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The present study examined if high levels of religious attendance (ORG), private religious activity (NOR), or intrinsic religiosity (SUB) buffer cardiovascular responses to active speech and anger recall lab stressors alone and by John Henryism Active Coping (JHAC) and educational attainment. A sample of 74 healthy African American males, aged 23 to 47 years, completed psychosocial surveys and a lab reactivity protocol involving active speech and anger recall with a 5-minute baseline and ensuing recovery periods. Measures of religiosity, JHAC, and education were related to continuous measures of systolic and diastolic blood pressure (BP), for each task and rest period with repeated measures ANOVA tests. The period by education by JHAC interaction effect was significant for diastolic BP responses at low but not higher NOR. At low education and low NOR, diastolic BP levels increased significantly during anger recall and ensuing recovery for high but not low JHAC persons. Thus, being deprived of education and private religious activity may put these African American men in a vulnerable situation where higher effort coping may exacerbate their cardiovascular reactivity and recovery to anger induction.

Although leisure is presumed to be beneficial, certain profiles of leisure may be especially good. This paper tests whether dimensions of self-selected leisure activities (SSLAs) differentially rel...

Objectives Religious coping arguably prevents negative health outcomes for stressed persons. This study examined the moderating role of religious coping (positive, negative, and combined) in the connection of care recipient functional status with diurnal salivary cortisol patterns among dementia family caregivers. Methods Thirty African American (AA) female dementia caregivers and 48 AA noncaregivers completed the Religious Coping (RCOPE) scale, the Activities of Daily Living scale, and the Revised Memory and Behavior Problem Checklist (RMBPC) and collected five saliva samples daily (at awakening, 9 A.M., 12 P.M., 5 P.M., and 9 P.M.) for 2 straight days. Results Hierarchical regression tests with mean diurnal cortisol slope as the outcome illustrated surprisingly that higher combined and positive (but not negative) RCOPE scores were associated with increasingly flatter or worse cortisol slope scores for caregivers (but not noncaregivers). Of note, the RCOPE by RMBPC interaction was significant. Among caregivers who reported higher RMBPC scores, higher combined and positive (but not negative) RCOPE scores were unexpectedly associated with increasingly flatter cortisol slopes. Conclusions These results extend current findings by showing that being AA, a caregiver, and high in positive religious coping may predict increased daily stress responses, mainly for those with higher patient behavioral problems. Because religious coping is a central coping strategy for AA caregivers, it is vital that epidemiologic assessments of religious coping in health and aging as well as tailored interventions focus on the unique reasons for this disparity.

The present study assessed the moderating role of depressive symptomology in the interactive role of John Henryism (i.e., persistent striving with daily psychosocial demands) and father's educational attainment in estimated cardiorespiratory fitness in women. Two hundred one female Midwestern college students completed online psychosocial surveys. Among high-John Henryism women who were depressed, higher father's education levels predicted better fitness. Conversely, higher father's education predicted worse fitness for nondepressed low-John Henryism women. Depression may moderate the role of John Henryism and socioeconomic status in health, with higher John Henryism and education associated with optimal health for depressives.

