Higher Heart Rate Levels Research Articles

Horses’ Cardiovascular and Glucocorticoid Responses to Equine-Assisted Therapy with Women with Intellectual Disability: An Exploratory Study

ABSTRACT Research on equine-assisted therapy (EAT) has primarily been centered on human health. Relatively few studies have addressed the impact of EAT on horses. This study sought to monitor four experienced therapy horses’ cardiovascular and glucocorticoid activity over the course of standardized EAT sessions designed to support women with intellectual disability. In the control condition, horses completed the EAT protocol solely with the therapist, thereby resembling a training session. Descriptive data analysis revealed higher levels of heart rate during an experimental EAT session and increased salivary cortisol when horses were navigated by the client through an obstacle course during the “challenge” phase of the protocol, pointing at a greater physical demand due to the recipient on horseback. Given the parasympathetic activity and overall heart rate variability across experimental EAT sessions and the cortisol recovery after the sessions, the findings do not give rise to any acute animal welfare concerns. For a more holistic interpretation of the present research results, further investigation into the horse perception of EAT, based on a bigger sample size and additional markers of welfare, is needed.

THE PREVALENCE, CHARACTERISTICS, AND PREDICTORS OF HYPERTENSION PHENOTYPES IN A CHINESE POPULATION

Objective: Different phenotypes of hypertension are associated with varying degrees of cardiovascular risk. However, there is limited data available regarding the features and predictors of hypertension phenotypes in Chinese populations. This study aimed to evaluate the prevalence, characteristics, and predictors of different patterns of hypertension in a Chinese population. Design and method: In this study, a cross-sectional design was employed, and a total of 13,073 community participants were included. Hypertension phenotypes were defined as isolated systolic hypertension (ISH, systolic blood pressure (SBP) no less than 140 mmHg and diastolic blood pressure (DBP) less than 90 mmHg), isolated diastolic hypertension (IDH, SBP less than 140 mmHg and DBP no less than 90 mmHg), and systolic-diastolic hypertension (SDH, SBP on less than 140 mmHg and DBP no less than 90 mmHg). Univariate and multivariate logistic regression analyses were utilized to investigate the predictors of various hypertension phenotypes. Results: The mean age of participants was 56.1 years, and 8625 (66%) were women. The prevalence rates of normotension, ISH, IDH, and SDH were 77.7%, 15.6%, 1.2%, and 5.6%, respectively. Compared with the normotensive group, participants with ISH were more likely to be older, men, overweight, obese, presenting with abdominal obesity, artery stiffness, and diabetes, as well as having lower levels of serum creatinine. Patients with IDH demonstrated a higher likelihood of being younger, men, presenting with abdominal obesity, and having higher levels of heart rate compared to normotensive individuals. Furthermore, male gender, alcohol consumption, overweight, obesity, abdominal obesity, artery stiffness, and higher levels of heart rate were predictors for SDH compared to normotension. Conclusions: Male gender and abdominal obesity were identified as common risk factors for three phenotypes of hypertension. However, age had a varying effect on the prevalence of distinct patterns of hypertension.

Diagnostic value of clinical-instrumental and hematological indicators in predicting complications of the hospital period of STEMI in conditions of chronic stress caused by wartime

The aim – to develop a diagnostic system that takes into account the peculiarities of clinical, instrumental and laboratory indicators in patients with STEMI against the background of wartime and will allow to objectify a tendency to a more difficult hospital course of ACS.Materials and methods. We studied a cohort of patients (n=133 individuals, 77.4 % men, average age 61.8±0.9 years) with STEMI, part of which (group 1) was hospitalized from February to May 2019 (n=87), while another part of which (group 2) was hospitalized in the period from February 24, 2022 to March 2023 (n=46) within the first 24 hours from the development of symptoms of the disease (average time of admission 5.2±0.4 hours). The groups were compared according to the clinical and anamnestic and laboratory parameters of the first day.Results and discussion. It was found that in the Ukrainian population during wartime, patients with STEMI are admitted to the hospital later, have a more burdensome history of cerebrovascular diseases, a greater number of significant coronary stenoses, a higher percentage of smokers, and also have higher heart rate levels upon admission, ESR, triglycerides, leukocytes (at the expense of lymphocytes and monocytes), as well as platelets (with lower indicators of their size inhomogeneity). Also, invasive treatment of these lesions leads to slightly worse results on the TIMI and MBG scales. Informativeness of hematology analysis indicators and other markers of inflammation/stress on the first day of STEMI in wartime was evaluated for predicting the risk of an complicated course of the hospital period (development of cardiac death, signs of LVEF, ventricular tachyarrhythmias, stent thrombosis, acute renal dysfunction, recurrence of ACS/angina). It was found that predictors of the undesirable course of STEMI during wartime are: heart rate > 70/min, ESR > 10 mm/h, glucose level > 8.5 mmol/l, leukocytes > 13 · 109/l, lymphocytes > 2 · 109/l, platelets > 270 · 109/l, large (>12 fl) platelets < 27 %, triglycerides > 1.3 mmol/l, as well as combined criteria made up of these indicators. Thus, the 6-component score (heart rate, ESR, glucose, levels of leukocytes, lymphocytes, and platelets) had an area under the ROC curve of 0.87 (for values ​​> 30 units – BP 6.39 (2.16–18.9), p<0.0001) when determining the risk of an undesirable course of ACS in patients during wartime. These predictors are specific to the stress-induced effects of war and are not informative in peacetime STEMI patients.Conclusions. The coexistence of acute stress caused by STEMI with chronic exposure to stress-associated wartime factors can worsen the course of the hospital period of STEMI, which is associated with an increase in heart rate, ESR, glucose level, leukocytes, lymphocytes, triglycerides, platelets with a decrease in their inhomogeneity in size. Taking into account these features allows predicting the risk of a complicated course of the hospital period of the STEMI in wartime.

