on their wellbeing. Guided by activity theory and the theory of volunteering and using data from the first and second waves of Midlife Development in the United States (MIDUS, 1995–1996 and MIDUS II, 2004–2006), this study examined the question of whether time volunteering and charitable donations nine years earlier had a positive direct effect on psychological wellbeing among individuals age 55 and above. Controlling for time 1 (T1) psychological wellbeing and T1 human, cultural, and social capital resources, a moderate amount (up to ten hours monthly) of T1 time volunteering and any amount of T1 charitable donations had a direct positive effect on time 2 (T2; nine years later) psychological wellbeing. The findings also show a greater effect on psychological wellbeing of any amount of charitable donations than of any amount of time volunteering, although the extent of the effect of both time volunteering and charitable donations was small. With regard to human, cultural, and social capital resources, T1 self-rated health and generative quality were significant predictors of T2 psychological wellbeing, but T1 social capital had no significant effect on T2 psychological wellbeing.
Using data from the first and second waves of the Survey of Midlife Development in the United States – MIDUS1 1995–1996 and MIDUS2 2004–2006, this paper examines the relationship between the extent of time and money volunteering among people aged 55 or more years at baseline and those of the same age nine years later. Following an analysis of the changes and stability in volunteering status, the paper examines the relationships between change or stability in volunteering and various socio-demographic attributes of the respondents and measures of their human capital, cultural capital and social capital. A majority of older volunteers of time and/or money were repeat volunteers, and the extent of volunteering at the start of the studied period was one of the most significant predictors of the extent of volunteering nine years later. The level of education was a consistent predictor of the extent of both time and money volunteering and of new engagement and stability in volunteering. Social network size, or social connectedness, represented by the number of various meetings attended, was a significant predictor not only of the hours of time volunteering, but also of new engagement and stability in both time and money volunteering. A high degree of religious identification also appeared to be a motivation for money volunteering and to affect the value of donations. The paper concludes by discussing the implications of the findings for the recruitment and retention of volunteers.
Money plays a significant role in people's lives, and yet little experimental attention has been given to the psychological underpinnings of money. We systematically varied whether and to what extent the concept of money was activated in participants' minds using methods that minimized participants' conscious awareness of the money cues. On the one hand, participants reminded of money were less helpful than were participants not reminded of money, and they also preferred solitary activities and less physical intimacy. On the other hand, reminders of money prompted participants to work harder on challenging tasks and led to desires to take on more work as compared to participants not reminded of money. In short, even subtle reminders of money elicit big changes in human behavior.
While perceived social support appears to be associated with buffered cardiovascular reactivity to short-term stressors, its impact on cardiovascular recovery is less clear. This relationship might be affected by trait hostility, with hostile individuals benefiting less from social support. However, despite the possibility that support provision might enhance well-being, limited empirical work has manipulated this in a laboratory context. The present study sought to investigate whether mentally activated support provision and support receipt influenced cardiovascular recovery from cognitive stress. Systolic blood pressure, diastolic blood pressure, heart rate, cardiac output, and total peripheral resistance were monitored continuously in a laboratory following exposure to a short-term cognitive stressor. Mixed factorial analyses of variance revealed that inducing thoughts of support provision resulted in elevated post-stressor systolic and diastolic blood pressure responses (p=.03; p=.004) in comparison to thoughts of support receipt or non-supportive social contact. Furthermore, these elevations were most pronounced for individuals high in trait hostility. From this study, support provision when already cognitively and physiologically stressed appears to be deleterious rather than beneficial for cardiovascular function. Moreover, individuals high in trait hostility may be particularly disadvantaged by providing support in everyday life.
Does thinking about time, rather than money, influence how effectively individuals pursue personal happiness? Laboratory and field experiments revealed that implicitly activating the construct of time motivates individuals to spend more time with friends and family and less time working-behaviors that are associated with greater happiness. In contrast, implicitly activating money motivates individuals to work more and socialize less, which (although productive) does not increase happiness. Implications for the relative roles of time versus money in the pursuit of happiness are discussed.
