Blunted cardiovascular reactivity to psychological stress and prospective health: a systematic review

O'Riordan, Adam; Howard, Siobhán; Gallagher, Stephen

doi:10.1080/17437199.2022.2068639

Cited by 21 publications

(24 citation statements)

References 82 publications

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“…In previous studies it was difficult to disentangle the effects of high chronic stress levels and depressive symptoms, since most patients with depression experience elevated stress levels, and increased stress levels in the population are also associated with an increased likelihood of depression. In light of the findings showing that blunted HR stress reactivity may be associated with motivational dysfunction, or in the case of people with cardiovascular disease even cardiovascular dysfunction (94), our study provides first data on the differential impact of both and can be used as a steppingstone for further research. In the past it has been shown that exercise therapy is highly beneficial for patients with mild to moderate depression and as supplementation even for patients with severe depression (76).…”

Section: Discussionmentioning

confidence: 85%

The cumulative effect of chronic stress and depressive symptoms affects heart rate in a working population

et al. 2022

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BackgroundChronic stress and depressive symptoms have both been linked to increased heart rate (HR) and reduced HR variability. However, up to date, it is not clear whether chronic stress, the mechanisms intrinsic to depression or a combination of both cause these alterations. Subclinical cases may help to answer these questions. In a healthy working population, we aimed to investigate whether the effect of chronic stress on HR circadian rhythm depends on the presence of depressive symptoms and whether chronic stress and depressive symptoms have differential effects on HR reactivity to an acute stressor.Methods1,002 individuals of the SWEET study completed baseline questionnaires, including psychological information, and 5 days of electrocardiogram (ECG) measurements. Complete datasets were available for 516 individuals. In addition, a subset (n = 194) of these participants completed a stress task on a mobile device. Participants were grouped according to their scores for the Depression Anxiety Stress Scale (DASS) and Perceived Stress Scale (PSS). We explored the resulting groups for differences in HR circadian rhythm and stress reactivity using linear mixed effect models. Additionally, we explored the effect of stress and depressive symptoms on night-time HR variability [root mean square of successive differences (RMSSD)].ResultsHigh and extreme stress alone did not alter HR circadian rhythm, apart from a limited increase in basal HR. Yet, if depressive symptoms were present, extreme chronic stress levels did lead to a blunted circadian rhythm and a lower basal HR. Furthermore, blunted stress reactivity was associated with depressive symptoms, but not chronic stress. Night-time RMSSD data was not influenced by chronic stress, depressive symptoms or their interaction.ConclusionThe combination of stress and depressive symptoms, but not chronic stress by itself leads to a blunted HR circadian rhythm. Furthermore, blunted HR reactivity is associated with depressive symptoms and not chronic stress.

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Section: Discussionmentioning

confidence: 85%

The cumulative effect of chronic stress and depressive symptoms affects heart rate in a working population

et al. 2022

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“…Future research needs to identify if different outcomes arise from blunted reactivity on different cardiovascular parameters. A recent systematic review and meta‐analysis (O'Riordan et al, in press ) confirmed that blunted HR reactivity is the most common reactivity predictor of negative outcomes. It may be the case that blunted cardiovascular reactions to stress signal different outcomes depending on whether they relate to HR specifically, or blood pressure.…”

Section: Discussionmentioning

confidence: 98%

“…A large body of literature now exists showing that blunted cardiovascular reactions to stress are associated with a range of negative health and psychological outcomes (e.g., O'Riordan et al, in press ; Phillips et al, 2013 ; Whittaker et al, 2021 ). However, as correctly identified by Bourassa and Sbarra ( 2022 ), much of the research employed laboratory tasks with low personal emotional relevance, such as mental arithmetic and Stroop.…”

