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Lana L. Watkins

Professor Emeritus in Psychiatry and Behavioral Sciences
Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences
Box 3119 Med Ctr, Durham, NC 27710
3119 Hosp South, Durham, NC 27710

Selected Publications


Effects of Lifestyle Modification on Psychosocial Function in Patients With Resistant Hypertension: SECONDARY OUTCOMES FROM THE TRIUMPH RANDOMIZED CLINICAL TRIAL.

Journal Article J Cardiopulm Rehabil Prev · January 1, 2024 PURPOSE: In a secondary analysis of the TRIUMPH clinical trial, psychological outcomes in patients with resistant hypertension (RH) receiving a diet and exercise intervention delivered in a cardiac rehabilitation setting were compared with those receiving ... Full text Link to item Cite

Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery.

Conference The journal of pain · January 2024 Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-media ... Full text Cite

Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery.

Conference J Pain · January 2024 Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-media ... Full text Link to item Cite

Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial.

Journal Article J Psychosom Res · July 2023 OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 2 ... Full text Link to item Cite

Exercise and Escitalopram in the Treatment of Anxiety in Patients with Coronary Heart Disease: One Year Follow-Up of the UNWIND Randomized Clinical Trial.

Journal Article J Cardiovasc Dev Dis · September 22, 2022 Anxiety is common among patients with coronary heart disease (CHD) and is associated with a worse prognosis. UNWIND was a 12-week randomized clinical trial comparing exercise and escitalopram to placebo on measures of anxiety, depression, and CHD biomarker ... Full text Link to item Cite

Longer term benefits of exercise and escitalopram in the treatment of anxiety in patients with coronary heart disease: Six month follow-up of the UNWIND randomized clinical trial.

Journal Article Am Heart J · September 2022 BACKGROUND: Anxiety is a common comorbidity in patients with coronary heart disease (CHD) and is associated with worse prognosis. However, effective treatment for anxiety in CHD patients is uncertain. The UNWIND randomized clinical trial showed that 12-wee ... Full text Link to item Cite

Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial.

Journal Article J Hypertens · July 1, 2022 BACKGROUND: Resistant hypertension is associated with increased risk of cognitive decline, stroke, and dementia. Lifestyle modification has been suggested to improve cognitive function through its salutary effects on vascular function. METHODS: Participant ... Full text Link to item Cite

Ambulatory Heart Rate Variability Monitoring: Comparisons Between the Empatica E4 Wristband and Holter Electrocardiogram.

Journal Article Psychosom Med · February 2022 OBJECTIVE: Heart rate variability (HRV) is a useful index of psychological and physiological stress. Although several wristband devices have purported to measure HRV, none have demonstrated reliability when compared with the criterion-standard Holter monit ... Full text Link to item Cite

Cerebrovascular Function, Vascular Risk, and Lifestyle Patterns in Resistant Hypertension.

Journal Article J Alzheimers Dis · 2022 BACKGROUND: Impaired cerebrovascular reactivity (CVR) and blunted cerebral hemodynamic recruitment are thought to be important mechanisms linking hypertension to cerebrovascular and cognitive outcomes. Few studies have examined cardiovascular or dietary co ... Full text Link to item Cite

Effect of Exercise, Escitalopram, or Placebo on Anxiety in Patients With Coronary Heart Disease: The Understanding the Benefits of Exercise and Escitalopram in Anxious Patients With Coronary Heart Disease (UNWIND) Randomized Clinical Trial.

Journal Article JAMA Psychiatry · November 1, 2021 IMPORTANCE: Anxiety is common among patients with coronary heart disease (CHD) and is associated with worse health outcomes; however, effective treatment for anxiety in patients with CHD is uncertain. OBJECTIVE: To determine whether exercise and escitalopr ... Full text Link to item Cite

Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial.

Journal Article Circulation · October 2021 BackgroundAlthough lifestyle modifications generally are effective in lowering blood pressure (BP) among patients with unmedicated hypertension and in those treated with 1 or 2 antihypertensive agents, the value of exercise and diet for lowering B ... Full text Cite

Effects of Mindfulness-Based Stress Reduction on Experimental Pain Sensitivity and Cortisol Responses in Women With Early Life Abuse: A Randomized Controlled Trial.

Journal Article Psychosom Med · July 2021 OBJECTIVE: Early life abuse (ELAb) initiates pathophysiological cascades resulting in long-term maladaptive stress responsivity, hyperalgesia, and an increased risk of psychopathology. Mindfulness-based stress reduction (MBSR) is effective in modifying psy ... Full text Link to item Cite

The effect of reducing posttraumatic stress disorder symptoms on cardiovascular risk: Design and methodology of a randomized clinical trial.

Journal Article Contemp Clin Trials · March 2021 Posttraumatic stress disorder (PTSD) has been associated with accelerated progression of coronary heart disease (CHD). However, the underlying pathophysiological pathway has remained elusive and it is unclear whether there is a direct link between PTSD and ... Full text Link to item Cite

Vascular α1-Adrenergic Receptor Responsiveness in Masked Hypertension.

Journal Article Am J Hypertens · August 4, 2020 BACKGROUND: Masked hypertension (nonhypertensive in the clinic setting but hypertensive outside the clinic during wakefulness) is characterized by increased blood pressure in response to physical and emotional stressors that activate the sympathetic nervou ... Full text Link to item Cite

The Effect of Perimenopausal Transdermal Estradiol and Micronized Progesterone on Markers of Risk for Arterial Disease.