The present study examined how financial decisions 'get under the skin'. Participants played an economic game in which they could donate some of their payment to another student. Affect was measured afterward and salivary cortisol was measured before and afterward. Participants who kept more money for themselves reported less positive affect, more negative affect, and more shame. Shame predicted higher levels of post-game cortisol, controlling for pre-game cortisol; stingy economic behavior therefore produced a significant indirect effect on cortisol via shame. Thus, shame and cortisol represent plausible emotional and biological pathways linking everyday decisions with downstream consequences for health.
An increasing number of studies has tested whether greater cardiovascular responses to acute mental stress predict future cardiovascular disease, but results have been variable. This review aimed quantitatively to evaluate the association between cardiovascular responses to laboratory mental stress and subsequent cardiovascular risk status in prospective cohort studies. We searched general bibliographic databases, PsycINFO, Web of Science, and PubMed, up to December 2009. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. There were 169 associations (36 articles) of stress reactivity and 30 associations (5 articles) of poststress recovery in relation to future cardiovascular risk status, including elevated blood pressure, hypertension, left ventricular mass, subclinical atherosclerosis, and clinical cardiac events. The overall meta-analyses showed that greater reactivity to and poor recovery from stress were associated longitudinally with poor cardiovascular status (r=0.091 [95% CI: 0.050 to 0.132], P<0.001, and r=0.096 [95% CI: 0.058 to 0.134], P<0.001, respectively). These findings were supported by more conservative analyses of aggregate effects and by subgroup analyses of the methodologically strong associations. Notably, incident hypertension and increased carotid intima-media thickness were more consistently predicted by greater stress reactivity and poor stress recovery, respectively, whereas both factors were associated with higher future systolic and diastolic blood pressures. In conclusion, the current meta-analysis suggests that greater responsivity to acute mental stress has an adverse effect on future cardiovascular risk status, supporting the use of methods of managing stress responsivity in the prevention and treatment of cardiovascular disease.
How physically and psychologically healthy are Americans at midlife? And why do some experience greater well-being than others? The MacArthur Foundation addressed these questions head-on by funding a landmark study known as "Midlife in the U.S." (MIDUS). How Healthy Are We? presents the key findings from the survey in three sections: physical health, quality of life and psychological well-being, and the contexts of midlife. This wide-ranging study measures not only healthâthe absence of illnessâbut also reports on the presence of wellness in middle-aged Americans. Researchers, policymakers, and others concerned with the quality of midlife will welcome its insights. "A decade of innovative research by an all-star scientific team yields this insightful description of strategies we use to navigate challenges over the life course. How Healthy Are We? redefines 'middle age' for scientists and for the rest of our society by debunking the myth of the midlife crisis and revealing the reality of middle age in America today."âJack W. Rowe, Chairman and CEO, Aetna
The current political-economic climate, which is generally supportive of both private and public sector down-sizing, increasingly demands that human service workers assess, engage, and creatively use consumer strengths and resources. This meta-analysis of thirty-seven independent studies provided the means of inferring not only that elder volunteers' sense of well-being seemed to be significantly bolstered through volunteering, but also that such relatively healthy older people represent a significant adjunct resource for meeting some of the service needs of more vulnerable elders, as well as those of other similarly vulnerable groups such as disabled children. Averaging across studies, 85 percent of the "clients" who received service from an older volunteer (e.g., peer-counseling of nursing home residents) scored better on dependent measures (e.g., diminished depression) than the average person in comparison conditions did (U3 = .847 [Cohen, 1988], combined p < .001). The policy implications of such beneficial effects among both older volunteers and the people they serve are discussed.
1. In humans, the hypertensive effects of adrenocorticotropic hormone (ACTH) infusion are reproduced by intravenous or oral Cortisol. Oral Cortisol increases blood pressure in a dose-dependent fashion. At a dose of 80–200 mg/day, the peak increases in systolic pressure are of the order of 15mmHg. Increases in blood pressure are apparent within 24 h.
2. Cortisol-induced hypertension is accompanied by a significant sodium retention and volume expansion. Co-administration of the type I (mineralocorticoid) receptor antagonist spironolactone does not prevent the onset of cortisol-induced hypertension. Thus, sodium retention is not the primary mechanism of cortisol-induced hypertension.
3. Direct and indirect measures of sympathetic activity are unchanged or suppressed during Cortisol administration, suggesting that cortisol-induced hypertension is not mediated by increased sympathetic tone.