Efficacy of Bluetooth-Operated Heart Rate Monitors for Use in Construction

In the construction industry, workers are constantly exposed to different environmental and other hazards that pose risks to their health. Bluetooth-connected devices host the potential to reduce health risks to workers by tracking heart rate (HR), particularly upon implementation into an Internet of Things (IoT) framework. An Internet of Things (IoT) system is one in which multiple devices are connected to transmit information to each other in real-time. A literature and industry review has been conducted to determine which devices would be most applicable to monitor HR in an IoT system to accurately portray real-time worker conditions. Experimentally, the most applicable devices found were then put under field tests imitating traditional work conditions through the performance of specific activities. The performance and accuracy of the devices under these conditions were then evaluated from the data collected. The study has been designed to determine whether chest, finger, and wrist devices could be used to actively track HR. The devices used included the Viatom Wellue O2Ring finger monitor, Polar Ignite GPS Fitness Watch wrist monitor, and the Polar H10 chest monitor, serving as test cases to see if and by how much the location of the device on the body differed with the HR found. All three devices could connect to the IoT system and transmit data within a specific timeframe correctly. Covariance and standard deviations measured by the Viatom Wellue O2Ring finger monitor and the Polar Ignite GPS Fitness Watch trials among participants were above the normal thresholds, indicating non-negligible differences around the mean and showing disparities in the accuracy of these devices. Furthermore, the results were found to be too inaccurate for widespread commercial deployment for tracking mid to high HR levels while performing construction-related labor. Overall, the use of Bluetooth-connected devices to track workers’ HR and other vitals has the potential applicability to improve safety in hazardous environments. However, future technological development must occur before implementing predictive safety systems into real-time monitoring to effectively monitor laborers performing strenuous tasks in harsh environments.

Cardiovascular effects of wearing respirators against particulate matter: A randomized crossover trial

Fine particles (PM2.5) are implicated as an important risk to cardiovascular health. N95 respirators had been widely used to provide protection by filtering particles. Yet the practical effects of wearing respirators have not been fully understood. This study aimed to evaluate the cardiovascular effects of respirator wearing against PM2.5 and underpin the understanding of the mechanisms of cardiovascular responses triggered by PM2.5. We conducted a randomized, double-blind crossover trial among 52 healthy adults in Beijing, China. Participants were exposed to outdoor PM2.5 for 2 h in alterations wearing true respirators (with membranes) or sham ones (without membranes). We measured ambient PM2.5 and tested the filtration efficiency of the respirators. We compared the heart rate variability (HRV), blood pressure and arterial stiffness indicators between the true respirator group and the sham respirator group. Concentrations of ambient PM2.5 during the 2-h exposure ranged from 4.9 to 255.0 μg/m3. The filtration efficiency of true respirators was 90.1 % and that of sham ones was 18.7 %. Between-group differences varied by pollution levels. On less polluted days (PM2.5< 75 μg/m3), participants wearing true respirators showed lower levels of HRV and higher levels of heart rate compared with those wearing sham respirators. These between-group differences were inconspicuous on heavily polluted days (PM2.5≥ 75 μg/m3). We found that a 10 μg/m3 increase in PM2.5 was associated with a 2.2 % to 6.4 % decrease in HRV, prominent at 1 h after the start of exposure. N95 respirators have good performance in reducing PM2.5 exposure. Short-term exposure to PM2.5 can induce very acute responses in autonomic nervous function. However, the overall effects of wearing respirators might be not always favorable to human health in terms of their inherent adverse effects, which seem dependent on the levels of air pollution. Precise individual protection recommendations warrant to be developed.

Metabolic and physiological demands of 3×3-min-round boxing fights in highly trained amateur boxers.

