Biomedical subjects

S R Waldstein

Publications and source records attributed to S R Waldstein.

11 recordsLinked to original sources

PubMed1996

Absence of enhanced sympathoadrenal activity and behaviorally evoked cardiovascular reactivity among offspring of hypertensives.

To determine whether offspring of hypertensives show enhanced sympathetic nervous system activity, we evaluated several indices of sympathoadrenal activation and cardiovascular responsiveness to behavioral stimuli among 90 normotensive, young adult men having either one or two hypertensive parents (PH+(-), PH++) or normotensive parents only (PH--) (n = 30/group). Measurements included heart rate (HR) and blood pressure (BP) reactions to three mental stressors (the Stroop test, mental arithmetic, mirror tracing), a cold pressor test, postural adjustment (60 degrees upright tilt), isometric exercise and bicycle ergometry, as well as the 24-h excretion of catecholamines (epinephrine [E], norepinephrine [NE]) and venous plasma catecholamine concentrations, both at rest (seated and supine) and in response to the Stroop test and upright tilt. The three groups did not differ in age, education, body mass index (BMI), estimated aerobic fitness, resting HR, cardiac preejection period (PEP) and PEP:LVET (left ventricular ejection time) ratio, 24-h Na or K excretion, or fasting lipids, insulin or plasma renin activity. Resting systolic and diastolic BP varied as a function of parental hypertension, and were significantly higher in PH++ than among PH-- subjects (P < .05). No significant group difference was observed on any measure of plasma or urinary catecholamines, nor did offspring of hypertensives (PH++ or PH+-) showed greater HR or BP reactions than PH-- subjects to any of the several laboratory challenges. In sum, we find no evidence of enhanced sympathetic activity or heightened cardiovascular responsiveness among normotensive young adults who are familially predisposed to essential hypertension.

Adolescent↗

PubMed1996

Hypertension and neuropsychological performance in men: interactive effects of age.

Potentially interactive effects of hypertension and age on the performance of neuropsychological and information processing tests were examined in 123 untreated hypertensive and 50 normotensive men. After covarying education, average alcohol consumption, trait anxiety, and depression scores, results indicated an interaction of age and hypertension. Young hypertensive men (23-40 years) scored significantly worse than young normotensive men on tests of attention/executive function and working memory; middle-aged hypertensive (41-56 years) and normotensive participants were not distinguished by any measures. Hypertensive men performed significantly more poorly than normotensive men on tests of manual dexterity. Results suggest that neuropsychological sequelae of hypertension are more pronounced in young than in middle-aged hypertensive individuals and are independent of various demographic, psychosocial, and alcohol-related factors.

Adult↗

PubMed1993

Relationship of cardiovascular reactivity and anger expression to serum lipid concentrations in healthy young men.

The relationship between behaviorally evoked cardiovascular reactivity, preferred mode of anger expression, and serum lipid concentrations was examined in 63 healthy, young adult males. Subjects derived from three studies, each evaluating cardiovascular response to laboratory stressors. All participants completed the Spielberger Anger Expression Scale and provided fasting blood samples for lipid determinations. A significant negative correlation, calculated by meta-analytic procedures, was noted between a baseline-free measure of heart rate reactivity and high density lipoprotein-cholesterol (HDL-C) concentrations (r = -0.26, p = 0.05). However, the previously reported relationship between cardiovascular reactivity and elevated total serum cholesterol (TSC) was not found. Additionally, men scoring high on a self-report measure of the tendency to express anger outwardly had significantly higher HDL-C concentrations than men scoring low on this measure (r = 0.30, p = 0.02); when subjects were stratified by level of cardiovascular reactivity, this relationship was apparent only among those showing the greatest magnitude of heart rate and blood pressure responses to acute mental stress.

Adolescent↗

PubMed1992

Acute cholesterol responses to mental stress and change in posture.

