This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Virtanen, R. Articles by Airaksinen, J. Search for Related Content PubMed PubMed Citation Articles by Virtanen, R. Articles by Airaksinen, J. Related Collections Health Psychology Personality Parasympathetic Nervous System Sympathetic Nervous System Blood Pressure

Anxiety and Hostility Are Associated With Reduced Baroreflex Sensitivity and Increased Beat-to-Beat Blood Pressure Variability

From the Department of Medicine (R.V., L.-M.V.-P., J.A.), Turku University Central Hospital; Research Department of the Social Insurance Institution (A.J., J.K.S.); and the Departments of Biostatistics (H.H.) and Applied Physics (T.K.), University of Turku, Turku; and the Department of Medicine (L.-M.V.-P.), Helsinki University Central Hospital, Helsinki, Finland.

Address reprint requests to: Raine Virtanen, MD, Department of Medicine, Turku University Central Hospital, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland. Email: raine.virtanen{at}fimnet.fi

OBJECTIVE: The purpose of this study was to determine whether psychological factors are associated with heart rate variability (HRV), blood pressure variability (BPV), and baroreflex sensitivity (BRS) among healthy middle-aged men and women.

METHODS: A population-based sample of 71 men and 79 women (35–64 years of age) was studied. Five-minute supine recordings of ECG and beat-to-beat photoplethysmographic finger systolic arterial pressure and diastolic arterial pressure were obtained during paced breathing. Power spectra were computed using a fast Fourier transform for low-frequency (0.04–0.15 Hz) and high-frequency (0.15–0.40 Hz) powers. BRS was calculated by cross-spectral analysis of R-R interval and systolic arterial pressure variabilities. Psychological factors were evaluated by three self-report questionnaires: the Brief Symptom Inventory, the shortened version of the Spielberger State-Trait Anger Expression Inventory, and the Toronto Alexithymia Scale.

RESULTS: Psychological factors were not related to HRV. Anxiety was associated with decreased BRS (p = 0.001) and higher low-frequency (p = 0.002) power of systolic arterial pressure variability. These associations were independent of age, gender, other psychological factors, heart rate, and systolic and diastolic blood pressures. Hostility was an independent correlate of increased low-frequency power of diastolic arterial pressure (p = 0.001) and increased high-frequency power of systolic arterial pressure (p = 0.033) variability.

CONCLUSIONS: Anxiety and hostility are related to reduced BRS and increased low-frequency power of BPV. Reduced BRS reflects decreased parasympathetic outflow to the heart and may increase BPV through an increased sympathetic predominance.

Key Words: heart rate variability, • blood pressure variability, • baroreflex sensitivity, • Brief Symptom Inventory, • Spielberger State-Trait Anger Expression Inventory, • Toronto Alexithymia Scale.

Abbreviations: BPV = blood pressure variability;; BRS = baroreflex sensitivity;; BSI-37 = shortened 37-item version of the Brief Symptom Inventory;; HRV = heart rate variability;; STAXI = Spielberger State-Trait Anger Expression Inventory;; TAS-26 = Toronto Alexithymia Scale.

This article has been cited by other articles:

				A. K. Mattila, E. Kronholm, A. Jula, J. K. Salminen, A.-M. Koivisto, R.-L. Mielonen, and M. Joukamaa Alexithymia and Somatization in General Population Psychosom Med, July 1, 2008; 70(6): 716 - 722. [Abstract] [Full Text] [PDF]

				M. E. Bleil, P. J. Gianaros, J. R. Jennings, J. D. Flory, and S. B. Manuck Trait Negative Affect: Toward an Integrated Model of Understanding Psychological Risk for Impairment in Cardiac Autonomic Function Psychosom Med, April 1, 2008; 70(3): 328 - 337. [Abstract] [Full Text] [PDF]

				A. K. Derrickson, J. R. Baber, and A. Agarwal A CASE OF ACUTE STRESS-INDUCED VENTRICULAR TACHYCARDIA Psychosom Med, October 1, 2007; 69(8): 825 - 825. [Full Text] [PDF]

				T. Ritz and B. Dahme Implementation and Interpretation of Respiratory Sinus Arrhythmia Measures in Psychosomatic Medicine: Practice Against Better Evidence? Psychosom Med, July 1, 2006; 68(4): 617 - 627. [Abstract] [Full Text] [PDF]

				M Elovainio, M Kivimaki, S Puttonen, H Lindholm, T Pohjonen, and T Sinervo Organisational injustice and impaired cardiovascular regulation among female employees Occup. Environ. Med., February 1, 2006; 63(2): 141 - 144. [Abstract] [Full Text] [PDF]

				M. J. Rice and K. Records Cardiac response rate variability in physically abused women of childbearing age. Biol Res Nurs, January 1, 2006; 7(3): 204 - 213. [Abstract] [PDF]

				M. E. Alvarenga, J. C. Richards, G. Lambert, and M. D. Esler Psychophysiological Mechanisms in Panic Disorder: A Correlative Analysis of Noradrenaline Spillover, Neuronal Noradrenaline Reuptake, Power Spectral Analysis of Heart Rate Variability, and Psychological Variables Psychosom Med, January 1, 2006; 68(1): 8 - 16. [Abstract] [Full Text] [PDF]

				M. M. Burg, R. Lampert, T. Joska, W. Batsford, and D. Jain Psychological Traits and Emotion-Triggering of ICD Shock-Terminated Arrhythmias Psychosom Med, November 1, 2004; 66(6): 898 - 902. [Abstract] [Full Text] [PDF]