The Effect of Hostility Reduction on Autonomic Control of the Heart and Vasculature

Abstract

Objective Hostility is associated with coronary artery disease (CAD). One candidate mechanism may be autonomic nervous system (ANS) dysregulation. In this study, we report the effect of cognitive behavioral treatment (CBT) on ANS regulation. Methods Participants were 158 healthy young adults, high in hostility measured by the Cook- Medley (CM) Hostility and Spielberger Trait Anger (TA) scales. Participants were also interviewed using the Interpersonal Hostility Assessment Technique (IHAT). They were randomized to a 12-week CBT program for reducing hostility or a wait-list control group. The outcome measures were pre-ejection period (PEP), low-frequency blood pressure variability (LF-BPV), and high-frequency heart rate variability (HF-HRV) measured at rest and in response to and recovery from cognitive and orthostatic challenge. Linear mixed models were used to examine group × session and group × session × period interactions while controlling for sex and age. Contrasts of differential group and session effects were used to examine reactivity and recovery from challenge. Results After Bonferroni correction, 2-way and 3-way interactions failed to achieve significance for PEP, LF-BPV or HF-HRV (p>0.002) indicating that hostility reduction treatment failed to influence ANS indices. Conclusion Reduction in anger and hostility failed to alter ANS activity at rest or in response to or recovery from challenge. These findings raise questions about whether autonomic dysregulation represents a pathophysiological link between hostility and heart disease.

Blood Pressure Variability and Cognitive Function: a Scoping Review

“…Variability in the time domain reflects fluctuations in blood pressure that result from defective regulatory processes within the autonomic nervous system and neurohumoral system in addition to arterial stiffness which are associated with hypertension and atherosclerosis, though the role each plays in the different time periods of variability remains unclear [10], [11], [29], [30]. Due to the influence of stressor and day-night differences towards SD index, ARV is a solution to obtain the average of the absolute differences between consecutive measurements and residual BPV [13]**.…”

Association between Irritable Affective Temperament and Nighttime Peripheral and Central Systolic Blood Pressure in Hypertension

“…This association between hostility and CV pathology is probably indirect, as the reduction of hostility failed to improve autonomic nervous system activity [30] and in other studies behavioral factors, like smoking, alcohol consumption, increased BMI and decreased physical activity suggested to be the mediators between hostility and increased CV risk [31,32]. There are also data in the literature about the association between irritable affective temperament and CV risk factors suggesting similar mediator pathways with hostility.…”

The Association of Cigarette Smoking With High-Frequency Heart Rate Variability: An Ecological Momentary Assessment Study

“…Errors not detected by Marquette editing were corrected using editing algorithms developed at Columbia University (23, 24). The outcome variables were computed for the 5-minute epochs of RR intervals immediately preceding the PDA prompt, using Fourier transforms as described previously (25). The outcome variables, R-R interval (RRI), High Frequency Heart Rate Variability (HF-HRV) and the root mean square of successive differences in beat-to-beat RR intervals (RMSSD), were computed for each 5-minute epoch.…”