Biomedical subjects

Tavis S Campbell

Publications and source records attributed to Tavis S Campbell.

8 recordsLinked to original sources

PubMed2006

The effects of experimenter status and cardiovascular reactivity on pain reports.

Existing evidence suggests that experimenter characteristics can influence research participants' pain reports. To examine the possibility that cardiovascular reactivity may serve as a potential mediating mechanism, blood pressure responses to stress were recorded in 117 healthy women during an arithmetic task and a subsequent cold pressor pain task. Laboratory sessions were conducted by two experimenters (i.e., a university professor and a graduate research assistant), who differed significantly on participant ratings of perceived social status. Participants tested by the university professor showed greater blood pressure responsivity to arithmetic and had higher pain tolerance and lower pain unpleasantness ratings compared to those tested by the research assistant. Further, hierarchical regression analyses indicated that blood pressure reactivity was a potential mediator of the association between experimenter status and both pain tolerance and unpleasantness, suggesting that perceived experimenter status may elicit physiological adaptations that can reduce sensitivity to painful laboratory stimuli.

Blood Pressure↗

PubMed2006

The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy.

OBJECTIVE: To provide updated, evidence-based recommendations for the management of hypertension in adults. OPTIONS AND OUTCOMES: For lifestyle and pharmacological interventions, evidence from randomized, controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. For lifestyle interventions, blood pressure (BP) lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field. For treatment of patients with kidney disease, the development of proteinuria or worsening of kidney function was also accepted as a clinically relevant primary outcome. EVIDENCE: MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. In addition, reference lists were scanned and experts were contacted to identify additional published studies. All relevant articles were reviewed and appraised independently by content and methodological experts using prespecified levels of evidence. RECOMMENDATIONS: Lifestyle modifications to prevent and/or treat hypertension include the following: perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm for men and less than 88 cm for women); limit alcohol consumption to no more than 14 standard drinks per week in men or nine standard drinks per week in women; follow a diet that is reduced in saturated fat and cholesterol and that emphasizes fruits, vegetables and low-fat dairy products; restrict salt intake; and consider stress management in selected individuals. Treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbid conditions. BP should be lowered to less than 140/90 mmHg in all patients, and to less than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease (regardless of the degree of proteinuria). Most adults with hypertension require more than one agent to achieve these target BPs. For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), angiotensin-converting enzyme (ACE) inhibitors (in nonblack patients), long-acting calcium channel blockers or angiotensin receptor antagonists. Other agents for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine calcium channel blockers or angiotensin receptor antagonists. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or in patients without albuminuria, thiazides or dihydropyridine calcium channel blockers) are appropriate first-line therapies; and in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended. All hypertensive patients should have their fasting lipids screened, and those with dyslipidemia should be treated using the thresholds, targets and agents recommended by the Canadian Hypertension Education Program Working Group on the management of dyslipidemia and the prevention of cardiovascular disease. Selected patients with hypertension, but without dyslipidemia, should also receive statin therapy and/or acetylsalicylic acid therapy. VALIDATION: All recommendations were graded according to strength of the evidence and voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.

Advisory Committees↗

PubMed2006

Asthma self-efficacy, high frequency heart rate variability, and airflow obstruction during negative affect in daily life.

BACKGROUND: Emotional stress has been considered an important asthma trigger for years, though the mechanisms by which stress may exacerbate asthma remain poorly understood. The stress-asthma morbidity association could occur through cognitive-behavioral pathways, such as decreased asthma self-efficacy and disorganized self-care, or through the more direct physiological effects of stress on autonomic (parasympathetic) nervous system activity. No study has examined how these two mechanisms may interact to contribute to greater airflow obstruction during emotional stress in daily life. This study investigated associations between peak expiratory flow rate (PEFR) and high frequency heart rate variability (HFHRV) during periods of negative affect and physical activity in daily life in patients with higher versus lower asthma self-efficacy scores. METHODS: Fifty-three patients with mild to moderate asthma completed the Asthma Self-Efficacy Scale (ASES) and underwent a 15 h ambulatory assessment of daytime HFHRV and PEFR, while completing self-report diaries of their physical activities and affect. RESULTS: In patients with lower asthma self-efficacy scores, increased levels of negative affect during daily life were associated with higher levels of HFHRV and decreased PEFR relative to patients with higher asthma self-efficacy scores. Increased levels of physical activity were associated with decreased levels of HFHRV irrespective of asthma self-efficacy scores. CONCLUSIONS: Findings suggest that lower asthma self-efficacy may be associated with increased parasympathetic activity and airflow obstruction during periods of negative affect during daily life.

Activities of Daily Living↗

PubMed2005

Airflow and autonomic responses to stress and relaxation in asthma: the impact of stressor type.

The impact of stress on respiratory airflow in asthmatics is unclear. Part of the uncertainty may spring from the different physiological effects of different stressors. Given their potential to elicit increases in parasympathetic vagal activity, stressful situations that present few opportunities for coping (passive coping stressors) may be particularly problematic for people with asthma. Thirty-one adult asthmatics participated in a protocol including a widely used passive coping stressor (the cold pressor test), an active coping stressor (mental arithmetic), an interview about an upsetting asthma-related incident (viewed as a potential passive coping stressor given the exposure to unpleasant memories), and progressive muscle relaxation. Repeated measurements of airflow (via peak expiratory flow), vagal tone (via heart rate variability), and other variables were obtained. The cold pressor test, asthma interview and progressive muscle relaxation produced significant decreases in airflow compared to the baseline period. The cold pressor test and progressive muscle relaxation produced significant, complementary increases in vagal tone. These results suggest that passive coping stressors and other stimuli (e.g., certain forms of relaxation) that elicit increased vagal tone may be associated with poorer asthma control, a view consistent with a significant negative correlation between the participant's mean vagal tone response to the tasks and score on a measure of asthma self-efficacy.