The relationship between blood pressure control and central nervous system (CNS) function in the development of essential hypertension is complex and multidirectional. For example significant, sustained elevations in blood pressure (BP) can produce neuropsychological deficits in persons with established hypertension (1). Recently however, a growing body of evidence suggests that subtle changes in CNS function can accompany or possibly precede BP increases, even within the normotensive range (2–5). The nature of these changes in brain function and their possible role in developmental pathophysiology of essential hypertension remains to be fully characterized. The well-established relationship between BP and pain sensitivity suggests a heretofore unappreciated mechanism of intimacy between brain function and BP control mechanisms. Reduced responsivity to painful stimuli has been well documented in hypertensive animals and humans (for a review see Ghione, 3). This inverse relationship between BP and pain sensitivity has been shown to extend throughout the normotensive range (2,6,7). Interestingly, this hypoalgesia has been observed in persons with a family history of hypertension before significant BP elevations have occurred (8,9), suggesting that the CNS changes may parallel or even precede significant blood pressure dysregulation. These findings suggest a previously uncharacterized interrelationship between cognitive appraisal of aversive stimuli and BP control. Recent research suggests that BP-associated hypoalgesia may reflect a more generalized dampening of emotional responsivity. For example, several studies have shown significant relationships between BP and affective responses to pain (7,10,11). Moreover, this association between BP and affect dampening has been seen in emotionally laden contexts unrelated to acute or chronic pain. For example, Nyklicek and colleagues (12,13) found reduced subjective self report of stress in some hypertensives. Moreover, they noted positive correlations between pain sensitivity and negative appraisal of psychological stressors, further suggesting that BP associated hypoalgesia may reflect a more general effect on emotional responding. These collective findings indicate that higher BP, even within the normotensive range, is associated with dampened response to emotionally-laden aversive stimuli. However, those studies did not systematically address a potential relationship between BP and positive affectivity. Therefore, we designed a study to assess BP and responses to emotionally positive as well as negative photographic scenes from the International Affective Series in normotensive, young adults (14). An emotional dampening hypothesis would postulate reduced affective response to both negatively and positively valenced stimuli. An alternative positivity bias hypothesis would postulate that persons with higher BP would show less negative appraisal of negatively valenced photos, and more positive appraisal of positively valenced photos (see Figure 1). Results showed that higher BP was associated with decreased intensity of emotional response to both positive and negative affective content, providing initial support for the cardiovascular emotional dampening hypothesis. Figure 1 A comparison of the emotional dampening and positivity bias hypotheses. Cardiovascular emotional dampening indicates that persons with higher BP show reduced emotional response to stimuli with negative emotional valence as well as stimuli with positive ... Coupled with the pain sensitivity data, these findings suggest that persons with elevated BP or other hypertension risk factors may also have impaired recognition of emotional meaning in, for example, facial expressions, written communication and possibly other important modalities of emotion expression. If this is the case, then persons at risk for hypertension may show significant impairment in recognition and response to emotionally-relevant communication by others. This emotional dampening may produce potentially adverse affects on social relationships, with increased psychosocial distress and possibly additional BP dysregulation. The present study seeks to further examine emotional dampening by examination of: 1) its effects on recognition of emotion in faces and written narratives, 2) its generalizability to an older high risk population, and 3) its underlying hemodynamic correlates. We used the Perception of Affect Test (PAT; 15) to determine if elevated resting cardiovascular levels were related to reduced recognition of emotionally salient stimuli in an African-American community-based sample (HANDLS-Pilot). We hypothesize that higher BP will be related to decreased accuracy in recognition of emotion in verbal (sentences) and nonverbal (faces) content. In addition, we examined the role of total peripheral resistance and cardiac output in the relationship between BP control and emotional dampening. Finally, the influence of resting cardiovascular levels on perception of affect was examined in a sample of mostly low SES African American adults with an average age of 52.6 years.

Introduction The John Henryism active coping (JHAC) hypothesis suggests that striving with life challenges predicts increased risk for cardiovascular disease for those with scarce coping resources. This study examined the moderating role of JHAC in the associations of 1) caregiver status and 2) care recipient functional status with diurnal salivary cortisol patterns among 30 African Americans (AAs) and 24 white female dementia caregivers and 63 noncaregivers (48 AAs). Methods Caregiver participants completed the JHAC-12 scale, Activities of Daily Living (ADL) scale, and Revised Memory and Behavior Problem checklist (RMBPC) and collected five saliva samples daily (at awakening, 9 A.M., 12 P.M., 5 P.M., and 9 P.M.) for 2 successive days. Results Univariate analysis of variance tests with mean diurnal cortisol slope as the outcome illustrated that among AA caregivers, higher JHAC scores were related to flatter (or more dysregulated) cortisol slopes. The JHAC by ADL and JHAC by RMBPC interactions were each significant for AA caregivers. Among AA caregivers who reported higher ADL and RMBPC scores, higher JHAC scores were associated with flatter cortisol slopes. Conclusions These findings extend recent studies by showing that being AA, a caregiver, and high in JHAC may elevate the risk for chronic disease, especially for those with higher patient ADL and behavioral problems. Thus, it is imperative that interventions appreciate the pernicious role of high-effort coping style, especially for AA caregivers, to minimize the stressful side effects of patient ADL and memory and behavioral problems for the caregiver.

