Martti T. Tuomisto

PERSONALITY AND ATTITUDINAL CORRELATES OF HEALTHY AND UNHEALTHY LIFE-STYLES IN YOUNG-ADULTS

The relationship between healthy lifestyle and personality and attitudinal variables was analyzed with data collected from 809 men and 996 women aged 18-30 years in England, Belgium, Finland and Norway as part of the European Health and Behaviour Survey. A health practices index was constructed on the basis of performance of sixteen behaviours including smoking, alcohol consumption, exercise, sleep time and a variety of dietary and preventive practices. Scores on the health practices index were higher in women than men, but in both sexes the index was normally distributed. Consistently healthy practices were positively correlated with extraversion and optimism, and negatively associated with neuroticism, psychoticism and chance locus of control beliefs. These effects were maintained after controlling for social desirability, but together accounted for only a modest proportion of the variance in the health practices index. The results are discussed in relation to the factors characterising health conscious and unhealthy lifestyles.

Age and gender differences in social anxiety symptoms during adolescence: The Social Phobia Inventory (SPIN) as a measure

The aim of the present study was to examine age and gender differences in social anxiety symptoms during adolescence, and to investigate the psychometrics of the Social Phobia Inventory (SPIN) among adolescents. The SPIN was administered to a large general population sample (n=5252) of Finnish adolescents aged 12-16 years. Age and gender trends in scores and internal consistency and factorial composition of the SPIN were examined in this sample. The test-retest reliability of the SPIN was examined in a smaller sample of adolescents (n=802). Results showed that girls scored higher than boys on the SPIN full scale and three subscales across the whole age range. Eighth graders (14- to 15-year-olds) scored higher than seventh and ninth graders on the full scale, for boys the differences were significant. Good test-retest reliability (r=0.81), and internal consistency (alpha=0.89) were found for the SPIN. An exploratory factor analysis (EFA) performed on a random half (n=2625) of the population sample yielded a one-factor model accounting for 38% of the variance between items. This one-factor model, plus an alternative three-factor model, were examined in the holdout half of the population sample (n=2627) by means of a confirmatory factor analysis (CFA). Some support was gained for both factor structures. Our results indicate that symptoms of social phobia may increase in mid-adolescence. The SPIN appears to be a reliable self-report instrument among adolescents.

Short-term variability of blood pressure and heart rate in borderline and mildly hypertensive subjects.

Electrocardiogram and intra-arterial blood pressure were recorded in 96 men (aged 35 to 45 years) by the Oxford method over a 30-hour period. The study involved 33 normotensive, 29 borderline hypertensive, and 34 mildly hypertensive individuals, as assessed by the cuff method. Five-minute periods during sleep and with subjects in supine, sitting, and standing positions were extracted from the recordings for frequency domain analysis. Power spectrum density estimates of systolic blood pressure, diastolic blood pressure, and heart rate were calculated by an autoregressive method over the bandwidths of 0.02 to 0.075 (low-frequency), 0.075 to 0.15 (midfrequency), and 0.15 to 0.35 Hz (high-frequency), attributable to thermoregulatory, baroreceptor, and respiratory activity. No significant intergroup differences were observed at nighttime, but in different body positions the borderline hypertensive subjects frequently had either greater low-frequency variability or smaller midfrequency variability than the other groups. In this respect, the power spectra for systolic and diastolic blood pressures provided better statistical differentiation between the groups than those for heart rate. Furthermore, the borderline hypertensive subjects exhibited attenuated night-day changes in the low-frequency band for all time series. The results suggest that in borderline hypertension the baroreceptor oscillations are shifted to lower frequencies, presumably reflecting altered function of the sympathetic nervous system. In conclusion, spectral analysis of blood pressure variability for controlled test situations made it possible to detect differences in the cardiovascular regulatory systems between normotensive, borderline hypertensive, and mildly hypertensive individuals.

