Overview
My current research focus is on biological, behavioral and sociocultural factors involved in the etiology and management of hypertension, coronary artery disease, and congestive heart failure. The role of stress and the sympathetic nervous system in disease onset and progression is of central interest. Current research issues being studied include: (i) Ethnicity and gender as factors related to the pathogenesis of hypertension; (ii) Mechanisms by which menopause increases the risk of cardiovascular disease in women; (iii) Mechanisms by which stress may provoke episodes of myocardial ischemia in patients with coronary artery disease; (iv) Stress biomarkers that are associated with adverse clinical outcomes in cardiac patients; (v) The development of coping skills interventions to improve prognosis and quality of life in patients with congestive heart failure; (vi) Circadian blood pressure profiles for risk stratification in patients with hypertension; (vii) Biological and behavioral factors contributing to elevated nighttime blood pressure and blunted nighttime blood pressure dipping.
Comprehensive assessments of cardiovascular regulatory systems define the daily activity in the biobehavioral research laboratory. Assessments include: (i) hemodynamic (blood pressure, cardiac output, systemic vascular resistance) and neurohumoral responses (plasma epinephrine and norepinephrine) during psychological and physical stress testing; (ii) alpha and beta adrenergic receptor function, the baroreceptor reflex, and cardiac vagal control; (iii) endothelial function, and vascular structure and compliance; (iv) left ventricular structure and function by echocardiography; (v) 24-hour ambulatory blood pressure and cardiac output monitoring; (vi) Noninvasive assessments of arterial stiffness and central aortic pressure; (vii) Psychometric assessments of personality and lifestyle characteristics related to cardiovascular disease.
A secondary research interest is in the use and development of noninvasive techniques for evaluating the cardiovascular system. Developments include an ambulatory impedance cardiography system, permitting assessment of 24-hour hemodynamics during normal daily activities, and biomarkers of cardiovascular risk obtained using ultrasound imaging.
RESINT.DOC 1/5/99
Comprehensive assessments of cardiovascular regulatory systems define the daily activity in the biobehavioral research laboratory. Assessments include: (i) hemodynamic (blood pressure, cardiac output, systemic vascular resistance) and neurohumoral responses (plasma epinephrine and norepinephrine) during psychological and physical stress testing; (ii) alpha and beta adrenergic receptor function, the baroreceptor reflex, and cardiac vagal control; (iii) endothelial function, and vascular structure and compliance; (iv) left ventricular structure and function by echocardiography; (v) 24-hour ambulatory blood pressure and cardiac output monitoring; (vi) Noninvasive assessments of arterial stiffness and central aortic pressure; (vii) Psychometric assessments of personality and lifestyle characteristics related to cardiovascular disease.
A secondary research interest is in the use and development of noninvasive techniques for evaluating the cardiovascular system. Developments include an ambulatory impedance cardiography system, permitting assessment of 24-hour hemodynamics during normal daily activities, and biomarkers of cardiovascular risk obtained using ultrasound imaging.
RESINT.DOC 1/5/99
Current Appointments & Affiliations
Professor in Psychiatry and Behavioral Sciences
·
2001 - Present
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences,
Psychiatry & Behavioral Sciences
Professor in the Department of Psychology and Neuroscience
·
2008 - Present
Psychology & Neuroscience,
Trinity College of Arts & Sciences
Recent Publications
Use of Impedance Cardiography to Guide Blood Pressure Lowering Medication Selection: Systematic Review of Randomized Controlled Trials.
Journal Article Am J Hypertens · October 14, 2024 BACKGROUND: Blood pressure (BP) control can be difficult to attain due to multiple factors, including choosing and titrating antihypertensive medications. Measurement of hemodynamic parameters using impedance cardiography (ICG) at the point of care may all ... Full text Link to item CiteDepressive symptoms are associated with clinical outcomes in heart failure with reduced ejection fraction.
Journal Article ESC Heart Fail · October 2024 AIMS: The objective of this study was to examine associations between elevated depressive symptoms and increased risk of adverse clinical events patients with heart failure and reduced ejection fraction (HFrEF), as well as the potential contribution of hea ... Full text Link to item CiteCognitive behavior therapy for insomnia for untreated hypertension with comorbid insomnia disorder: The SLEEPRIGHT clinical trial.
Journal Article J Clin Hypertens (Greenwich) · April 2024 Insomnia and poor sleep are associated with an increased risk of developing cardiovascular disease (CVD) and its precursors, including hypertension. In 2022, the American Heart Association (AHA) added inadequate sleep to its list of health behaviors that i ... Full text Link to item CiteRecent Grants
An evaluation of insomnia treatment to reduce cardiovascular risk in patients with posttraumatic stress disorder
ResearchCo-Principal Investigator · Awarded by National Institutes of Health · 2020 - 2026Improving Lung Transplant Outcomes with Coping Skills and Physical Activity
ResearchCo Investigator · Awarded by National Institutes of Health · 2019 - 2026Sleep Quality and Mechanisms of Cardiovascular Risk in Adults with Hypertension
ResearchPrincipal Investigator · Awarded by National Institutes of Health · 2019 - 2024View All Grants
Education, Training & Certifications
University of Hull (United Kingdom) ·
1982
Ph.D.