Cardiovascular reactivity in cardiovascular disease: “Once more unto the breach”

  • Stephen B. Manuck


Discussed here are conceptual and methodologic issues that bear on the role of bebaviorally evoked cardiovascular reactivity in cardiovascular disease. It is argued that recent criticisms concerning the validity of cardiovascular reactivity as a stable dimension of individual differences arise from inadequacies of measurement prevalent in prior literature. With standardization of test stimuli and application of psychometric principles to protocol development, assessments of reactivity are found to be highly reliable and, in turn, to demonstrate the dispositional nature of this construct. Recent studies also document an underlying heterogeneity of hemodynamic reactions to stress, with distinct cardiac and vascular components. Because hemodynamic adjustments show some plasticity under differing task conditions, responses seen in particular contexts reflect influences of both an individual-specific response potential and response-eliciting properties of the stimulus. On the question of disease relevance, it is concluded that cardiovascular reactivity cannot yet be considered as established risk factor for either coronary heart disease or hypertension. However, the preponderance of existing clinical, experimental, and epidemiologic evidence is consistent with such an association and warrants further study in the context of population-based, prospective investigation.

Key words

cardiovascular reactivity stress hypertension coronary heart disease (CHD) 


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  1. Adler, N., & Matthews, K. A. (in press). Health psychology. Annual Review of Psychology.Google Scholar
  2. Ahem, D. K., Gorktn, L., Anderson, J. L., Ticrncy, C., Hallstrom, A., Ewarl, C, Capone, R. J., Scbron, E., Kornfeld, D., Herd, J. A., Richardson, D. W., & Follick, M. J. (1990). Biobehavio ral variables and mortality or cardiac arrest in the Cardiac Arrhythia Pilot Study (CAPS). American Journal of Cardiology, 66, 59–62.CrossRefGoogle Scholar
  3. Ajzen, I. (1988). Altitudes, personality and behavior. Chicago: Dorsey.Google Scholar
  4. Ambrosioni, E., Costa, F. V., Mantebugnoli, L., Borghi, C., & Magnani, B. (1981). Intralymphocytic sodium concentration as an index of response to stress and exercise in young subjects with borderline hypertension. Clinical Science, 61, S25-S27.Google Scholar
  5. Andren, L., & Hansson, L. (1980). Circulatory effects of stress in essential hypertension. Acta Medica Scandinavica, 646, 69–72.Google Scholar
  6. Andren, L., Hansson, L., Eggertsen, R., Hedner, T., & Karlberg, O. (1983). Circulatory effect of noise. Acta Medica Scandinavica, 213, 31–35,PubMedGoogle Scholar
  7. Blascovich, J., & Katkin, E. S. (Eds.). (1993). Cardiovascular reactivity to psychological stress and disease. Washington, DC; American Psychological Association.Google Scholar
  8. Borghi, C., Costa, F, V., Boschi, S., Mussi, A., & Ambrosioni, F. (1986). Predictors of stable hypertension in young borderline subjects: A five-year follow-up study. Journal of Cardiovascular Pharmacology, 8, S138-S141.PubMedCrossRefGoogle Scholar
  9. Burton, A. C. (1972). Physiology and biophysics of the circulation. Chicago: Year Book Medical.Google Scholar
  10. Cohen, S., Kaplan, J. R., & Manuck, S. B. (in press). Social support and coronary heart disease: Underlying psychologic and biologic mechanisms. In S. A. Shu maker & S. M. Czakowski (Eds.), Social support and cardiovascular disease. New York: Plenum.Google Scholar