Objective. To explore the associations among ethnicity, educational attainment, and cortisol secretion. Design. Participants included 63 white (n=31) and African-American (n=32) adult men and women. Subjects provided salivary cortisol samples immediately upon awakening and again, 30 minutes later. Results. Analyses adjusted for relevant covariates revealed a steeper awakening response among whites with higher education compared to other groups. Cortisol levels were significantly lower among African-American participants with lower levels of education. All effects were independent of perceived stress. Conclusions. These preliminary findings demonstrate significant ethnic and education-related differences in awakening cortisol secretion responses. Our data highlight the importance of considering ethnicity and the moderating effects of social class when examining the associations among social contextual factors and cortisol secretion.

The John Henryism (JH) hypothesis argues that prolonged high-effort coping with chronic psychosocial stressors may be associated with elevated risk for negative health outcomes among those without sufficient socioeconomic resources. Early JH studies found a significant association between high JH, low socioeconomic status, and hypertension among African-Americans. More recently, these findings have been extended to a wide array of health status outcomes, including cardiovascular reactivity, neurohormonal secretion, and negative health behaviors. The present review provides a comprehensive overview of JHs conceptual bases and empirical support. Limitations of the construct are discussed and recommendations are made to guide future theoretical and research efforts in the area.

The current study examined affective responses to ambiguous interpersonal interactions containing both ambiguous and overtly racist content. Participants included 74 African American males (ages 18-47), half of whom heard a depiction of a negative social interaction with blatantly racist content (BRC). The remaining participants heard a similar scenario containing no racist content (NRC). Negative affect scores were higher for those in the BRC group, yet individuals in the ambiguous (NRC) condition who reported perceptions of racism in the scenario showed greater negative affect reactivity than those who saw no racism in the scenario. Among those in the NRC group, self-reported past experiences with racial discrimination moderated the effect of perceived racism on negative affect. The authors conclude that the perception of racial discrimination, in particular when evaluating ambiguous situations, may have profound affective consequences for Black men.

Objective: The John Henryism hypothesis proposes that a high level of John Henryism (JH: high-effort coping with psychosocial demands) is predictive of hypertension at low but not high socioeconomic status (SES). The objectives of the present study were to determine whether high JH and low SES (education, income, job status, and job strain) were associated with increased cardiovascular responses to laboratory social stressors. Methods: Subjects were 58 normotensive, healthy black men age 23 to 47 years. The procedure included the completion of psychosocial questionnaires and participation in a psychophysiological reactivity protocol. The reactivity protocol involved the following experimental tasks and associated recovery periods: an active speech task and an anger recall task. Measures of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and rate pressure product (RPP) were obtained continuously using a Finapres beat-to-beat blood pressure monitor throughout the reactivity protocol. Results: At high JH, low (compared with high) education level was linked with higher DBP during anger recall and final recovery, higher SBP during final recovery, and higher HR and RPP during speech preparation and final recovery (p .05). Among subjects with low education, high (vs. low) JH was associated with higher SBP, HR, and RPP during final recovery (p .05). Conclusions: John Henryism may increase the risk of cardiovascular disease among people with low education by increased cardiovascular reactivity and prolonged recovery to stress. Key words: coping, socioeconomic status, cardiovascular reactivity, hypertension, blacks. ANOVA analysis of variance; BP blood pressure; CVR cardiovascular response; DBP diastolic blood pressure; HR heart rate; HRV heart rate variability; JH John Henryism; JHAC John Henryism Scale of Active Coping; JS job strain; RPP rate pressure product; SBP systolic blood pressure; SES socioeconomic status.