Journal Article J Clin Endocrinol Metab · May 1, 2020 BACKGROUND: The arterial effects of hormone therapy remain controversial. This study tested the effects of transdermal estradiol plus intermittent micronized progesterone (TE + IMP) in healthy perimenopausal and early postmenopausal women on several mechan ... Full text Link to item Cite

Negative Affect-Related Autonomic Arousal Mediates the Association between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults.

Journal Article J Psychophysiol · October 2019 Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting I ... Full text Link to item Cite

The modifying effects of social support on psychological outcomes in patients with heart failure.

Journal Article Health Psychol · June 2019 OBJECTIVE: We examined the modifying effects of social support on depressive symptoms and health-related quality of life (QoL) in patients receiving coping skills training (CST). METHOD: We considered the modifying effects of social support in the Coping E ... Full text Link to item Cite

Posttraumatic Safety Behaviors: Characteristics and Associations With Symptom Severity in Two Samples

Journal Article Traumatology · January 1, 2019 People with anxiety-related disorders often engage in safety behaviors: overt or covert actions performed to prevent the occurrence of a feared outcome and/or reduce associated distress. Although clinical experience and conceptual models of posttraumatic s ... Full text Cite

Microvascular Endothelial Function and Neurocognition Among Adults With Major Depressive Disorder.

Journal Article Am J Geriatr Psychiatry · October 2018 BACKGROUND: Cardiovascular risk factors (CVRFs) and endothelial dysfunction have been associated independently with poorer neurocognition in middle-aged adults, particularly on tests of frontal lobe function. However, to our knowledge, no studies have exam ... Full text Link to item Cite

Physical activity and psychosocial function following cardiac rehabilitation: One-year follow-up of the ENHANCED study.

Journal Article Gen Hosp Psychiatry · November 2017 OBJECTIVE: To examine the long-term association between physical activity (PA) and psychosocial functioning following completion of cardiac rehabilitation (CR) among participants in the ENHANCED study. METHOD: ENHANCED was a 3-month clinical trial examinin ... Full text Link to item Cite

Effects of Lifestyle Modification on Psychosocial Function in Patients With Resistant Hypertension: SECONDARY OUTCOMES FROM THE TRIUMPH RANDOMIZED CLINICAL TRIAL.

Journal Article J Cardiopulm Rehabil Prev · January 1, 2024 PURPOSE: In a secondary analysis of the TRIUMPH clinical trial, psychological outcomes in patients with resistant hypertension (RH) receiving a diet and exercise intervention delivered in a cardiac rehabilitation setting were compared with those receiving ... Full text Link to item Cite

Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery.

Conference The journal of pain · January 2024 Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-media ... Full text Cite

Higher Cardiovagal Baroreflex Sensitivity Predicts Increased Pain Outcomes After Cardiothoracic Surgery.

Conference J Pain · January 2024 Excessive postoperative pain can lead to extended hospitalization and increased expenses, but factors that predict its severity are still unclear. Baroreceptor function could influence postoperative pain by modulating nociceptive processing and vagal-media ... Full text Link to item Cite

Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial.

Journal Article J Psychosom Res · July 2023 OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 2 ... Full text Link to item Cite

Exercise and Escitalopram in the Treatment of Anxiety in Patients with Coronary Heart Disease: One Year Follow-Up of the UNWIND Randomized Clinical Trial.

Journal Article J Cardiovasc Dev Dis · September 22, 2022 Anxiety is common among patients with coronary heart disease (CHD) and is associated with a worse prognosis. UNWIND was a 12-week randomized clinical trial comparing exercise and escitalopram to placebo on measures of anxiety, depression, and CHD biomarker ... Full text Link to item Cite

Longer term benefits of exercise and escitalopram in the treatment of anxiety in patients with coronary heart disease: Six month follow-up of the UNWIND randomized clinical trial.

Journal Article Am Heart J · September 2022 BACKGROUND: Anxiety is a common comorbidity in patients with coronary heart disease (CHD) and is associated with worse prognosis. However, effective treatment for anxiety in CHD patients is uncertain. The UNWIND randomized clinical trial showed that 12-wee ... Full text Link to item Cite

Lifestyle modification and cognitive function among individuals with resistant hypertension: cognitive outcomes from the TRIUMPH trial.

Journal Article J Hypertens · July 1, 2022 BACKGROUND: Resistant hypertension is associated with increased risk of cognitive decline, stroke, and dementia. Lifestyle modification has been suggested to improve cognitive function through its salutary effects on vascular function. METHODS: Participant ... Full text Link to item Cite

Ambulatory Heart Rate Variability Monitoring: Comparisons Between the Empatica E4 Wristband and Holter Electrocardiogram.

Journal Article Psychosom Med · February 2022 OBJECTIVE: Heart rate variability (HRV) is a useful index of psychological and physiological stress. Although several wristband devices have purported to measure HRV, none have demonstrated reliability when compared with the criterion-standard Holter monit ... Full text Link to item Cite

Cerebrovascular Function, Vascular Risk, and Lifestyle Patterns in Resistant Hypertension.

Journal Article J Alzheimers Dis · 2022 BACKGROUND: Impaired cerebrovascular reactivity (CVR) and blunted cerebral hemodynamic recruitment are thought to be important mechanisms linking hypertension to cerebrovascular and cognitive outcomes. Few studies have examined cardiovascular or dietary co ... Full text Link to item Cite

Effect of Exercise, Escitalopram, or Placebo on Anxiety in Patients With Coronary Heart Disease: The Understanding the Benefits of Exercise and Escitalopram in Anxious Patients With Coronary Heart Disease (UNWIND) Randomized Clinical Trial.

Journal Article JAMA Psychiatry · November 1, 2021 IMPORTANCE: Anxiety is common among patients with coronary heart disease (CHD) and is associated with worse health outcomes; however, effective treatment for anxiety in patients with CHD is uncertain. OBJECTIVE: To determine whether exercise and escitalopr ... Full text Link to item Cite

Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial.