  11. Corea, L., Benlivoglio, M., & Verdecchia, P. (1983). Echocardiography left ventricular hypertrophy as related to arterial pressure and plasma norepinephrine concentration in arterial hypertension. Hypertension, 5, 837–840.PubMedGoogle Scholar
  12. Coresh, J., Klag, M. J., Mead, L. A., Liang, K. Y., & Whellon, P. K. (1992). Vascular reactivity in young adults and cardiovascular disease. A prospective study. Circulation, 19, 218–223.Google Scholar
  13. Corse, C. D., Manuck, S. B., Cantwell, J. D., Giordani, B., & Matthews, K. A. (1982). Coronary prone behavior pattern and cardiovascular response in persons with and without coronary heart disease. Psychosomatic Medicine, 44, 449–459.PubMedGoogle Scholar
  14. Costa, P. T., Zondcrman, A. B., Engel, B. T., Baile, W. F., Brimlow, D. L., & Brinker, J. A. (1985). The relation of chest pain symptoms to coronary artery stenosis and neuroticism. Psychosomatic Medicine, 47, 285–293.PubMedGoogle Scholar
  15. Craven, T. E., Ryu, J. E., Espeland, M. A., Kahl, F. R., McKinney, W. M., Toole, J. F., McMahon, M. R., Thompson, C. J., Heiss, G., & Crouse, J. R., (1990). Evaluation of the associations between carotid artery atherosclerosis and Coronary artery stenosis. Circulation, 82, 1230–1242.PubMedGoogle Scholar
  16. Crouse, J. R., Toole, J. F., McKinney, W. M., Dignan, M. B., Howard, G., Kahl, F. R., McMahan, M. R., & Harpold, G. H. (1987). Risk factors for extracranial carotid artery atherosclerosis. Stroke, 18, 990–996.PubMedGoogle Scholar
  17. Dernbroski, T. M., MacDougall, J. M., & Lushenc, R. (1979). Interpersonal interaction and cardiovascular response in Type A subjects and coronary patients. Journal of Human Stress, 5, 28–36.Google Scholar
  18. Deveieux, R. B. (1989). Importance of left ventricular mass as a predictor of cardiovascular morbidity in hypertension. American Journal of Hypertension, 2, 650–654.Google Scholar
  19. Devcreux, R. B. (1990). Does increased blood pressure cause left ventricular hypertrophy or vice versa? Annate of Internal Medicine, 112, 157–159.Google Scholar
  20. Devereux, R. B., Pickering, T. G., Harsbfield, G. A., Kleinert, H. D., Denby, L., Clarck, L., Prcgibon, D., Jason, M., Kleiner, B., Borer, J. S., & Laragh, J. H. (1983). Left ventricular hypertrophy in patients with hypertension: Importance of blood pressure response to regularly recurring stress. Hypertension, 68, 470–476.Google Scholar
  21. Uimsdale, J. F., Herd, A., & Hartley, L. H. (1983). Epinephrine mediated increases in plasma cholesterol. Psychosomatic Medicine, 45, 227–232.Google Scholar
  22. Rich, R. H., & Jacobscn, E. C. (1967). Vascular reacitivity in medical students followed for 10 years. Journal of Chronic Disease, 20, 583–592.CrossRefGoogle Scholar
  23. Engel, B. T., & Bickford, A. F. (1961). Response-specificity: Stimulus-response and individualresponse specificity in essential hypertensives. Archives of General Psychiatry, 5, 478–489.PubMedGoogle Scholar
  24. Epstein, S. (1979). The stability of behavior: I. On predicting most of the people much of the lime. Journal of Personality and Social Psychology, 37, 1097–1126.CrossRefGoogle Scholar
  25. Epstein, S. (1980). The stability of behavior: H, Implications for psychological research. American Psychologist, 35, 790–807.CrossRefGoogle Scholar