Original article Absorption in Self-Selected Activities Is Associated With Lower Ambulatory Blood Pressure but Not for High Trait Ruminators Matthew J. Zawadzki, 1 Joshua M. Smyth, 1 Marcellus M. Merritt, 2 and William Gerin 1 methods Participants (n = 38) reported engagement in SSAs and how absorbing they were, responded to trait rumination and perceived stress ques- tionnaires, wore an ABP monitor for 24 hours, and at each ABP meas- urement answered electronic diary questions assessing activity levels, affect, social interactions, and caffeine and tobacco use. results Regression analyses tested whether the reported absorption of SSAs, trait rumination, and their interaction predicted daytime and nighttime systolic and diastolic ABP. Greater absorption predicted lower daytime and nighttime ABP (bs = −18.83 to −8.79; Ps < .05), but this relation- ship was moderated by trait rumination (bs = 3.72 to 9.97; Ps < .05). Follow-up analyses revealed that absorption was unrelated to ABP for those with high trait rumination but that more absorption predicted lower ABP for those less prone to rumination. conclusions Our results suggest that regular engagement in absorbing SSAs is related to lower ABP. These findings have implications for the devel- opment of nonpharmacological interventions and suggest SSAs may serve as an adjuvant intervention strategy to lower BP. Keywords: absorption; ambulatory blood pressure; blood pressure; hypertension; intervention; nonpharmacological; rumination. doi:10.1093/ajh/hpt118 Hypertension affects approximately 30% of Americans, 1,2 and is a risk factor for heart disease and stroke. 1,3 Nonpharmacological (behavioral) interventions, includ- ing meditation and controlled breathing, have shown effectiveness in reducing blood pressure (BP) 4,5 and are recommended for BP control programs. 6 Moreover, evi- dence suggests that these interventions produce addi- tive effects to drug therapy. 7 Although effective, patients report that these interventions are not always enjoyable and require significant alterations to daily routines. 8–10 These negative experiences may represent barriers to engagement and may predict lowered adherence to these interventions. Notably, nonpharmacological interventions appear to share a common component in requiring individuals to direct and sustain their attention away from their thoughts, which are often negative, 11 and become absorbed in the intervention activity. Diverting attention away from negative thoughts is potentially quite important. For example, rumi- nating or brooding about negative experiences can elicit and maintain a stress response, including autonomic and immu- nological activation, that can elevate acute BP and lead to sustained BP elevations over time. 12–14 Conversely, provid- ing a positive or enjoyable way to absorb one’s attention after a stressor prevents rumination and speeds up BP recovery subsequent to the stressor. 15,16 Thus, we propose that recur- ring engagement in activities that sustain and direct atten- tion away from one’s negative thoughts can have long-term effects in lowering BP that should persist beyond engage- ment in the activity itself. If so, we further propose that individuals could engage in a wide range of activities that absorb attention and thus could Correspondence: Matthew Zawadzki (mjz172@psu.edu). 1 Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania; 2 Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, Wisconsin. Initially submitted April 10, 2013; date of first revision May 31, 2013; accepted for publication June 21, 2013; online publication July 16, 2013. © American Journal of Hypertension, Ltd 2013. All rights reserved. For Permissions, please email: journals.permissions@oup.com American Journal of Hypertension 26(11) November 2013 1273 Downloaded from http://ajh.oxfordjournals.org/ at Pennsylvania State University on August 26, 2014 background A range of nonpharmacological interventions (e.g., meditation) have posi- tive effects on blood pressure (BP) but tend to have poor adherence. These interventions may lower BP partly by absorbing and directing attention away from one’s negative thoughts. We hypothesized that recurring self- selected activities (SSAs) that are attentionally absorbing may similarly lower BP. We examined the effect of reported engagement in SSAs dur- ing the previous month prior to participation on ambulatory BP (ABP) and whether those prone to rumination were less likely to show these effects.

Persons with higher blood pressure have emotional dampening in some contexts. This may reflect interactive changes in central nervous system control of affect and autonomic function in the early stages of hypertension development. The purpose of this study is to determine the independence of cardiovascular emotional dampening from alexithymia to better understand the role of affect dysregulation in blood pressure elevations. Ninety-six normotensives were assessed for resting systolic and diastolic (DBP) blood pressure, recognition of emotions in faces and sentences using the Perception of Affect Task (PAT), alexithymia, anxiety, and defensiveness. Resting DBP significantly predicted PAT emotion recognition accuracy in men after adjustment for age, self-reported affect, and alexithymia. Cardiovascular emotional dampening is independent of alexithymia and affect in men. Dampened emotion recognition could potentially influence interpersonal communication and psychosocial distress, thereby further contributing to BP dysregulation and increased cardiovascular risk.