Journal Article Circulation · October 2021 BackgroundAlthough lifestyle modifications generally are effective in lowering blood pressure (BP) among patients with unmedicated hypertension and in those treated with 1 or 2 antihypertensive agents, the value of exercise and diet for lowering B ... Full text Cite

Effects of Mindfulness-Based Stress Reduction on Experimental Pain Sensitivity and Cortisol Responses in Women With Early Life Abuse: A Randomized Controlled Trial.

Journal Article Psychosom Med · July 2021 OBJECTIVE: Early life abuse (ELAb) initiates pathophysiological cascades resulting in long-term maladaptive stress responsivity, hyperalgesia, and an increased risk of psychopathology. Mindfulness-based stress reduction (MBSR) is effective in modifying psy ... Full text Link to item Cite

The effect of reducing posttraumatic stress disorder symptoms on cardiovascular risk: Design and methodology of a randomized clinical trial.

Journal Article Contemp Clin Trials · March 2021 Posttraumatic stress disorder (PTSD) has been associated with accelerated progression of coronary heart disease (CHD). However, the underlying pathophysiological pathway has remained elusive and it is unclear whether there is a direct link between PTSD and ... Full text Link to item Cite

Vascular α1-Adrenergic Receptor Responsiveness in Masked Hypertension.

Journal Article Am J Hypertens · August 4, 2020 BACKGROUND: Masked hypertension (nonhypertensive in the clinic setting but hypertensive outside the clinic during wakefulness) is characterized by increased blood pressure in response to physical and emotional stressors that activate the sympathetic nervou ... Full text Link to item Cite

The Effect of Perimenopausal Transdermal Estradiol and Micronized Progesterone on Markers of Risk for Arterial Disease.

Journal Article J Clin Endocrinol Metab · May 1, 2020 BACKGROUND: The arterial effects of hormone therapy remain controversial. This study tested the effects of transdermal estradiol plus intermittent micronized progesterone (TE + IMP) in healthy perimenopausal and early postmenopausal women on several mechan ... Full text Link to item Cite

Negative Affect-Related Autonomic Arousal Mediates the Association between Baroreflex Dysfunction and Insulin Resistance in Non-Diabetic Young Adults.

Journal Article J Psychophysiol · October 2019 Autonomic dysfunction, in particular under-regulation of heart rate (HR) by the baroreflex, is implicated in development of insulin resistance (IR). According to reactivity hypothesis, sympathetic response to stressors may be more sensitive at predicting I ... Full text Link to item Cite

The modifying effects of social support on psychological outcomes in patients with heart failure.

Journal Article Health Psychol · June 2019 OBJECTIVE: We examined the modifying effects of social support on depressive symptoms and health-related quality of life (QoL) in patients receiving coping skills training (CST). METHOD: We considered the modifying effects of social support in the Coping E ... Full text Link to item Cite

Posttraumatic Safety Behaviors: Characteristics and Associations With Symptom Severity in Two Samples

Journal Article Traumatology · January 1, 2019 People with anxiety-related disorders often engage in safety behaviors: overt or covert actions performed to prevent the occurrence of a feared outcome and/or reduce associated distress. Although clinical experience and conceptual models of posttraumatic s ... Full text Cite

Microvascular Endothelial Function and Neurocognition Among Adults With Major Depressive Disorder.

Journal Article Am J Geriatr Psychiatry · October 2018 BACKGROUND: Cardiovascular risk factors (CVRFs) and endothelial dysfunction have been associated independently with poorer neurocognition in middle-aged adults, particularly on tests of frontal lobe function. However, to our knowledge, no studies have exam ... Full text Link to item Cite

Physical activity and psychosocial function following cardiac rehabilitation: One-year follow-up of the ENHANCED study.

Journal Article Gen Hosp Psychiatry · November 2017 OBJECTIVE: To examine the long-term association between physical activity (PA) and psychosocial functioning following completion of cardiac rehabilitation (CR) among participants in the ENHANCED study. METHOD: ENHANCED was a 3-month clinical trial examinin ... Full text Link to item Cite

Racial differences in the association between heart rate variability and left ventricular mass.

Journal Article Exp Physiol · July 1, 2017 What is the central question of this study? Decreased heart rate variability (HRV) is associated with increased cardiovascular disease (CVD) risk, including greater left ventricular mass (LVM). Despite their enhanced CVD risk profile, African Americans hav ... Full text Link to item Cite

Effects of Coping Skills Training on Quality of Life, Disease Biomarkers, and Clinical Outcomes in Patients With Heart Failure: A Randomized Clinical Trial.

Journal Article Circ Heart Fail · January 2017 BACKGROUND: Heart failure (HF) is a chronic disease that compromises patients' quality of life (QoL). Interventions designed to reduce distress and improve disease self-management are needed. We evaluated the efficacy of a telephone-based coping skills tra ... Full text Link to item Cite

Trauma and Autonomic Dysregulation: Episodic - Versus Systemic - Negative Affect Underlying Cardiovascular Risk in Posttraumatic Stress Disorder.

Journal Article Psychosom Med · December 9, 2016 OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart-rate variability (HRV) in cross-sectional research. Recent evidence suggests that this link may be driven by individual differences in autonomic a ... Full text Link to item Cite

Circadian Contrasts in Heart Rate Variability Associated With Posttraumatic Stress Disorder Symptoms in a Young Adult Cohort.

