From the Departments of Psychology and Psychiatry (Kamarck), Biostatistics (Li), Psychology (Wright), Medicine (Muldoon), and Psychology (Manuck), University of Pittsburgh, Pennsylvania.
Psychosom Med. 2018 Oct;80(8):774-782. doi: 10.1097/PSY.0000000000000627.
We examined whether associations between daily psychosocial stressor exposures and carotid artery intima-medial thickness (IMT) may be stronger among those showing larger stress-related cardiovascular reactivity (CVR) during the course of daily living.
A total of 474 healthy working adults (ages 30-54 years) collected ambulatory blood pressure and recorded their daily experiences, using electronic diaries, during two 2-day periods for a week. Measures of mean momentary task strain and social conflict were used as indices of stressor exposure, and partial regression coefficients linking momentary strain and conflict with ambulatory blood pressure fluctuations were used as measures of CVR. IMT was assessed in the carotid arteries using B-mode ultrasound.
After covariate adjustment, associations between mean task strain exposure and IMT were significant among those high in CVR to strain (for systolic blood pressure, p = .006, for diastolic blood pressure, p = .011) but not among those low in strain CVR. Similarly, associations involving mean conflict exposure were significant among those high in CVR to social conflict (p < .001 for systolic blood pressure, p = .001 for diastolic blood pressure) but not among low social conflict reactors. Significant moderation effects were more consistently shown for task strain than for social conflict, but the overall pattern of results was robust across two different types of statistical modeling procedures.
Individual differences in CVR may moderate the effects of daily psychosocial stress on subclinical CVD among healthy employed adults. Using ecological momentary assessment to measure stress exposure as well as stress reactivity may facilitate our ability to detect these effects.
我们研究了日常生活中，那些表现出较大应激相关心血管反应性（CVR）的人，其每日心理社会应激源暴露与颈动脉内膜中层厚度（IMT）之间的关联是否更强。
共 474 名健康的在职成年人（年龄 30-54 岁）在两周内的两个 2 天周期中，使用电子日记记录他们的日常经历并收集动态血压。平均瞬时任务应激和社会冲突的测量值被用作应激源暴露的指标，而将瞬时应变和冲突与动态血压波动联系起来的偏回归系数被用作 CVR 的测量值。使用 B 型超声评估颈动脉 IMT。
经过协变量调整后，在 CVR 较高的人群中，平均任务应激暴露与 IMT 之间存在显著关联（收缩压，p =.006，舒张压，p =.011），但在 CVR 较低的人群中则没有。同样，在 CVR 较高的人群中，平均冲突暴露与 IMT 之间存在显著关联（收缩压，p <.001，舒张压，p =.001），但在 CVR 较低的人群中则没有。与社会冲突相比，任务应激的调节效应更为一致，但总体结果模式在两种不同的统计建模程序中均具有稳健性。
CVR 的个体差异可能会调节健康在职成年人的日常生活中心理社会应激对亚临床 CVD 的影响。使用生态瞬时评估来测量应激暴露和应激反应性可能会提高我们检测这些影响的能力。