Reduced arterial compliance has been implicated as a risk factor for future cardiovascular events in hypertensive patients. Recently, several non-invasive techniques have been used to access arterial compliance. However, comparisons of these techniques with older individuals and African-Americans have not been done. In the present study, beat-to-beat blood pressure was examined in 75 males and females (n = 24 old Caucasian; n = 24 young Caucasian; n = 27 African-Americans) who were part of the Baltimore Longitudinal Study of Aging (BLSA). Resting beat-to-beat blood pressure (5 minutes) was assessed using the PORTAPRES Ambulatory Blood Pressure Device. Results indicated that the three-element windkessel and the stroke volume-pulse pressure ratio measures of arterial compliance provide comparable estimates. Specifically, arterial compliance is reduced in the oldest individuals in our sample with young and African-Americans showing higher compliance. These results indicate that the simpler stroke volume-pulse pressure ratio provides reliable estimates of arterial compliance in both older adults and African-Americans. This technique is an excellent means to assess arterial compliance and is a useful measure to determine risk for adverse cardiovascular events.

This study evaluated cardiovascular responses (CVR) to an active speech task with blatantly discrimi-natory (BRC) versus neutral (NRC) stimuli and an anger recall task in a sample of Black men ( N 73;age 18 to 47). Diastolic blood pressure scores were higher for NRC versus BRC stimuli during angerrecall ( p .05). Moreover, persons in the NRC group who perceived high levels of racism (vs. no racismor BRC group) during active speech showed larger increases in blood pressure across postspeech rest,anger recall, and subsequent rest ( p .03). The notable elevation in CVR in response to an ambiguousevent extends current models of racism suggesting that subtle racism is a psychosocial stressor thaterodes health through chronically elevated CVR.Keywords: racism, cardiovascular reactivity, hypertension, anger, Blacks

Recent evidence indicates that poor autonomic regulation, indexed by decreased heart period variability (HPV), is associated with decreased working memory. HPV analyses are computed on the interbeat interval time series derived from the electrocardiogram (EKG). Unfortunately, the duration of the data collection and the issue of the size of ambulatory monitors with sufficient storage capacity for multi-day records is somewhat problematic. In the present paper we describe a system that allows for the collection of large amounts of high quality data using a small data collection device. The recording system consists of a miniature, single-module electrocardiogram-recording device. This module consists of an integrated three-electrode device that is attached to the chest of the subject. A low power 8-bit micro-controller detects the R-spike and stores the time between R-spikes in milliseconds on a 512 KB EEPROM. This system can record continuously for over four days. This system will allow the recording of cardio-dynamics in the field and provide highly reliable data across multiple days. The use of this device to assess physiological function in military operations would allow researchers to examine longer data records across several contexts and to understand the role of changes in autonomic function as they relate to performance.

Power spectral analysis of beat-to-beat heart rate variability (HRV) has provided a useful means of understanding the interplay between autonomic and cardiovascular functionality. Despite their utility, commonly employed frequency-domain techniques are limited in their prerequisite for stationary signals and their inability to account for temporal changes in the power spectral and/or frequency properties of signals. The purpose of this study is to develop an algorithm that utilizes continuous wavelet transform (CWT) parameters as inputs to a Kohonen self-organizing map (SOM), providing a method of clustering subjects with similar wavelet transform signatures. Continuous interbeat-intervals were recorded (Portapres monitor at 200 Hz) during a perception of affect test in 79 African-American volunteers (ages 21-83), where after a 5-min baseline, participants evaluated emotional expressions in sentences and pictures of faces, followed by a 5-min recovery. Individual HRV biosignals from each session were pre-processed (artifact replacement and signal resampling at 2 Hz) and a CWT was applied (db9 wavelet basis function over 32 scales). Standard deviations of resulting wavelet coefficients at each scale were calculated, normalized, and used as inputs into a SOM with Kullback-Leibler divergence as the dissimilarity measure used for clustering. Differences in subject demographics between two final clusters were assessed via two-independent-groups t-tests or chi-square or Fisher's exact tests of contingency tables. Significant differences were found for age, initial systolic blood pressure, smoking status, and mean s.d. of coefficients in the high frequency band (0.15-0.4 Hz). These findings may have clinical significance and the developed algorithm provides an alternative means of analyzing HRV data originating from populations with complex covariates.