Journal Article J Trauma Stress · October 2016 Prior research has demonstrated that individuals exposed to trauma have shown impaired autonomic function. We sought to determine if heart rate variability (HRV), a marker of impaired autonomic function, differed across periods of wake, rest, and sleep as ... Full text Link to item Cite

Examining the Crux of Autonomic Dysfunction in Posttraumatic Stress Disorder: Whether Chronic or Situational Distress Underlies Elevated Heart Rate and Attenuated Heart Rate Variability.

Journal Article Psychosom Med · September 2016 OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart rate variability (HRV) in cross-sectional research. Using ecological momentary assessment and minute-to-minute HRV/HR monitoring, we examined whet ... Full text Link to item Cite

Effects of Exercise and Sertraline on Measures of Coronary Heart Disease Risk in Patients With Major Depression: Results From the SMILE-II Randomized Clinical Trial.

Journal Article Psychosom Med · June 2016 OBJECTIVE: To assess the effects of supervised and home-based aerobic exercise training, and antidepressant pharmacotherapy (sertraline) on coronary heart disease (CHD) risk factors in a sample of participants with major depressive disorder (MDD). METHODS: ... Full text Link to item Cite

Treatment of anxiety in patients with coronary heart disease: Rationale and design of the UNderstanding the benefits of exercise and escitalopram in anxious patients WIth coroNary heart Disease (UNWIND) randomized clinical trial.

Journal Article Am Heart J · June 2016 BACKGROUND: Anxiety is highly prevalent among patients with coronary heart disease (CHD), and there is growing evidence that high levels of anxiety are associated with worse prognosis. However, few studies have evaluated the efficacy of treating anxiety in ... Full text Link to item Cite

Enhancing Cardiac Rehabilitation With Stress Management Training: A Randomized, Clinical Efficacy Trial.

Journal Article Circulation · April 5, 2016 BACKGROUND: Cardiac rehabilitation (CR) is the standard of care for patients with coronary heart disease. Despite considerable epidemiological evidence that high stress is associated with worse health outcomes, stress management training (SMT) is not inclu ... Full text Link to item Cite

An investigation of vago-regulatory and health-behavior accounts for increased inflammation in posttraumatic stress disorder.

Journal Article J Psychosom Res · April 2016 OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to chronic inflammation, a condition that poses a risk for cardiovascular disease. Attenuated vagal activity has been proposed as a potential mediator of PTSD and inflammation, although associ ... Full text Link to item Cite

Exploring the relationship between posttraumatic stress disorder symptoms and momentary heart rate variability.

Journal Article J Psychosom Res · March 2016 OBJECTIVE: Exposure to trauma-related cues has been associated with a prolonged decrease in heart rate variability (HRV) under laboratory conditions, however the relationship between PTSD symptoms and HRV has not been evaluated during everyday life. The pr ... Full text Link to item Cite

Lifestyle modification for resistant hypertension: The TRIUMPH randomized clinical trial.

Journal Article Am Heart J · November 2015 BACKGROUND: Resistant hypertension (RH) is a growing health burden in this country affecting as many as 1 in 5 adults being treated for hypertension. Resistant hypertension is associated with increased risk of adverse cardiovascular disease (CVD) events an ... Full text Link to item Cite

Computing a Synthetic Chronic Psychosocial Stress Measurement in Multiple Datasets and its Application in the Replication of G × E Interactions of the EBF1 Gene.

Journal Article Genet Epidemiol · September 2015 Chronic psychosocial stress adversely affects health and is associated with the development of disease [Williams, 2008]. Systematic epidemiological and genetic studies are needed to uncover genetic variants that interact with stress to modify metabolic res ... Full text Link to item Cite

Orthostatic hypotension in young adults with and without posttraumatic stress disorder.

Journal Article Psychol Trauma · May 2015 The purpose of this research is (a) to evaluate differences in orthostatic hypotension (OH) among young adults with and without posttraumatic stress disorder (PTSD) and (b) to examine whether group differences may be attributable to behavioral risk factors ... Full text Link to item Cite

Work and home stress: associations with anxiety and depression symptoms.

Journal Article Occup Med (Lond) · March 2015 BACKGROUND: In the evolving work environment of global competition, the associations between work and home stress and psychological well-being are not well understood. AIMS: To examine the impact of psychosocial stress at work and at home on anxiety and de ... Full text Link to item Cite

Association of depressive and anxiety symptoms with 24-hour urinary catecholamines in individuals with untreated high blood pressure.

Journal Article Psychosom Med · 2015 OBJECTIVE: Depression and anxiety are considered risk factors for cardiovascular disease (CVD). The explanatory mechanisms, however, are still to be characterized. One proposed pathophysiological pathway is dysregulation of the autonomic nervous system, in ... Full text Link to item Cite

Posttraumatic stress, heart rate variability, and the mediating role of behavioral health risks.

Journal Article Psychosom Med · October 2014 OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to reduced heart rate variability (HRV), which is in turn a risk factor for cardiovascular disease and death. Although hyperarousal and anxiety are thought to underlie this association, behavi ... Full text Link to item Cite

Behavioral health mediators of the link between posttraumatic stress disorder and dyslipidemia.

Journal Article J Psychosom Res · July 2014 OBJECTIVES: Posttraumatic stress disorder (PTSD) has been linked to dyslipidemia, which is a major risk factor for coronary artery disease. Although this link is thought to reflect response to heightened stress, behavioral health risks, including smoking, ... Full text Link to item Cite

The long-term effects of lifestyle change on blood pressure: One-year follow-up of the ENCORE study.