  26. Follick, M. J., Ahern, D. K., Gorkin, L., Niaura, R. S., Herd, J. A., Ewart, C., Schron, E. B., Kornfeld, D. S., & Capone, R. J. (1990). Relation of psychosocial and stress reactivity variables to ventricular arrhythmias in the Cardiac Arrhythmia Pilot Study (CAPS). American Journal of Cardiology, 66, 63–67.PubMedCrossRefGoogle Scholar
  27. Friedman, M. H., O’Brien, V., & Ehrich, L. W. (1975). Calculations of pulsatile flow through a branch. Circulation Research, 36, 277–284.PubMedGoogle Scholar
  28. Frohlich, E. D., Chobanian, A. V., Devereux, R. B., Dustan, H. P., Dzau, V., Fauad-Tarazi, F., Horan, M. J., Marcus, M., Massic, B., Pfefrer, M. A., Re, R. N., Roccella, E. J., Savage, D., & Sbub, C. (1992). The heart in hypertension. New England Journal of Medicine, 327, 998–1008.PubMedGoogle Scholar
  29. Gtaconi, S., Palombo, C., Marabolti, C., Genovesi- Ebert, A., Mezzasalma, L., Volterranim, D., & Ghione, S. (1989). Left ventricular mass in borderline hypertension, assessed by echocardiography: Relationships with resting and stress blood pressure. Journal of Nuclear Medicine and Allied Sciences, 33, 26–31.Google Scholar
  30. Gordon, D., Guyton, J. R., & Karnovsky, M. J. (1981). Intimal alterations in rat aorta induced by stressful stimuli. Laboratory Investigation, 45, 14–27.PubMedGoogle Scholar
  31. Grossman, P., & Svebak, S. (1987). Respiratory sinus arrhythmia as an index of parasympathetic cardiac control during active coping. Psychophysiology, 24, 228–235.PubMedCrossRefGoogle Scholar
  32. Hammond, I. W., Devereux, R. B., Alderman, M. H., Lutas, E. M., Spitzer, M. C., Crowley, J. S., & Laragh, J. H. (1986). The prevalence and correlates of echocardiography left ventricular hypertrophy among employed patients with uncomplicated hypertension. Journal of the American College of Cardiology, 7, 639–650.PubMedCrossRefGoogle Scholar
  33. Harbin, T. J. (1989), The relationship between Type A behavior pattern and physiological responsivity: A quantitative review. Psychophsiology, 26, 110–119.CrossRefGoogle Scholar
  34. Hardy, J. D., & Smith, T. W. (1988). Cynical hostility and vulnerability to disease: Social support, life stress, and physiological response to conflict. Health Psychology, 7, 447–459.PubMedCrossRefGoogle Scholar
  35. Harlan, W. R., Osborne, R. K., & Graybiel, A. (1964). Prognostic value of the cold pressor lest. American Journal of Cardiology, 13, 832–837.CrossRefGoogle Scholar
  36. Hirsch, K. Z., Maksem, J. A., & Gagen D. (1984). Effects of stress and propranolol on ihe aortic inti’ma of rats. Arteriosclerosis, 4, 526.Google Scholar
  37. Houston, B. K. (1992). Personality characteristics, reactivity, and cardiovascular disease. In J. R. Turner, A. Sherwood, & K. C. Light (Eds.), Individual differences in cardiovascular responses to stress (pp. 103–124). New York: Plenum.Google Scholar
  38. Jern, S., Uergbrant, A., Bjorntorp, P., & Hansson, L., (1992). Relation of central hemodynamics to obesity and body fat distribution. Hypertension, 19, 520–527.PubMedGoogle Scholar
  39. Julius, S. (1988). The blood pressure seeking properties of the central nervous system. Journal of Hypertension, 6, 177–185.PubMedCrossRefGoogle Scholar
  40. Julius, S., Li, Y., Vrant, D., Krause, L., & Buda, A. J. (1989). Neurogenic pressor episodes fail to cause hypertension, but do induce cardiac hypertrophy. Hypertension, 13, 422–429.PubMedGoogle Scholar