Section: Discussionmentioning

confidence: 99%

“…Since its detailed explanation in the 1980s (Obrist, 1981 ), across 40 years of research, many studies have confirmed its prospective value in predicting a range of indicators of cardiovascular disease and disease endpoints (e.g., Barnett et al, 1997 ; Carroll, Ginty, Der, et al, 2012 ; Carroll, Ginty, Painter, et al, 2012 ). However, within the past two decades, the “blunted” model of reactivity has also shown that low, as well as high, cardiovascular reactions to stress are prospectively associated with negative health outcomes (e.g., Ahern et al, 1990 ; Carroll et al, 2008 ; de Rooij et al, 2010 ; O'Riordan et al, in press ; Phillips et al, 2012 ), and poorer self‐reported health (de Rooij & Rosebook, 2010 ; Phillips et al, 2009 ). It is thought that blunted cardiovascular reactivity to stress is associated with poorer health via indirect routes, such as changes in health behavior, depression, and motivational dysregulation (Carroll et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Life event stress is associated with blunted cardiovascular responding to both personally salient and personally non‐salient laboratory tasks

et al. 2022

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The association between physiological reactions to stress and health outcomes is a cornerstone of psychosomatic medicine. A key paradigm within the literature is the "reactivity hypothesis" where exaggerated and/or sustained cardiovascular reactions to stress have been shown to be prospectively associated with a range of indicators of cardiovascular diseases as well as disease mortality (e.g., Chida & Steptoe, 2010). Since its detailed explanation in

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“…Interestingly, Type D personality has been associated with both high (O’Riordan, Howard, Brown, & Gallagher, 2020; Williams et al, 2009) and low (Howard et al, 2011; Kelly-Hughes et al, 2014; Lü & Yao, 2021; O’Leary et al, 2013; O’Riordan, Howard, & Gallagher, 2022) cardiovascular responses to acute psychological stress. To date, the literature has accentuated two likely moderating factors that may account for these antithetical effects, including the social salience of the experimental stressor and the sex of the sample.…”

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confidence: 99%

Type D personality and cardiovascular reactivity to acute psychological stress: A systematic review and meta-analysis.

O'Riordan,

Gallagher,

Howard

2023

Health Psychology

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Objectives: Type D personality has been associated with adverse cardiovascular health, with atypical cardiovascular reactions to psychological stress considered a possible mechanism of effect. However, studies examining Type D personality and cardiovascular reactions to acute stress have yielded mixed findings.Here, we conducted a systematic review and meta-analyses to examine if, and under what conditions, Type D personality is associated with cardiovascular reactivity to stress; a particular focus was placed on sex and the social salience of the stressor as potential moderators of effects. Method: Electronic databases (Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science) were searched for relevant publications. A total of 401 articles were retrieved and screened for eligibility. Inclusion criteria included studies with nonclinical samples employing a resting baseline period followed by a psychological stress task period and measurement of cardiovascular reactivity. Following screening and removal of irrelevant articles, 17 peer-reviewed studies were included in the review. Result: Type D personality was associated with lower blood pressure reactivity to acute psychological stress. Subgroup analyses revealed an association between Type D personality and lower cardiovascular reactivity among females, but not males. Additionally, Type D personality was primarily associated with lower cardiovascular reactivity in response to nonsocial stressors. Conclusions: Type D personality is associated with lower blood pressure reactivity to acute psychological stress, particularly among females and in response to nonsocial stressors. This lower response may be indicative of blunted cardiovascular reactivity and therefore signals an increased risk of adverse health outcomes. Public Significance StatementThe current review indicates that Type D personality is associated with lower cardiovascular reactivity to acute stress, particularly among females and in response to nonsocial stressors. These lower cardiovascular responses may constitute a physiological mechanism leading to adverse cardiovascular health for Type D individuals.

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Blunted cardiovascular reactivity to psychological stress and prospective health: a systematic review

Cited by 21 publications

References 82 publications

The cumulative effect of chronic stress and depressive symptoms affects heart rate in a working population

The cumulative effect of chronic stress and depressive symptoms affects heart rate in a working population

Life event stress is associated with blunted cardiovascular responding to both personally salient and personally non‐salient laboratory tasks

Type D personality and cardiovascular reactivity to acute psychological stress: A systematic review and meta-analysis.

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