Journal Article Am J Hypertens · May 2014 BACKGROUND: There is a paucity of data describing the sustained benefits of lifestyle interventions on health behaviors and blood pressure (BP). METHODS: We examined the persistence of changes in health habits and BP in the ENCORE study, a trial in which 1 ... Full text Link to item Cite

Campath, calcineurin inhibitor reduction and chronic allograft nephropathy (3C) study: Background, rationale, and study protocol

Journal Article Transplantation Research · May 6, 2013 Background: Kidney transplantation is the best treatment for patients with end-stage renal failure, but uncertainty remains about the best immunosuppression strategy. Long-term graft survival has not improved substantially, and one possible explanation is ... Full text Cite

Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease.

Journal Article J Am Heart Assoc · March 19, 2013 BACKGROUND: Depression has been related to mortality in coronary heart disease (CHD) patients, but few studies have evaluated the role of anxiety or the role of the co-occurrence of depression and anxiety. We examined whether anxiety is associated with inc ... Full text Open Access Link to item Cite

Multi-scale heart rate dynamics detected by phase-rectified signal averaging predicts mortality after acute myocardial infarction.

Journal Article Europace · March 2013 AIMS: Acceleration and deceleration capacity (AC and DC) for beat-to-beat short-term heart rate dynamics are powerful predictors of mortality after acute myocardial infarction (AMI). We examined if AC and DC for minute-order long-term heart rate dynamics a ... Full text Link to item Cite

Reply

Journal Article Journal of the American College of Cardiology · December 11, 2012 Full text Cite

Interactive associations of depression and sleep apnea with adverse clinical outcomes after acute myocardial infarction.

Journal Article Psychosom Med · October 2012 OBJECTIVE: Depression and sleep apnea (SA) are common among patients with a recent acute myocardial infarction (AMI), and both are associated with increased risk for adverse outcomes. We tested the hypothesis that there is an interaction between them in re ... Full text Link to item Cite

Exercise and pharmacological treatment of depressive symptoms in patients with coronary heart disease: results from the UPBEAT (Understanding the Prognostic Benefits of Exercise and Antidepressant Therapy) study.

Journal Article J Am Coll Cardiol · September 18, 2012 OBJECTIVES: The aim of this study was to assess the efficacy of exercise and antidepressant medication in reducing depressive symptoms and improving cardiovascular biomarkers in depressed patients with coronary heart disease. BACKGROUND: Although there is ... Full text Link to item Cite

Coping effectively with heart failure (COPE-HF): design and rationale of a telephone-based coping skills intervention.

Journal Article J Card Fail · March 2011 BACKGROUND: Coping Effectively with Heart Failure (COPE-HF) is an ongoing randomized clinical trial funded by the National Institutes of Health to evaluate if a coping skills training (CST) intervention will result in improved health status and quality of ... Full text Link to item Cite

Increased non-gaussianity of heart rate variability predicts cardiac mortality after an acute myocardial infarction.

Journal Article Front Physiol · 2011 Non-Gaussianity index (λ) is a new index of heart rate variability (HRV) that characterizes increased probability of the large heart rate deviations from its trend. A previous study has reported that increased λ is an independent mortality predictor among ... Full text Link to item Cite

Study of Heart and Renal Protection (SHARP): randomized trial to assess the effects of lowering low-density lipoprotein cholesterol among 9,438 patients with chronic kidney disease.

Journal Article Am Heart J · November 2010 BACKGROUND: Lowering low-density lipoprotein (LDL) cholesterol with statin therapy has been shown to reduce the incidence of atherosclerotic events in many types of patient, but it remains uncertain whether it is of net benefit among people with chronic ki ... Full text Link to item Cite

Cerebrovascular risk factors and cerebral hyperintensities among middle-aged and older adults with major depression.

Journal Article Am J Geriatr Psychiatry · September 2010 OBJECTIVES: To examine the association between cerebral hyperintensities and cerebrovascular risk factors (CVRF) among middle-aged and older adults with major depressive disorder (MDD). METHODS: Thirty patients (aged 55-77 years) with MDD and no history of ... Full text Link to item Cite

Phobic anxiety and increased risk of mortality in coronary heart disease.

Journal Article Psychosom Med · September 2010 OBJECTIVES: To evaluate whether phobic anxiety is associated with increased risk of cardiac mortality in individuals with established coronary heart disease (CHD) and to examine the role of reduced heart rate variability (HRV) in mediating this risk. Previ ... Full text Open Access Link to item Cite

Effects of the dietary approaches to stop hypertension diet alone and in combination with exercise and caloric restriction on insulin sensitivity and lipids.

Journal Article Hypertension · May 2010 This study examined the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on insulin sensitivity and lipids. In a randomized control trial, 144 overweight (body mass index: 25 to 40) men (n=47) and women (n=97) with high blood pressure (13 ... Full text Link to item Cite

Posttraumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence.

Journal Article Ann Behav Med · February 2010 BACKGROUND: Posttraumatic stress disorder (PTSD) is a significant risk factor for cardiovascular and metabolic disease. PURPOSE: The purpose of the current review is to evaluate the evidence suggesting that PTSD increases cardiovascular and metabolic risk ... Full text Link to item Cite

Effects of the DASH diet alone and in combination with exercise and weight loss on blood pressure and cardiovascular biomarkers in men and women with high blood pressure: the ENCORE study.

Journal Article Arch Intern Med · January 25, 2010 BACKGROUND: Although the DASH (Dietary Approaches to Stop Hypertension) diet has been shown to lower blood pressure (BP) in short-term feeding studies, it has not been shown to lower BP among free-living individuals, nor has it been shown to alter cardiova ... Full text Link to item Cite

Enhancing standard cardiac rehabilitation with stress management training: background, methods, and design for the enhanced study.