BACKGROUND: Serum lipid levels vary widely within individuals, but the causes of these fluctuations are poorly understood. One area of research concerns elevations in cholesterol concentration in response to emotional stress. In a laboratory-based experiment, we compared the effects of acute mental stress and postural change (standing) on serum cholesterol concentration. In addition, plasma volume was indirectly monitored to determine whether cholesterol changes with mental stress, if present, were a function of hemoconcentration. METHODS: Twenty-six men attended two laboratory sessions, each consisting of baseline (30 minutes), task (20 minutes), and recovery (30 minutes) periods. Subjects rested in the supine position during the baseline and recovery periods. During the task period of one session, subjects performed a mental task (Stroop test and mental arithmetic); during the other session, the subjects stood for the task period. RESULTS: Both mental stress and standing elicited significant elevations in heart rate, blood pressure, and plasma catecholamine concentrations, relative to the baseline and recovery periods. Both the mental and orthostatic tasks also significantly increased serum cholesterol concentration (by 0.10 and 0.57 mmol/L [3.7 and 21.9 mg/dL], respectively), as well as hemoglobin level and hematocrit. Cholesterol elevations with standing were reversible, while those resulting from mental stress persisted through the recovery period. When values were corrected for concomitant hemoconcentration, no net change in serum cholesterol level occurred during either task. CONCLUSIONS: Acute mental stress can produce rapid elevations in serum cholesterol concentration. It can also increase hemoglobin concentration and hematocrit (ie, reduce plasma volume). Therefore, increases in serum cholesterol level after acute mental stress are analogous to those with standing and may reflect hemoconcentration rather than altered lipoprotein metabolism.

Adolescent↗

PubMed1991

Learning and memory function in men with untreated blood pressure elevation.

Learning and memory processes were compared in 20 men with untreated blood pressure elevation and 20 normotensive control subjects matched for age, education, and average alcohol consumption. Subjects were identified from a larger sample of 469 factory workers who had participated in an epidemiologic investigation. Three measures (e.g., Symbol-Digit Learning Test [Ryan & Butters, 1980] and Visual Reproductions-Immediate and Delayed Recall [Wechsler, 1945] ) from a previously administered test battery were chosen for comparison on the basis of statistical power calculations. Results indicate that relative to normotensive control subjects, men with elevated blood pressure performed more poorly on all three tests. These results are independent of other known influences on neuropsychological performance and are likely a consequence of elevated blood pressure.

Adult↗

PubMed1991

Neuropsychological correlates of hypertension: review and methodologic considerations.

Essential hypertension is a chronic disorder having many potential physical and behavioral sequelae. This article evaluates the impact of hypertension on neuropsychological test performance. First, cross-sectional and longitudinal studies that examine the neuropsychological correlates of hypertension are reviewed. In general, hypertensives are found to perform more poorly than normotensives, particularly on tests of memory, attention, and abstract reasoning, and less consistently on tests of perception, constructional ability, mental flexibility, and psychomotor speed. Next, the influence of variables that may moderate relationships between hypertension and neuropsychological performance--such as age, education, and medication usage--are examined. Finally, potential mechanisms, both physiological and psychological, underlying associations between hypertension and neuropsychological performance are discussed.

Brain↗

PubMed1991

Neurobehavioral effects of antihypertensive medications.

Although millions of hypertensive individuals receive chronic treatment with antihypertensive medication, the effect on the central nervous system by these drugs is poorly understood. Such treatment, while generally well tolerated, frequently produces symptoms of drowsiness, weakness, altered memory and impaired concentration. In addition to subjective evidence derived from patient reports, a large number of investigations have now been published which attempt to objectively assess the influence of antihypertensive medication on behavioral or cognitive performance. This paper summarizes and critically evaluates experimental studies of the effect of antihypertensive medication on subjects' performance of neuropsychological tasks and reviews the pharmacologic mechanisms by which these drugs may affect behavior. The literature is incomplete in its assessment of all domains of neuropsychological performance and all drug classes, and methodologic deficiencies are common. Nonetheless, the consensus of all studies and the findings of well-designed studies in particular do not identify any notable areas of performance impairment in patients receiving antihypertensive medication. Moreover, results suggest that, in certain instances, drug treatment may even enhance performance. In light of the limitations of the literature, however, an adequate understanding of the effects of antihypertensive therapy on behavioral functioning awaits completion of large, well-designed investigations including all major drug classes and thorough neurobehavioral assessments.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Predictors of neuropsychological impairment in alcoholics: antisocial versus nonantisocial subtypes.