This study investigated the role of personality traits and sex differences in emotion recognition. In several studies using samples with mostly young Caucasian and Asian students, Matsumoto et al.1 found strong evidence that recognition of emotional expression in faces was related to Openness to Experience and, to a lesser extent, Conscientiousness. Openness is one of the major dimensions of the five-factor model2 (FFM) of personality that might play an important role in the recognition of emotion. Open individuals tend to be intellectually curious, imaginative, and sensitive to aesthetics and inner feelings. The present study seeks to replicate Matsumoto et al. and extend the findings to an older African American and an older Caucasian sample. Furthermore, this study tests whether the relation between personality traits and emotion recognition can be replicated with a purely verbal task. Finally, the hypothesis that women tend to be better than men in decoding facial expressions of emotion will be tested.

Seventy-nine African-American participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) pilot study were genotyped for the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and had spectral power of their high-frequency (HF) heart rate variability (HRV) determined by fast-Fourier transformation. HF HRV was highest in II, intermediate in ID, and lowest in DD (II vs DD, p

Traditionally baroreflex sensitivity (BRS) has been assessed with pharmacological approaches such as phenylephrine infusion. Recently, non-invasive approaches using spectral analytic techniques have been employed to combine heart rate and blood pressure variability parameters to estimate BRS (the alpha index). Some authors have argued that BRS assessed at different frequencies of cardiovascular variabilities provide identical information and they should be combined into a single index of BRS based on total variability. The present study examined the relationship between BRS assessed using low, high, and total heart rate and blood pressure variabilities, and indices of cardiac vagal control assessed by standard spectral measures. Participants were 105 older male and female African-Americans who were part of the Healthy Aging In Nationally Diverse Longitudinal Samples (HANDLS) Study. Heart rate and blood pressure variabilities (HRV and BPV) were assessed using the Fast-Fourier Transform (FFT). The alpha index was computed as the square root of the ratio of low, high, or the mean of low and high frequency heart rate variability and the corresponding frequency ranges for systolic blood pressure variability. Correlations examining the relationships among BRS and various (e.g. log, normalized) indices of high frequency heart period variability (HF) were calculated for the total sample and by gender. Results indicated that the different BRS indices do not have the same relationship to all indices of HF. The results suggest that an aggregation of the power across bands is problematic at best, and indicates the need to examine the various frequency components separately.

Recently, time-frequency analysis has become very popular for examining non-stationary time series and for researching fast changing phenomena. We used the smoothed-pseudo Wigner-Ville distribution to model the underlying dynamic autonomic nervous system changes during the intracarotid sodium amobarbital (ISA) or so-called Wada test. The Wada test involves injecting sodium amobarbitol into the internal carotid artery that results in inactivation of cerebral structures supplied by the ipsilateral anterior and middle cerebral arteries. Electrocardiogram (EKG) data were recorded during the entire procedure and the 10 minutes prior to each injection were used as baseline values for that hemisphere. Interbeat-interval time series were created from these data for a 13 year old patient and were examined using a smoothed-pseudo Wigner-Ville distribution. Inspection of these data indicated that sodium amobarbitol injection to either side produced decreased power in the vagally mediated high frequency band (.14-.40 Hz). Importantly, this decrease was greater when the right hemisphere was inactivated as compared to the left. These results are consistent with the known lateralized innervation of the heart such that right-sided autonomic inputs have greater influence on cardiac chronotropy. The present results also revealed the very rapid changes in autonomic control that characterized the inactivation and subsequent recovery of the cerebral hemispheres. These findings confirm the utility of time-frequency analysis in the investigation of cardiac time series.