  41. Julius, S., Weder, A. B., & Hinderlitcr, A. L. (1986). Does behaviorally induced blood pressure variability lead to hypertension? In K. A. Matthews, S. M. Weiss, T. Detre, T. M. Dembroski, B. Falkner, S. B. Manuck, &. R. B. Williams, Jr. (Eds.), Handbook of stress, reactivity and cardiovascular disease (pp. 71–82). New York; Wiley.Google Scholar
  42. Kamarck, T. W. (1992). Heceat developments in the study of cardiovascular reactivity: Contributions from psychometric theory and social psychology. Psychophysiotogy, 29, 491–503.CrossRefGoogle Scholar
  43. Kamaick, T. W., & Jennings, J. R. (1091). Biobchavioral factors in sudden cardiac death. Psychological Bulletin, 109, 42–47.CrossRefGoogle Scholar
  44. Kamarck, T. W., Jennings, J. R., Debski, T. T., Glickman-Weiss, E., Johnson. P. S., Eddy, M. J., & Manuck, S. B. (1992). Reliable measures of bchaviorally-evokcd cardiovascular reactivity from a PC-based lest battery: Results from student and community samples. Psychophysiotogy, 29, 17–28.CrossRefGoogle Scholar
  45. Kamarck, T. W., Jennings, J. R., & Manuck, S. B. (in press). Psychometric applications in the assessment of cardiovascular reactivity. Homeostasis in Health and Disease.Google Scholar
  46. Kamarck, T. W., Jennings, J. R., Stewart, C. J., & Eddy, M. J. (in press). Reliable responses lo a cardiovascular reactivity protocol: A replication study in a bi-racial female sample. Psychophysiotogy.Google Scholar
  47. Kaplan, J, R., Clarkson, T. B., & Manuck, S. B. (1984). Pathogenesis of carotid bifurcation atherosclerosis in cynomolgus monkeys. Stroke, 14, 904–1000.Google Scholar
  48. Kaplan, J. R., Manuck, S. B., Adams, M. R., & Ctarkson, T. B. (1987). The effects of beta-adrenergic blocking agents on atherosclerosis and its complications. European Heart Journal, 8, 928–944.PubMedGoogle Scholar
  49. Kaplan, J. R., Manuck, S. B., Adams, M. R., Weingand, K. W., & Clarkson, T. B. (1987). Inhibition of coronary arthcrosclerosis by propranolol in behaviorally predisposed monkeys fed an atherogenic diet. Circulation, 76, 1364–1372.PubMedGoogle Scholar
  50. Kaplan, J. R., Manuck, S. B., Adams, M. R., Williams, J. K., Selwyn, A. P., & Clarkson, T. B. (1991). Nonhuman primates as a model for evaluating behavioral influences on atherosclerosis, and cardiac Structure and function. In A. P. Shapiro & A. Baum (Eds.), Perspectives on behavioral medication (pp. 105–129). Hillsdale. NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
  51. Kaplan, J. R., Manuck, S. B., Clarkson, T. B., Lusso, F. M., & Taub, D. B. (1982). Social status, environment, and atherosclerosis in cynomolgus monkeys. Arteriosclerosis, 2, 359–368.PubMedGoogle Scholar
  52. Kaplan, J. R., Manuck, S. B., Clarkson, T. B., &. Prichard, R. W. (1985). Animal models of behavioral influences on athcrogenesis. In E. S. Katkin & S. B. Manuck (Eds.), Advances in behavioral medicine (Vol. 1, pp. 55–110). Greenwich, CT: JAI.Google Scholar
  53. Kaplan, J. R., Pcttersson, K., Manuck, S. B., & Olsson, G. (1991). The role of sympathoadrenal medullarv activation in the initiation and progression of atherosclerosis. Circulation. 84(Suppl, VI), 23–32.Google Scholar
  54. Kasprowicz A. L., Manuck, S. B., Malkoff, S. B., & Krantz, D. S. (1990). Individual differences in behaviorally evoked cardiovascular response: Temporal stability and hemodynamic patterning. Psychophysiotogy, 27, 605–619.CrossRefGoogle Scholar
  55. Keys, A., Taylor, H. L., Blackburn, J., Anderson, J.T., & Somonson, E.(1971). Mortality and coronary heart disease among men studied for 23 years. Archives of Internal Medicine, 128, 201–214.PubMedCrossRefGoogle Scholar