4. Preliminary evidence in humans suggests that suppression of the nitric oxide system may play a role in cortisol-induced hypertension.
5. These potential mechanisms of Cortisol action may be relevant in a number of clinical contexts, including Cushing's syndrome, apparent mineralocorticoid excess, the hypertension of liquorice abuse and chronic renal failure. There is also preliminary evidence suggesting a role for Cortisol in essential hypertension.
BACKGROUND: Arterial tonometry is a noninvasive technique for monitoring the arterial blood pressure in a continuous manner. Real-time arterial blood pressure measurements are advantageous in many clinical settings, but arterial tonometric devices must be validated prior to clinical acceptance. Guidelines for accuracy for noninvasive blood pressure monitors have been established by the Association for the Advancement of Medical Instrumentation. OBJECTIVE: To test the Colin Pilot 9200 configured with an arterial tonometry module with 20 patients and to compare tonometric blood pressure measurements with intra-arterial blood pressure measurements. METHODS: All of the patients in the study were aged over 14 years and weighed over 35 kg; testing was performed in the operating room or in the intensive care unit. Data from each patient consisted of multiple simultaneous recordings of tonometric and intra-arterial blood pressure values. The data were then compared; the mean and SD of the difference between the two measurement devices were then calculated. RESULTS: Tonometric values were slightly less than the intra-arterial pressure measurements; the mean difference for systolic blood pressure was 2.24 +/- 8.7 mmHg and for diastolic pressure was 0.26 +/- 8.88 mmHg. CONCLUSION: The arterial tonometry module incorporated into the Colin Pilot 9200 was investigated for use with selected adult and pediatric populations. With our patients, it generated accurate data throughout a wide blood pressure range. It satisfied Association for the Advancement of Medical Instrumentation standards for mean systolic and diastolic blood pressure measurements and only minimally exceeded the allowable SD. This technology should prove to be a valuable tool for noninvasive blood pressure monitoring of various patient populations.
Studies often fail to adequately test the causal relationship between volunteering and well-being. Yet the media and empirical research have focused attention on the impact of volunteering on the well-being of elderly persons. This study addresses two questions: First, does volunteering improve the psychological and physical well-being of elderly persons? Second, do elderly volunteers experience different benefits than younger adults?
Using nationally representative panel data, I assessed the long-term impact of volunteering on the life satisfaction and perceived health of persons aged 60 and over. I then compared ordinary least squares regression results for seniors with those for younger adults.
I found that older volunteers experienced greater increases in life satisfaction over time as a result of their volunteer hours than did younger adult volunteers, especially at high rates of volunteering. Older adults experienced greater positive changes in their perceived health than did younger adult volunteers.
The type of volunteer work in which older and younger adults engage may be part of the reason for these differential effects. But the context in which older and younger adults volunteer and the meaning of their voluntarism are more likely explanations. Researchers should take into account volunteer commitment when studying volunteering's effect on well-being, not simply volunteer role.
Objective:
Statistical models, such as linear or logistic regression or survival analysis, are frequently used as a means to answer scientific questions in psychosomatic research. Many who use these techniques, however, apparently fail to appreciate fully the problem of overfitting, ie, capitalizing on the idiosyncrasies of the sample at hand. Overfitted models will fail to replicate in future samples, thus creating considerable uncertainty about the scientific merit of the finding. The present article is a nontechnical discussion of the concept of overfitting and is intended to be accessible to readers with varying levels of statistical expertise. The notion of overfitting is presented in terms of asking too much from the available data. Given a certain number of observations in a data set, there is an upper limit to the complexity of the model that can be derived with any acceptable degree of uncertainty. Complexity arises as a function of the number of degrees of freedom expended (the number of predictors including complex terms such as interactions and nonlinear terms) against the same data set during any stage of the data analysis. Theoretical and empirical evidence--with a special focus on the results of computer simulation studies--is presented to demonstrate the practical consequences of overfitting with respect to scientific inference. Three common practices--automated variable selection, pretesting of candidate predictors, and dichotomization of continuous variables--are shown to pose a considerable risk for spurious findings in models. The dilemma between overfitting and exploring candidate confounders is also discussed. Alternative means of guarding against overfitting are discussed, including variable aggregation and the fixing of coefficients a priori. Techniques that account and correct for complexity, including shrinkage and penalization, also are introduced.