Psychological stress tasks in the prediction of blood pressure level and need for antihypertensive medication: 9-12 years of follow-up

Increased blood pressure (BP) reactivity to subtypes of psychological stimuli may differentially predict the development of future BP elevation or hypertension. The authors present the 9-12-year follow-up results of 82 (86%) of 95 male participants with different BP levels. They were healthy, untreated, and age-matched volunteers from a routine health checkup carried out on all 35-, 40-, and 45-year-olds from a medium-sized city. Intra-arterial systolic blood pressure (SBP) during the psychological tasks improved the prediction of future casual SBP and noninvasive 24-hr ambulatory SBP compared with predictions from casual diagnostic measurements. Diastolic blood pressure (DBP) was very useful when added to casual DBP in predicting the need for antihypertensive medication. Reactivity to active tasks especially predicts the need for antihypertensive medication.

Pulse pressure is the best predictor of future left ventricular mass and change in left ventricular mass: 10 years of follow-up.

Background Ambulatory blood pressure correlates more closely with left ventricular mass (LVM) than casual blood pressure in cross-sectional studies, but prospective evidence is very limited. Objective To evaluate the best predictors of LVM and change in LVM during 10 years of follow-up, in a prospective study. Methods At baseline, blood pressure was recorded by casual measurements and 24 h intra-arterial ambulatory monitoring. The study participants were 97 healthy, untreated, 35–45-year-old men (34 normotensive, 29 borderline hypertensive, and 34 mildly hypertensive). At 10-year follow-up, echocardiography was performed in 86 (89%) of the men; echocardiographic data were available both at baseline and at follow-up from 70 (72%) of them. Individuals who were not receiving antihypertensive medication (n = 66) were included in the prediction of LVM index (LVMI), which was analysed as a continuous variable. Results The blood pressure variables that were best in predicting the LVMI were: 24 h pulse pressure (r = 0.308, P = 0.012), night-time pulse pressure (r = 0.291, P = 0.018), daytime pulse pressure (r = 0.253, P = 0.041), and casual systolic blood pressure (r = 0.212, P = 0.088). The LVMI was best predicted by a model including 24 h pulse pressure, positive family history of hypertension, body mass index, and age (adjusted coefficients of determination (adj. R2) = 0.197; that for the casual blood pressure model was adj. R2 = 0.140). During the follow-up, LVMI increased by +7.5 g/m2 and +23 g/m2 in individuals receiving and not receiving antihypertensive medication, respectively (P = 0.015). The change in LVMI was best predicted by the change in casual pulse pressure and use of antihypertensive medication (adj. R2 = 0.102). Conclusions Ambulatory blood pressure improved the prediction of future LVMI compared with that obtained from casual measurements. To our knowledge, this is the longest prospective follow-up to show that pulse pressure is the most significant blood pressure parameter in predicting future LVMI and change in LVMI.

Blood pressure and heart rate variability and reactivity as related to daily activities in normotensive men measured with 24-h intra-arterial recording.

The effect of blood pressure and heart rate reactivity on respective variability in everyday life conditions was studied in a group of middle-aged, normotensive men (n = 22, mean age 39.3 years, range 35-45 years). Continuous intra-arterial tape recording was used to measure 24-h blood pressure and heart rate and the subjects completed a 24-h behavioural diary. The variability of blood pressure and heart rate was analysed using 30-s averages and cumulative distribution curves. The overall blood pressure and heart rate variability was calculated as the difference between the 90 and 10% levels of the cumulative distribution curves. Reactivity caused by different daily activities was calculated as the change from baseline level, defined as the 10% level determined from the cumulative distribution curve of waking hours. All regular activities were monitored. Large interindividual differences were found in variability and reactivity. The mean reactivity to different activities varied from 3.3 to 44.7 mmHg for systolic blood pressure, from 1.8 to 16.3 mmHg for diastolic blood pressure and from 2.0 to 46.0 beats/min for heart rate. The mean contribution of reactivity to variability varied between 21 and 74% for systolic blood pressure, from 19 to 58% for diastolic blood pressure and from 20 to 82% for heart rate. As expected, blood pressure and heart rate levels were significantly higher at work than at home. We conclude that the reactivity caused by daily activities has a pronounced influence on blood pressure level and variability during waking hours.