  56. Krantz, D. S., Hclmers, K. F., Bairey, C. W., Nebel, L. E., Hedges, S. M., & Rozanski, A. (1991). Cardiovascular reactivity and menial stress-induced myocardial ischemia in patients with coronary artery disease. Psychosomatic Medicine, 53, 1–13.PubMedGoogle Scholar
  57. Krantz, D. S., &. Manuck, S. B. (1984). Acute psychophysiological reactivity and risk of cardiovascular disease: Areview and methodologic critique. Psychological Bulletin, 96, 435–464.PubMedCrossRefGoogle Scholar
  58. Krantz, D. S., Sqhaeffer, M. A., Davis, J. E., Dembroski, T. M., MacDougall, J. M., & Shaffer, R. T. (1981). Extent of coronary atherosclerosis, Type A behavior, and cardiovascular response to social interaction. Psychophysiology, 18, 654–664.PubMedCrossRefGoogle Scholar
  59. Larkin, K. T., Manuck, S. B., & Kasprowicz, A. L. (1990). The effect of feedback-assisted reduction in heart rate reactivity on videogame performance. Biofeedback and Self-Regulation, 15, 285–303.PubMedCrossRefGoogle Scholar
  60. Levy, D., Garrison, R. J., Savage, D. D., Kannel, W. B., & Caslelli, W. P. (1990). Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. New England Journal of Medicine, 322, 1561–1566.PubMedGoogle Scholar
  61. Light, K. C., Dolan, C. A., Davis, M. R., & Sherwood, A. (1992). Cardiovascular responses to an active coping challenge as predictors of blood pressure patterns 10 to 15 years later. Psychosomatic Medicine, 54, 217–230.PubMedGoogle Scholar
  62. Mahoney, L. T., Schieken, R. M., Clarke, W. R., & Lauer, R. M. (1988). Left ventricular mass and exercise responses predict future blood pressure: The Muscatine Study. Hypertension, 112, 157–159.Google Scholar
  63. Malkoff, S. B., Muldoon, M. F., Zeigler, Z. R., & Manuck, S. B. (in press). Blood platelet responsivity to acute mental stress. Psychosomatic Medicine.Google Scholar
  64. Malmo, R. B., Shagass, C., & Davis, E. H. (1950). Symptom specificity and bodily reactions during psychiatric interview. Psychosomatic Medicine, 12, 362–376.PubMedGoogle Scholar
  65. Manuck, S. B. Kamarck, T. W., Kasprowicz, A. S., & Waldsfein, S. R. (1993). Stability and patterning of bchaviorally evoked cardiovascular reactivity. In J. Blascovich & E. S. Kalkin (Eds.), Cardiovascular reactivity to psychological stress and disease (pp. 111–134). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  66. Manuck, S. B., Kaplan, J. R., Adams, M. R., & Clarkson, T. B. (1989). Behaviorally elicited heart rate reactivity and athrosclcrosis in female cynomolgus monkeys (Macaca fascicularis). Psychosomatic Medicine, 51, 306–318.PubMedGoogle Scholar
  67. Manuck, S. B., Kaplan, J. R., & Clarkson, T. B. (1983). Behaviorally induced heart rale reactivity and alhrosclerosis in cynomolgus monkeys. Psychosomatic Medicine, 45, 95–108.PubMedGoogle Scholar
  68. Manuck, S. B., Kaplan, J. R., & Matthews, K. A. (1986). Behavioral antecedents of coronary heart disease and atherosclerosis. Arteriosclerosis, 6, 2–14.PubMedGoogle Scholar
  69. Manuck, S. B., Kaplan, J. R., Muldoon, M. F., Adams, M. R., & Clarkson, T. B. (1991). The behavioral exacerbation of atherosclerosis and its inhibition by propranolol. In P. McCabe, N. Schneiderman, T. Field, & J. Skylar (Eds.), Stress, coping, and disease (pp. 51–72). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