Journal Article J Cardiopulm Rehabil Prev · 2010 PURPOSE: Enhancing Standard Cardiac Rehabilitation with Stress Management Training in Patients with Heart Disease (ENHANCED) is a randomized clinical trial funded by the National Heart Lung and Blood Institute to evaluate the effects of stress management t ... Full text Link to item Cite

Association between n-3 fatty acid consumption and ventricular ectopy after myocardial infarction.

Journal Article Am J Clin Nutr · May 2009 BACKGROUND: n-3 (omega-3) Fatty acids are associated with a reduced risk of cardiovascular disease; however, the relation between dietary intake of n-3 fatty acids and ventricular arrhythmias has not been investigated among acute post-myocardial infarction ... Full text Link to item Cite

Ethnic differences in the treatment of depression in patients with ischemic heart disease.

Journal Article Am Heart J · January 2009 OBJECTIVE: The aim of this study is to examine ethnic differences in depressive symptoms and antidepressant treatment in a cohort of patients undergoing diagnostic coronary angiography. BACKGROUND: Coronary heart disease (CHD) is the leading cause of morta ... Full text Link to item Cite

Nighttime heart rate and survival in depressed patients post acute myocardial infarction.

Journal Article Psychosom Med · September 2008 OBJECTIVES: To determine if: 1) depressed patients with a recent acute myocardial infarction (AMI) have higher nighttime heart rate (HR) than nondepressed patients, and 2) elevated nighttime HR is associated with decreased survival post AMI. Depression is ... Full text Link to item Cite

Depression and five year survival following acute myocardial infarction: a prospective study.

Journal Article J Affect Disord · July 2008 Depression has been shown to be a risk factor for mortality during the 12 months following an acute myocardial infarction (MI), but few studies have examined whether it is associated with increased risk over longer periods. Most of the existing studies uti ... Full text Link to item Cite

Heart rate turbulence, depression, and survival after acute myocardial infarction.

Journal Article Psychosom Med · January 2007 OBJECTIVE: Depression is a risk factor for mortality after acute myocardial infarction (AMI), possibly as a result of altered autonomic nervous system (ANS) modulation of heart rate (HR) and rhythm. The purposes of this study were to determine: a) whether ... Full text Link to item Cite

Exercise and pharmacotherapy in the treatment of major depressive disorder.

Journal Article Psychosom Med · 2007 OBJECTIVE: To assess whether patients receiving aerobic exercise training performed either at home or in a supervised group setting achieve reductions in depression comparable to standard antidepressant medication (sertraline) and greater reductions in dep ... Full text Link to item Cite

Ventricular ectopy: impact of self-reported stress after myocardial infarction.

Journal Article Am Heart J · January 2007 BACKGROUND: Although psychologic stress has been implicated in the pathogenesis of ventricular arrhythmias, the relationship between self-reported stress and ventricular ectopy has not been evaluated under naturalistic conditions in acute post-myocardial i ... Full text Link to item Cite

Understanding prognostic benefits of exercise and antidepressant therapy for persons with depression and heart disease: the UPBEAT study--rationale, design, and methodological issues.

Journal Article Clin Trials · 2007 BACKGROUND: Depression is relatively common in patients with coronary heart disease (CHD) and is associated with worse prognosis. Recently there has been interest in evaluating the impact of treating depression on clinical outcomes. Anti-depressant medicat ... Full text Link to item Cite

Depression and prognosis in cardiac patients

Chapter · January 1, 2006 Coronary heart disease (CHD) is the leading cause of death in the USA and Europe [1, 2]. In roughly half the cases, the first clinical manifestations of CHD – myocardial infarction (MI) or sudden death – are catastrophic. These events are sudden, unexpecte ... Full text Cite

Phobic anxiety, depression, and risk of ventricular arrhythmias in patients with coronary heart disease.

Journal Article Psychosom Med · 2006 OBJECTIVE: Findings of an association between phobic anxiety and elevated risks of sudden cardiac death suggest that phobic anxiety may be related to increased risk of ventricular arrhythmias. The purpose of this study was to examine whether phobic anxiety ... Full text Link to item Cite

Effects of paroxetine and venlafaxine XR on heart rate variability in depression.

Journal Article J Clin Psychopharmacol · October 2005 Depressed patients may exhibit reduced heart rate variability (HRV), and antidepressants which block norepinephrine uptake may also lower HRV. This study compared paroxetine (PAR) and venlafaxine XR (VEN-XR) on HRV. Outpatients were randomly assigned to do ... Full text Link to item Cite

Impaired endothelial function in coronary heart disease patients with depressive symptomatology.

Journal Article J Am Coll Cardiol · August 16, 2005 OBJECTIVES: The purpose of this study was to assess whether depressive symptomatology was associated with vascular endothelial dysfunction in patients with coronary heart disease (CHD). BACKGROUND: In patients with CHD, the presence of depression is associ ... Full text Link to item Cite

Low heart rate variability and the effect of depression on post-myocardial infarction mortality.

Journal Article Arch Intern Med · July 11, 2005 BACKGROUND: Depression is associated with an increased risk for mortality after acute myocardial infarction (MI). The purpose of this study was to determine whether low heart rate variability (HRV) mediates the effect of depression on mortality. METHODS: T ... Full text Link to item Cite

Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: a randomized controlled trial.

Journal Article JAMA · April 6, 2005 CONTEXT: Observational studies have shown that psychosocial factors are associated with increased risk for cardiovascular morbidity and mortality, but the effects of behavioral interventions on psychosocial and medical end points remain uncertain. OBJECTIV ... Full text Link to item Cite

Social support and religiosity as coping strategies for anxiety in hospitalized cardiac patients.

