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From the Department of Psychiatry and Behavioral Sciences (A.S., J.W.H.), Department of Pharmacology (C.K.), Duke University Medical Center, Durham, NC; and Department of Medicine (A.L.H.) at the University of North Carolina, Chapel Hill, NC.
Address correspondence and reprint requests to Andrew Sherwood, Ph.D., DUMC-3119, Durham, NC 27710. E-mail: sherw002{at}mc.duke.edu
OBJECTIVE: Based on previous findings in men, the hypothesis that hostility would be associated with blunted responsiveness of cardiovascular ß-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.
METHODS: 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 ß-adrenergic receptor responsiveness. Twenty-four-hour urinary catecholamine excretion was used to index sympathetic nervous system activity.
RESULTS: Hostility was related to blunted cardiac (R = 0.33, p < .01) and vascular (R = 0.23, p < .05) ß-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 ß-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) ß-adrenergic receptor responsiveness.
CONCLUSIONS: 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 ß-adrenergic receptor responsiveness in middle-aged women. They also suggest that heightened sympathetic nervous system activity associated with hostility may contribute to ß-adrenergic receptor blunting. Because blunted ß-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.
Key Words: adrenergic receptor responsiveness, • Cook-Medley Hostility, • social support, • catecholamines, • menopause.
Abbreviations: AR = adrenergic receptor;; CD25 = chronotropic dose of isoproterenol required to increase HR by 25 bpm;; DBP = diastolic blood pressure;; ECG = electrocardiogram;; Ho = Cook Medley Hostility scale;; HR = heart rate;; MAP = mean arterial pressure;; PD25 = dose of phenylephrine required to increase MAP by 25 mm Hg;; SBP = systolic blood pressure;; SSQ = Sarason Brief Social Support scale;; SVR = systemic vascular resistance;; VD40 = vasodilatory dose of isoproterenol required to decrease SVR by 40%.
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