Adult↗

PubMed2004

Relationship of ethnicity, gender, and ambulatory blood pressure to pain sensitivity: effects of individualized pain rating scales.

UNLABELLED: A growing literature has reported significant reductions in pain sensitivity associated with increasing levels of blood pressure. However, most of this research has been limited to casual blood pressure assessments in white men. The present study examined associations between pain reports and ambulatory blood pressure in a sample of African American and white men and women. Possible response bias during pain assessment due to ethnicity and gender was evaluated with individualized pain rating scales. One hundred thirty-five (72 African American and 63 white) men and women underwent 24-hour blood pressure monitoring and arm ischemia pain sensitivity evaluation with both standard verbal rating scales and individually ordered verbal rating scales of intensity and unpleasantness. Lower individualized pain intensity and unpleasantness ratings were associated with higher levels of ambulatory blood pressure. African Americans and women reported higher levels of pain intensity when using the standard verbal rating scale but not when using the individually ordered rating scale. Collectively, these results support previous research relating reduced pain sensitivity with increased blood pressure among men and women. Furthermore, reported differences in pain sensitivity between ethnic groups and genders might in part be associated with variations in response styles to standard pain assessment tools. PERSPECTIVE: The findings of the present study suggest that, in some instances, different ethnic groups and genders may use the same descriptors to report different levels of pain. In the context of clinical pain assessment, it may be important to consider the possibility that descriptions of painful sensations reflect, in part, demographic characteristics.

Adult↗

PubMed2003

Adolescent pain sensitivity is associated with cardiac autonomic function and blood pressure over 8 years.

Low pain sensitivity has been reported in hypertensive subjects as well in groups deemed to be at increased risk of development of the disorder. However, it is uncertain whether individual differences in pain sensitivity are associated prospectively with increases in blood pressure. In the current study, 24-hour blood pressure and heart rate variability were recorded in 110, 22-year-old men previously assessed at age 14 years for casual blood pressure and pain sensitivity (mechanical finger pressure). Significant correlations were observed between pain tolerance in 14-year-olds and current 24-hour systolic blood pressure (r=0.37, P<0.01) and diastolic blood pressure (r=0.36, P<0.01). Hierarchical multiple regression analyses indicated that information regarding pain tolerance improved prediction of systolic and diastolic blood pressure at age 22 years beyond that afforded by differences in blood pressure, parental history of hypertension, and body mass index at age 14 years. Similar analyses revealed that average pain sensitivity at age 14 was also associated with 24-hour high-frequency heart rate variability (r=0.28, P<0.01) and low-frequency/high-frequency heart rate variability at age 22 (r=-0.35, P<0.01), suggesting increased sympathetic and reduced parasympathetic tone among individuals less sensitive to pain. These results provide further evidence that blood pressure related hypoalgesia might be related to processes involved in blood pressure regulation as well as in the development of sustained high blood pressure.

Adolescent↗

PubMed2002

Exaggeration of blood pressure-related hypoalgesia and reduction of blood pressure with low frequency transcutaneous electrical nerve stimulation.

Reduced pain perception has been observed in hypertensive individuals and normotensive individuals at risk for high blood pressure and may involve increased endogenous opioid release or receptor sensitivity. The present study examined the issue by administering two subjectively similar but physiologically different forms of the pain-reducing procedure transcutaneous electrical nerve stimulation (TENS). Men varying in resting blood pressure and parental history of hypertension participated in three testing sessions during which was presented (a) high-frequency (100 Hz) TENS; (b) low-frequency (2 Hz) TENS, the type believed to elicit endogenous opioid activity; or (c) no-TENS stimulation. Measurements of blood pressure (BP) and other physiological variables were obtained during this period. Afterwards, two pain stimuli were presented: a series of electric shocks and 5 min of arm ischemia. There was a significant negative association between pain and resting systolic blood pressure (SBP), and pain and parental history of hypertension in the no-TENS and high-frequency TENS conditions that was significantly strengthened by administration of low-frequency TENS. As well, low-frequency TENS produced a modest but significant acute reduction in SBP, especially among those with higher resting levels. These results provide further evidence that opioid mechanisms are involved in blood pressure-related hypoalgesia and blood pressure regulation.

Adult↗

PubMed2002

A longitudinal study of pain sensitivity and blood pressure in adolescent boys: results from a 5-year follow-up.

A growing literature has observed a significant reduction in pain sensitivity among hypertensive animals and humans. It is uncertain whether a reduced sensitivity to pain can be observed in nonnotensive individuals who go on to develop high blood pressure. Blood pressure (BP) was reassessed in one hundred fifteen 19-year-old boys initially tested at age 14, when they were also presented with a pain stimulus (mechanical finger pressure). Hierarchical regression analyses indicated that information regarding pain tolerance improved prediction of changes in systolic and diastolic blood pressure beyond that afforded by differences in BP at age 14, parental history of hypertension, and body mass index. These analyses suggest that pain sensitivity may be associated with physiological processes involved in the development of sustained high blood pressure.

Adolescent↗