  70. Manuck, S. B., Kasprowicz, A. L., Monroe, S. B., Larkin, K. T., & Kaplan, J. R. (1989). Psychophysiologic reactivity as a dimension of individual differences. In N. Schneiderman, S. B. Weiss, & P. Kaufmann (Eds.), Handbook of methods and measurements in cardiovascular behavioral medicine (pp. 365–382). New York: Plenum.Google Scholar
  71. Manuck, S. B., Kasprowicz, A. L., & Muldoon, M. F., (1990). Behaviorally-cvoked cardiovascular reactivity and hypertension: Conceptual issues and potential associations. Annals of Behavioral Medicine, 12, 17–29.CrossRefGoogle Scholar
  72. Manuck, S. B. & Krantz, D. S. (1986). Psychophysiologic reactivity in coronary heart disease and essentia! hypertension. In K. A. Matthews, S. M. Weiss, T. Detre, T. M. Dembroski, B. Falkner, S. B. Manuck, & R. B. Williams, Jr. (Eds.), Handbook of stress, reactivity and cardiovascular disease (pp. 11–34). New York: Wiley.Google Scholar
  73. Manuck, S. B., Muldoon, M. F., Kaplan, J. R., Adams, M. R., & Polefrone, J. M. (1989). Coronary artery atherosclerosis and cardiac response to stress in cynomolgus monkeys. In A. W. Sicgman & T. M. Dembroski (Eds.), In search of coronary-prone behavior (pp. 207–227). Hillsdale, NJ: Lawrence Lrlbaum Associates, Inc.Google Scholar
  74. Manuck, S. B., Olsson, G., Hjemdahl, P., & Rehnqvisl, N. (1992). Does cardiovascular reacliv. ity to mental stress have prognostic value in postinfarction patients? A pilot study. Psychosomatic Medicine, 54, 102–108.PubMedGoogle Scholar
  75. Markovilz, J. H., & Matthews, K. A. (1991). Platelets in coronary heart disease: Potential pathophysiologic mechanisms. Psychosomatic Medicine, 53, 643–668.Google Scholar
  76. Marks, M. M., Morady, F., & Swan, J. H. C. (1973). Myocardial hypertrophy produced by chronic infusion of subhypcrlcnsive doses of norepinephrine in the dog. Chest, 64, 75.CrossRefGoogle Scholar
  77. Marsland, A. L., Manuck, S. B., Rabin, B. S., & Cohen, S. (1993). Beta-adrenergic receptor density as a predictor of cardiovascular response to mental stress. Annals of Behavioral Medicine, 15(Suppl.), S669.Google Scholar
  78. Matthews, K. A. (1938). Coronary heart disease and Type A behavior: Update on and alternative to the Booth-Kewley and Friedman quantitative review. Psychological Bulletin, 104, 373–380.CrossRefGoogle Scholar
  79. Matthews, K. A., Weiss, S. M., Detre, T., Dembroski, T. M., Falkner, B., Manuck, S. B., & R. B. Williams, Jr. (Eds.). (1986). Handbook of stress, reactivity and cardiovascular disease. New York: Wiley.Google Scholar
  80. Matthews, K. A., Woodall, K. L., & Alien, M. T. (in press). Cardiovascular reactivity to stress predicts future blood pressure status. Hypertension.Google Scholar
  81. McCubbin, J. A., Kaplan, J. R., Manuck, S. B., & Adams, M. R. (1993). Opioidergic inhibition of circulatory and endocrine stress responses in oynomolgus monkeys: A preliminary study. Psychosomatic Medicine, 55, 23–28.PubMedGoogle Scholar
  82. McCubbin, J. A., Surwit, R. S., & Williams, R. B. (1985). Opioid dysfunction and risk for hypertension: Naloxone and blood pressure responses during different types of stress. Hypertension, 7, 808–811.PubMedGoogle Scholar
  83. Menkes, M. S., Matthews, K. A., Krantz, D. S., Lundbcrg, U., Mead, L. A., Qaqisb, B., Liang, K. Y., Thomas, C. B., & Pearson, T. A. (1989). Cardiovascular reactivity to the cold pressure lest as a predictor of hypertension. Hypertension, 14, 524–530.PubMedGoogle Scholar
  84. Mills, P. J., & Dimsdale, J. E. (1988). The promise of receptor studies in psychophysiologic research. Psychosomatic Medicine, 50, 555–566.PubMedGoogle Scholar
