Catherine M. Stoney

Menopausal status influences ambulatory blood pressure levels and blood pressure changes during mental stress.

BackgroundFrequent and large cardiovascular and neuroendocrine responses to psychological stress are thought to enhance an individuals risk for cardiovascular diseases. Preliminary data suggest that levels of reproductive hormones affect the magnitude of stress responses, perhaps contributing to the protective effect of ovarian hormones on premenopausal womens rates of coronary heart disease. Methods and ResultsHealthy middle-aged men and premenopausal and postmenopausal women performed a series of standardized mental and physical challenges while blood pressure, heart rate, plasma catecholamines, lipids, and lipoproteins were measured. Subjects then wore an ambulatory blood pressure monitor during two consecutive workdays. Results showed that postmenopausal women had larger mean±SEM stress-induced increases in systolic blood pressure (24.7±2.2 mm Hg) and diastolic blood pressure (143±1.0 mm Hg) compared with either premenopausal women (16.9±1.3 and 10.2±0.9 mm Hg) or men (17.7±1.5 and 10.9 ± 1.1 mm Hg, respectively). Postmenopausal women and men had higher mean±SEM ambulatory diastolic blood pressure levels (75.5±3.2 and 76.4±±1.8 mm Hg) than did premenopausal women (69.9±2.2 mm Hg). Large blood pressure responses during public speaking were associated with high cholesterol levels and low educational attainment. ConclusionMenopause is associated with enhanced stress-induced cardiovascular responses and elevated ambulatory blood pressure during the workday. These effects may contribute to the risk of cardiovascular morbidity and mortality after the menopause.

Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease A Scientific Statement From the American Heart Association

In the 2011 “Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents,” several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2) position MDD and BD as tier II moderate-risk conditions that require the application of risk stratification and management strategies in accordance with Expert Panel recommendations. In this scientific statement, there is an integration of the various factors that putatively underlie the association of MDD and BD with CVD, including pathophysiological mechanisms, traditional CVD risk factors, behavioral and environmental factors, and psychiatric medications.

A natural experiment on the effects of ovarian hormones on cardiovascular risk factors and stress reactivity: Bilateral salpingo oophorectomy versus hysterectomy only.

To test the effects of declining ovarian hormone levels on cardiovascular risk factors, blood pressure, lipids, weight, and physiological responses to stress were evaluated in 29 middle-aged premenopausal women prior to and following elective hysterectomy and/or bilateral salpingo oophorectomy (BSO). Prior to surgery, there were no group differences in standard or putative risk factors, with the exceptions of body composition measures and total cholesterol level. After surgery, women who had undergone BSO (n = 10) had higher levels of atherogenic lipids and stress-induced lipids and tended to have higher circulating levels of epinephrine and stress-induced systolic and diastolic blood pressure than women who had undergone hysterectomy only (n = 19). This study is consistent with the hypothesis that presence of ovarian hormones plays a key role in determining womens risk factor status.

Family characteristics and school achievements of type A children.

We examined the familial characteristics of Type A children and the consequences of Type A behaviors for childrens classroom achievements. A maximum of 156 boys and 190 girls enrolled in elementary and middle schools and their parents participated in various aspects of the data collection procedures and analyses reported in this article. Results showed that Type A children were not more likely to have families with a history of cardiovascular-related diseases or families of upper socioeconomic status. Young Type A boys, but not girls, had Type A mothers and fathers, suggesting an early modeling of Type A behaviors by boys. Competitive boys and girls and Type A girls had higher achievement test scores and classroom grades, independent of IQ test scores, than did relatively noncompetitive children and Type B girls, respectively. Thus, the competitive aspect of Type A leads to important early achievements, independent of ability, perhaps because care givers and teachers respond to Type A behaviors of children by encouraging them to continue to strive to achieve. Gender differences in the findings were also discussed and related to the adult literature.

T-lymphocyte reactivity during the menstrual cycle in women.

Reactivity of blood lymphocytes to nonspecific mitogenic stimulation with phytohemagglutinin (PHA) was measured in nine healthy, regularly cycling women at three phases of their menstrual cycles corresponding to peak levels of estradiol (midfollicular phase), peak levels of progesterone (midluteal phase), and the lowest levels of both hormones (menstrual phase). Sampling points were verified by radioimmunoassay of estrogen, progesterone, luteinizing hormone, and follicle-stimulating hormone. There were significant increases in reactivity associated with an increasing concentration of PHA and with autologous plasma vs AB plasma. However, no differences were found in reactivity to PHA over the three menstrual cycle phases and correlational analyses indicated no relationship between counts and any of the hormones measured.