Journal Article Ann Behav Med · December 2004 BACKGROUND: Prospective studies have demonstrated that anxiety is associated with an increased risk of mortality and sudden cardiac death. There is therefore a need to understand what factors contribute to anxiety in patients with coronary heart disease (C ... Full text Link to item Cite

Depression and anxiety symptoms are related to increased 24-hour urinary norepinephrine excretion among healthy middle-aged women.

Journal Article J Psychosom Res · October 2004 OBJECTIVE: Depression is a risk factor for morbidity and mortality in a variety of populations, and anxiety has also been associated with risk of mortality among cardiac patients. Dysfunction of the autonomic nervous system may be involved in this risk. Th ... Full text Link to item Cite

Effects of daily stress on autonomic cardiac control in patients with coronary artery disease.

Journal Article Am J Cardiol · May 15, 2004 Emotional stress has been implicated in the development and progression of coronary artery disease, with 1 proposed causal pathway being changes in cardiac autonomic tone. One hundred thirty-five patients with coronary artery disease underwent 48 hours of ... Full text Link to item Cite

Depression as a risk factor for mortality after acute myocardial infarction.

Journal Article Am J Cardiol · December 1, 2003 The ENRICHD clinical trial, which compared an intervention for depression and social isolation to usual care, failed to decrease the rate of mortality and recurrent acute myocardial infarction (AMI) in post-AMI patients. One explanation for this is that de ... Full text Link to item Cite

Effects of exercise and weight loss on cardiac risk factors associated with syndrome X.

Journal Article Arch Intern Med · September 8, 2003 BACKGROUND: Patients with high blood pressure (BP) often exhibit syndrome X, an aggregation of abnormalities in carbohydrate and lipoprotein metabolism associated with increased risk of coronary heart disease (CHD). The present study evaluated the effects ... Full text Link to item Cite

Cognitive and somatic symptoms of depression are associated with medical comorbidity in patients after acute myocardial infarction.

Journal Article Am Heart J · July 2003 BACKGROUND: Depression is common in patients with acute myocardial infarction (AMI) and is associated with adverse health outcomes. However, the extent to which clinical depression is related to comorbid medical conditions is unknown. This study examined t ... Full text Link to item Cite

Effects of depression on QT interval variability after myocardial infarction.

Journal Article Psychosom Med · 2003 OBJECTIVES: Clinical depression is a risk factor for cardiac mortality in patients with coronary heart disease. High QT interval variability is a risk factor for arrhythmic events, including sudden cardiac death. The purpose of this study was to determine ... Full text Link to item Cite

Depression, heart rate variability, and acute myocardial infarction

Journal Article Revista de Psiquiatria Clinica · September 14, 2002 Cite

Association of anxiety with reduced baroreflex cardiac control in patients after acute myocardial infarction.

Journal Article Am Heart J · March 2002 BACKGROUND: Although depression has been associated with increased mortality in patients after acute myocardial infarction (AMI), little is known about the effects of depression on autonomic nervous system control of heart rate. This study evaluated whethe ... Full text Link to item Cite

Effect of kava extract on vagal cardiac control in generalized anxiety disorder: preliminary findings.

Journal Article J Psychopharmacol · December 2001 Anxiety disorders are associated with low vagal control of heart rate and increased risk of cardiac mortality and sudden cardiac death. This study examined whether the herbal anxiolytic, kava, produces improvement in vagal control in generalized anxiety di ... Full text Link to item Cite

Depression, heart rate variability, and acute myocardial infarction.

Journal Article Circulation · October 23, 2001 BACKGROUND: Clinical depression is associated with an increased risk for mortality in patients with a recent myocardial infarction (MI). Reduced heart rate variability (HRV) has been suggested as a possible explanation for this association. The purpose of ... Full text Link to item Cite

Enhancing Recovery in Coronary Heart Disease (ENRICHD) study intervention: rationale and design.

Journal Article Psychosom Med · 2001 OBJECTIVE: Depression and low social support are risk factors for medical morbidity and mortality after acute MI. The ENRICHD study is a multicenter, randomized, controlled clinical trial of a cognitive-behavioral treatment for depression and low social su ... Link to item Cite

Is there a glycemic threshold for impaired autonomic control?

Journal Article Diabetes Care · June 2000 OBJECTIVE: Although hyperglycemia has been recognized as a predictor of cardiovascular autonomic neuropathy in diabetic patients, the glucose threshold at which autonomic control begins to become impaired has not been evaluated. This study examined whether ... Full text Link to item Cite

Worried to death? [4] (multiple letters)

Journal Article Circulation · September 14, 1999 Cite

Association of depressive symptoms with reduced baroreflex cardiac control in coronary artery disease.

Journal Article Am Heart J · March 1999 BACKGROUND: Although depression has been associated with cardiac death in coronary artery disease (CAD), little is known about the effects of depression on autonomic nervous system control of heart rate. This study evaluated whether depressive symptomatolo ... Full text Link to item Cite

Anxiety reduces baroreflex cardiac control in older adults with major depression.

Journal Article Psychosom Med · 1999 OBJECTIVE: Although depression and anxiety predict risk of cardiac mortality, the contributions of depression and anxiety to vagal cardiac control have not been systematically evaluated. The goal of this study was to examine the relationship between state ... Full text Link to item Cite

Anxiety and vagal control of heart rate.

Journal Article Psychosom Med · 1998 OBJECTIVE: Prospective studies have demonstrated that anxiety predicts sudden cardiac death, but the mechanism underlying this increased risk is unclear. This study examined whether anxiety is associated with reductions in vagal control of heart rate in he ... Full text Link to item Cite

Blood pressure responses to mental stress in emotionally defensive patients with stable coronary artery disease.