  85. Mills, P. J., Dimsdale, J. E., Ziegler, M. G., Berry, C. C., & Bain, R. D. (1990). Beta-adrenergic receptors predict heart rale reactivity to a psychosoical stressor. Psychosomatic Medicine, 52, 621–623.PubMedGoogle Scholar
  86. Muldoon, M. F., Terrell, D. F., Bunker, C. H., & Manuck, S. B. (1993). Family history studies in hypertension research: Review of the literature. American Journal of Hypertension, 6, 76–88.PubMedGoogle Scholar
  87. Murphy, J. K., Alpert, B. S., & Walker, S. S. (1992). Ethnicity, pressor reactivity, and children’s blood pressure: Five years of observations. Hypertension, 20, 327–332.PubMedGoogle Scholar
  88. Parali, G., Tarazzi, S., Ravogli, A., Casadei, R., Omboni, S., & Mancia, G. (1991). Methodological problems in evaluation of cardiovascular effects of stress in humans. Hypertension, 17(Suppl. III), 50–55.Google Scholar
  89. Pickering, T. G., & Gerin, W. (1990). Cardiovascular reactivity in the laboratory and the role of behavioral factors in hypertension: A critical review. Annals of Behavioral Medicine, 12, 3–16.CrossRefGoogle Scholar
  90. Rubens, J., Espeland, M. A., Ryu, J., Harpofd, G., McKinney, W. M., Kahl, F. R., Toole, J. F., & Crouse, J. R. (1988). Individual variation in susceptibility to extracranial carotid atherosclerosis. Arteriosclerosis, 8, 389–397.PubMedGoogle Scholar
  91. Ryu, J. E., Murros, K., Espeland, M. A., Rubens, J., McKinney, W. M., Toole, J. F., & Crouse, J. R. (1989). Extracranial carotid atherosclerosis in Black and While patients with transient ischemic attacks. Stroke, 20, 1133–1137.PubMedGoogle Scholar
  92. Saab, P. G., Llabre, M. M., Hurwitz, B. E., Frame, C. A., Reineke, L. J., Fins, A. I., MeCalla, J., Cieply, I. K., & Schneiderman. N. (1992). Myocardial and peripheral vascular responses to behavioral challenges and their stability in Black and White Americans. Psychophysiology, 29, 384–397.PubMedCrossRefGoogle Scholar
  93. Saab, P. G., Llabre, M. M., Hurwilz, B. E., Schneiderman, N., Wohlgemuth, W., Durel, L. A., Massie, C., & Nagel, J. (1993). The cold pressor lest: Vascular and myocardial response patterns and their stability. Psychophysiology, 30, 366–373.PubMedCrossRefGoogle Scholar
  94. SaJonen, J. T., & Saloncn, R. (1991). Ultrasonographically assessed carotid morphology and the riskof coronory heart Unease. Arteriosclerosis and Thrombosis, 11, 1245–1249.Google Scholar
  95. Saloncn, R., Haapanen, A., & Salonen, J. T. (1991). Measurement of intima media thickness of common carotid arteries with high-resolution B-mode ultrasonography: Inter- and intra-observer reliability. Ultrasound in Medicine and Biology, 17, 225–230.CrossRefGoogle Scholar
  96. Schmieder, R. E., Grube, E., Ruddel, H., Schachinger, H., & Schulte, W. (1990). Relation of hemodynamic reaction during stress to left ventricular hypertrophy in essential hypertension. American Journal of Hypertension, 3, 281–287.PubMedGoogle Scholar
  97. Schnall, P. L., Pieper, C, Schwartz, J. E., Karasek, R. A, Schlussel, Y., Devereux, R. B., Ganau, A., Alderman, M., Warren, K., & Pickering, T. G. (1990). The relation between “job strain,” workplace diastolic blood pressure, and left ventricular mass index: Results of a case-control study. Journal of the American Medical Association, 263, 1929–1935.PubMedCrossRefGoogle Scholar