The role of demographic, perinatal/developmental, and acquired subject characteristics in determining neuropsychological (NP) performance was investigated in 22 alcoholics with Antisocial Personality Disorder (ASPD) and 84 non-ASPD alcoholics. Results of stepwise multiple regression analyses revealed that in ASPD subjects, poor NP performance was predicted by less education, childhood symptoms of Conduct Disorder, drinks per drinking day, and history of head injury, accounting for 80% of the explained variance (p < .0001). In non-ASPD subjects, NP performance was predicted by self-reported history of diagnosed Attention Deficit Disorder, Verbal Learning Disability, and symptoms of Nonverbal Learning Disability, accounting for 24% of the explained variance (p < .0001). These results suggest the presence of potentially different lifelong paths to NP impairment among ASPD and non-ASPD alcoholics. Further exploration of the multivariate predictors of neuropsychological performance in subgroups of alcoholics is warranted.

Adult↗

PubMedDate not supplied

Hypertension and neuropsychological function: a lifespan perspective.

This article explores the relationship of hypertension to neuropsychological performance from a lifespan perspective. First, I examine cross-sectional and longitudinal studies of neuropsychological performance in cohorts of young to middle-aged hypertensive patients (ages 20-60); older hypertensive patients (ages 60-80+); and the young, normotensive offspring of hypertensive parents (ages 18-25). The pattern of performance deficits associated with hypertension is generally found to differ from that related to hypertension risk. Next, I discuss potential mechanisms underlying hypertension-performance relationships in the aforementioned cohorts. I suggest that lowered levels of performance in the offspring of hypertensives reflect genetic risk for hypertension. Compromised neuropsychological function in young and middle-aged hypertensives may occur secondary to alterations in neurophysiological function that result from elevated blood pressure. Such neurophysiological changes may predispose to neuroanatomical changes in older hypertensive patients.

Adolescent↗

PubMedDate not supplied

Neuropsychological consequences of antihypertensive medication use.

A growing proportion of the general population is being prescribed antihypertensive medications for the long-term treatment of essential hypertension. Untreated hypertensive individuals exhibit some neuropsychological performance decrements, and numerous researchers have sought to determine whether drug therapy for hypertension worsens, improves, or leaves unaltered objectively measured cognitive skills. These issues may be especially important in the elderly, among whom both high blood pressure and compromised cognitive function are common. In this review, we collate the findings of more than 50 clinical studies according to class of antihypertensive medication studied and domains of neuropsychological performance assessed. Special attention is given to investigations of elderly subjects, and a critical summary is provided.

Antihypertensive Agents↗

PubMedDate not supplied

Neuropsychological performance of young men who vary in familial risk for hypertension.

Neuropsychological performance was examined as a function of parental history of hypertension. Thirty-five normotensive offspring of two hypertensive parents (PH+/+) were compared to 35 offspring of two normotensive parents (PH-/-) and 35 offspring of one hypertensive and one normotensive parent (PH+/-) on tests of abstract reasoning, attention/mental flexibility, memory, perception, psychomotor skills, and visuospatial/constructional abilities. Results indicated that PH+/+ offspring performed more poorly than PH-/- offspring on tests of visuospatial/constructional and visuoperceptual ability; PH+/- offspring tended to score lower than PH-/- offspring on these tests. These findings were independent of age, education, diastolic blood pressure levels, average alcohol consumption, trait anxiety, and depression. Results of this study may indicate subtle central nervous system involvement associated with familial risk for hypertension.

Adolescent↗