Journal Article Am J Cardiol · August 1, 1997 Emotional defensiveness, defined by concealment of both negative emotions and personal vulnerability, was substantially and consistently correlated with the magnitude of blood pressure reactions to 2 types of mental stress among coronary patients, independ ... Full text Link to item Cite

Incremental bias in Finapres estimation of baseline blood pressure levels over time.

Journal Article Hypertension · April 1997 Finapres finger blood pressure monitoring appears to provide a reliable alternative to intra-arterial blood pressure measurement under many circumstances. However, few studies have focused on the limitations of Finapres assessment. In a previous pilot inve ... Full text Link to item Cite

Cardiac vagal control and dynamic responses to psychological stress among patients with coronary artery disease.

Journal Article Am J Cardiol · December 15, 1996 Two groups of patients with coronary artery disease who differed in level of cardiac vagal control were compared in their cardiovascular responses to psychological stress. Patients with lower vagal control manifested increased reactions in diastolic blood ... Full text Link to item Cite

Noninvasive assessment of baroreflex control in borderline hypertension. Comparison with the phenylephrine method.

Journal Article Hypertension · August 1996 In this study, we examined the sensitivity of two recently developed noninvasive baroreflex measurement techniques to assess baroreflex control in hypertension. We assessed baroreflex sensitivity noninvasively from covariations of systolic pressure and RR ... Full text Link to item Cite

The effect of hypoxia on baroreflexes and pressor sensitivity in sleep apnea and hypertension.

Journal Article Sleep · December 1995 Many persons with sleep apnea are hypertensive. Forty-two subjects of similar age and weight were divided into four groups of hypertensives and normotensives with and without sleep apnea. All subjects had heart rate, blood pressure (BP), baroreflex sensiti ... Link to item Cite

Assessment of baroreflex control from beat-to-beat blood pressure and heart rate changes: a validation study.

Journal Article Psychophysiology · July 1995 In this study, we tested the validity of a new method designed to estimate baroreflex control of heart rate from spontaneous changes in systolic pressure and pulse interval. This method was compared with a conventional method of assessing baroreflex contro ... Full text Link to item Cite

Reduced beta 2-receptor mediated vasodilation in African Americans.

Journal Article Life Sci · 1995 It is well recognized that African Americans have a higher prevalence of cardiovascular disease than White Americans although the underlying mechanisms are not entirely understood. This study was perfumed to evaluate racial differences in the chronotropic ... Full text Link to item Cite

A technique for improved blood sampling during sleep studies.

Journal Article Psychophysiology · November 1994 Research protocols often require that blood samples be drawn during sleep. This study compares the efficacy of obtaining nocturnal blood samples using a standard heparinized intravenous setup versus the same intravenous setup used in conjunction with a sma ... Full text Link to item Cite

Mechanisms underlying cardiovascular defense reaction evoked by dorsal periaqueductal gray stimulation.

Journal Article Am J Physiol · November 1993 Hemodynamic and autonomic mechanisms underlying the cardiovascular defense reaction elicited by electrical stimulation of the dorsolateral periaqueductal gray region were evaluated in pentobarbital sodium-anesthetized Sprague-Dawley rats. Stimulation of th ... Full text Link to item Cite

Hypotensive effect of clonidine is not mediated by enhanced baroreflex gain in rats.

Journal Article J Cardiovasc Pharmacol · February 1993 We wished to examine whether enhanced depressor baroreflexes contribute to the hypotensive effect of clonidine in rats. Clonidine's hypotensive effect and clonidine's effect on baroreflex gain mean heart rate/mean blood pressure, (delta HR/delta BP) were c ... Full text Link to item Cite

Mechanisms underlying cardiovascular defense reaction evoked by dorsal periaqueductal gray stimulation

Journal Article American Journal of Physiology - Regulatory Integrative and Comparative Physiology · January 1, 1993 Hemodynamic and autonomic mechanisms underlying the cardiovascular defense reaction elicited by electrical stimulation of the dorsolateral periaqueductal gray region were evaluated in pentobarbital sodium- anesthetized Sprague-Dawley rats. Stimulation of t ... Cite

The effect of pentobarbital anesthesia on the autonomic nervous system control of heart rate during baroreceptor activation.

Journal Article J Auton Nerv Syst · November 1991 This study determined the influence of pentobarbital anesthesia on the autonomic nervous system control of baroreceptor mediated reflex bradycardia in the rat. Reflex bradycardia was elicited by phenylephrine-induced hypertension in conscious and pentobarb ... Full text Link to item Cite

Alpha 1-adrenergic receptor-mediated downregulation of angiotensin II receptors in neuronal cultures.

Journal Article J Neurochem · October 1986 Previous evidence has suggested that brain catecholamine levels are important in the regulation of central angiotensin II receptors. In the present study, the effects of norepinephrine and 3,4-dihydroxyphenylethylamine (dopamine) on angiotensin II receptor ... Full text Link to item Cite

α1-Adrenergic receptor-mediated downregulation of angiotensin II receptors in neuronal cultures

Journal Article Journal of Neurochemistry · 1986 Previous evidence has suggested that brain catecholamine levels are important in the regulation of central angiotensin II receptors. In the present study, the effects of norepinephrine and 3,4-dihydroxyphenylethylamine (dopamine) on angiotensin II receptor ... Cite

Failure of 2-deoxy-D-glucose to stimulate feeding in deermice.

Journal Article Physiol Behav · January 1985 Deermice (Peromyscus maniculatus) did not increase their food intake above baseline following treatment with 2-deoxy-D-glucose (2DG, 500 or 1000 mg/kg). They did eat more following food deprivation or treatment with insulin at a high dose (100 U/kg). House ... Full text Link to item Cite