  98. Schnall, P. L., Schwartz, J. E., Landsbergis, P. A., Warren, K., & Pickering, T. G. (1992). Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension, 19, 488–494.PubMedGoogle Scholar
  99. Schneiderman, N. (1987). Psychophysiologic factors in albcrogenesis and coronary artery disease. Circulation, 76(Suppl. 6), S41-S47.Google Scholar
  100. Shapiro, A. P. (1961). An experimental study of comparative responses of blood pressure lo different noxious stimuli. Journal of Chronic Diseases, 13, 293–311.CrossRefGoogle Scholar
  101. Sherwood, A., Allen, M. T., Fahrenberg, J., Kelsey, R. M., Lovallo, W. R., & van Doornen, L. J. P. (1990). Methodological guidelines for impedance cardiography. Psychophysiology, 27, 1–23.PubMedCrossRefGoogle Scholar
  102. Sherwood, A., Dolan, C. A., & Light, K. C. (1990). Hemodynamics of blood pressure responses during active and passive coping. Psychophysiology, 27, 656–668.PubMedCrossRefGoogle Scholar
  103. Smith, T. W., & Allred, K. D. (1989). Blood pressure responses during social interaction inhigh- and low-cynically hostile males. Journal of Behavioral Medicine, 12, 135–143.PubMedCrossRefGoogle Scholar
  104. Spencc, J. D., Bass, M., Robinson, H., Cheung, H., Melendez, L. J., Arnold, J. M. O., & Manuck, S. B. (1991). Prospective study of ambulatory monitoring and echocardiography in borderline hypertension. Clinical and Investigative Medicine, 14, 241–250.Google Scholar
  105. Strawn, W. B., Bondjers, G., Kaplan, J. R., Manuck, S. B., Schwenke, D. C., Hansson, G. K., Shivcly, C. A., & Clarkson, T. B. (1991). Endothelial dysfunction in response lo psychosocial stress in monkeys. Circulation Research, 68, 1270–1279.PubMedGoogle Scholar
  106. Suarez, E. C., & Williams, R. B. (1989). Situational determinants of cardiovascular and emotional reactivity in high and low hostile men. Psychosomatic Medicine, 51, 404–418.PubMedGoogle Scholar
  107. Sutton-Tyrrell, K., Wolfson, S. K., Thompson, T., & Kelsey, S. F. (1992). Measurement variability in duplex scan assessment of carotid atherosclerosis. Stroke, 23, 215–220.PubMedGoogle Scholar
  108. Trimarco, B., Ricciardelli, B., & DcLuca, N. (1985). Participation of endogenous catecholamines in the regulation of left ventricular mass in progeny of hypertensive parents. Circulation, 72, 38–46.PubMedGoogle Scholar
  109. Turner, J. R., Sherwood, A., & Light, K. C. (Eds.). (1992). Individual differences in cardiovascular response to stress. New York: Plenum.Google Scholar
  110. Waldstcin, S. R., Polcfrone, J. M., Bachcn, E. A., Muldoon, M. F., Kaplan, J. R., & Manuck, S. B. (1993). Relationship of cardiovascular reactivity and anger expression lo serum lipid concentrations in heallhy young men. Journal of Psychosomatic Research, 37, 249–256.CrossRefGoogle Scholar
  111. Wood, D. L., Sheps, S. G., Elveback, L. R., &. Schirger, A. (1984). Cold pressor test as a predictor of hypertension. Hypertension, 6, 301–306.PubMedGoogle Scholar
  112. Young, W., Gofman, J. W., Tandy, R., Malamud, N., & Waters, E. S. G. (1960). The quantitation of atherosclerosis: III. The extent or correlation oT degrees of atherosclerosis within and between the coronary and cerebral vascular beds. American Journal of Cardiology, 6, 300–308.CrossRefGoogle Scholar

Copyright information

© International Society of Behavioral Medicine 1994

Authors and Affiliations

  • Stephen B. Manuck
    • 1
  1. 1.Behavioral Physiology Laboratory, Department of PsychologyUniversity of PittsburghPittsburghUSA

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