Intra-arterial blood pressure and heart rate reactivity to behavioral stress in normotensive, borderline, and mild hypertensive men.

Intra-arterial blood pressure (BP) stress reactivity was studied in newly detected, World Health Organization-classified (1978), age-matched normotensive (NT; n = 33), borderline hypertensive (BHT; n = 30), and hypertensive (HT; n = 32) men recruited through routine health examinations. They underwent a relaxation baseline followed by 8 standardized behavioral challenges. BHT and HT men displayed exaggerated BP reactivity compared with NT men, particularly on perceptual-motor and social tasks, and HT men showed higher reactivity than NT men in the cold pressor test. These results are the first to show reactivity differences between NT men and BHT or HT men in an intra-arterial experiment. Diastolic BP (DBP) discriminated the groups better than systolic BP (SBP) or heart rate (HR). The few differences in SBP compared with DBP among the groups combined with hardly any differences in HR indicate the predominance of vascular factors in middle-aged as opposed to younger men with borderline or mild hypertension.

TERVA: wellness monitoring system

Long-term monitoring of physiological and psychosocial variables would be beneficial to investigate slowly developing deterioration in wellness status of a subject. We designed a personal wellness monitoring system (TERVA), which allows monitoring wellness-related variables at home for many weeks or even months. The TERVA system runs on a PC computer and interfaces with different measurement devices through serial interface. Measured variables include beat-to-beat RR intervals, activity level, blood pressure, weight, temperature, respiration, ballistocardiography, movements, and sleep stages. In addition, self-assessments of daily wellbeing are stored by keeping a behavioral diary. To test the system, one healthy man was monitored for 10 weeks and an aged woman was monitored for 2 weeks. The data allows conclusion that the TERVA system provides a method to investigate wellness-related data over several weeks or even months in out-of-hospital conditions.

The Relationship Between Cardiac Reactivity in the Laboratory and in Real Life

OBJECTIVE An excessive cardiovascular response to acute stress is a probable risk factor for cardiovascular (CV) disease. Such reactivity is usually assessed from the CV response to laboratory stressors. However, if it is a risk factor, correlated responses must occur in real life. DESIGN In the present study, we investigated the relationship between the heart rate (HR) response to five laboratory stressors and HR reactivity in the field. MEASURES HR variation, the response to a real life stressor (public speaking), and the increase in HR with periods of self-reported tense arousal. Ambulatory HR, activity and posture were measured continuously over a 7-hr period. RESULTS The HR increase to laboratory stressors did not relate to HR variation consistently, but it did relate to the other two field measures. CONCLUSION The results suggested that a tendency to increased HR reactivity may be a risk factor for cardiovascular disease when combined with exposure to stress.

Comparison of neuroendocrine measurements under laboratory and naturalistic conditions

Urinary catecholamines and cortisol were measured in healthy nonsmoking white collar workers (14 male and 15 female managers, 15 male and 14 female clerical workers), aged 30-50 years, during a one-hour period of laboratory-induced stress comprising five tests and a Type A interview, and during a subsequent period of rest in the laboratory. Values were compared with data obtained four months earlier from the same subjects during a normal day at work (4 values) and during a work-free day at home (4 values). No significant group differences were found during rest in the laboratory. However, during laboratory-induced stress, female managers had the highest norepinephrine values, which contributed to significantly (p less than 0.01) higher values in women than in men. Correlations between absolute measurements from laboratory and naturalistic conditions were generally positive and reached significance in most cases. Correlations between reactivity measurements in the laboratory and at work (change from rest to stress and from home to work, respectively) were generally low, whereas correlations between reactivity at different times of the day were relatively high. The data suggest that generalizability of neuroendocrine reactivity from laboratory stress to real-life stress is low. However, in agreement with earlier experimental findings, absolute levels of catecholamine and cortisol excretion were consistent over conditions and time.