The aim of this study was to evaluate the energy requirements of the aerobic oxidative, anaerobic lactic (glycolytic), or anaerobic alactic systems in highly trained amateur boxers during a 3×3-min-round boxing fight. On three separate occasions, 10 highly trained male amateur boxers undertook a progressive treadmill run, a progressive bag-punching exercise, and a full-contact competitive boxing fight of the 3×3-min format. Expired gas and heart rate (HR) were recorded throughout all exercise tasks, with the exception of a gas analysis during the competitive fight. Total energy expenditure and the contribution of the three major energy-supply systems were calculated based on oxygen uptake (V̇O<inf>2</inf>) and HR during exercise, blood lactate accumulation, and excess V̇O<inf>2</inf> during the fast phase of the recovery. The blood lactate concentration was >15 (range: 12-18) mmol·L-1 after the fight. The HR reached >93% of the maximal (HR<inf>max</inf>) in rounds 1 and 2 and >97% in the final round and was strongly correlated with HR<inf>max</inf> (r=0.885). The average calculated O<inf>2</inf> uptake during the boxing fight was 89% of V̇O<inf>2max</inf>, whereas O<inf>2</inf> uptake equivalent calculated from the involvement of all three major energy supply systems was 122% of V̇O<inf>2max</inf>. The calculated energy provision during the fight was 73% aerobic, 19% anaerobic alactic and 8% anaerobic glycolytic. In highly trained male amateur boxers, 3×3-min boxing match elicits very high HR and blood lactate levels with predominant involvement of aerobic and substantial contribution of anaerobic alactic energy systems.

Horses' (Equus caballus) Ability to Solve Visible but Not Invisible Displacement Tasks Is Associated With Frustration Behavior and Heart Rate.

Many frameworks have assessed the ultimate and ontogenetic underpinnings in the development of object permanence, but less is known about whether individual characteristics, such as sex or training level, as well as proximate factors, such as arousal or emotional state, affect performance in these tasks. The current study investigated horses’ performance in visible and invisible displacement tasks and assessed whether specific ontogenetic, behavioral, and physiological factors were associated with performance. The study included 39 Icelandic horses aged 2–25 years, of varying training levels. The horses were exposed to three tasks: (a) a choice test (n = 37), (b) a visible displacement task (n = 35), and (c) an invisible displacement task (n = 31). 27 horses in the choice test, and 8 horses in the visible displacement task, performed significantly better than expected by chance, while none did so in the invisible displacement task. This was also reflected in their group performance, where horses performed above chance level in the choice task and the visible displacement task only. In the invisible displacement task, the group performed significantly worse than expected by chance indicating that horses persistently chose the side where they had last seen the target. None of the individual characteristics included in the study had an effect on performance. Unsuccessful horses had higher heart rate levels, and expressed more behavior indicative of frustration, likely because of their inability to solve the task. The increased frustration/arousal could lead to a negative feedback loop, which might hamper performance in subsequent trials. Care should thus be taken in future experimental designs to closely monitor the arousal level of the tested individuals in order to safeguard comparability.

Influence of the Pedagogical Model and Experience on the Internal and External Task Load in School Basketball

The methodology used by the teacher in Physical Education sessions conditions the physical fitness of the students, since the design of the tasks determines the physical and physiological demands to which they are exposed. This study aimed to quantify and compare, according to the teaching methodology and students’ previous experience, the external (eTL) and internal (iTL) load resulting from the application of three intervention programmes that follow different teaching methodologies to teach school basketball: the Tactical Games Approach (TGA), Direct Instruction (DI) and Service Teacher’s Basketball Unit (STBU). The Ratings of Perceived Exertion (RPEs) recorded in the assessments (pre-test/post-test) were also studied. A total of 49 students, aged 11 to 12 and divided into three class groups, from the sixth grade of primary education at a state school in Spain, participated in the study. Teaching–learning programs were randomly assigned to student groups. All the sessions were monitored with inertial devices that made it possible to record physical activity and convert the information into kinematic parameters. The results indicated that during the sessions, the students who followed the TGA method recorded higher values of eTL (player load; DI = 4.92, TGA = 6.95, STBU = 2.99) and iTL (mean heart rate; DI = 142.94, TGA = 157.12, STBU = 143.98). In addition, during the evaluation tests, they presented heart rate levels similar to those obtained by the students in the other programmes. However, they spent more time doing high-intensity activity, working longer in the running (DI = 3.42, TGA = 11.26, STBU = 8.32) and sprinting speed ranges (DI = 0.00, TGA = 0.12, STBU = 0.11), and presenting better physical fitness. During the assessments, students with no prior basketball experience showed higher levels of top speed; experienced students had higher levels of heart rate. The TGA method favours the physical condition and health of primary education students, which is why this method is recommended when planning Physical Education sessions.

Atenolol's Inferior Ability to Reduce Central vs Peripheral Blood Pressure Can Be Explained by the Combination of Its Heart Rate-Dependent and Heart Rate-Independent Effects.

Objective Whether the inferior ability of atenolol to reduce central (aortic) compared to peripheral (brachial) blood pressure (BP) is related to its heart rate (HR)-dependent or -independent effects, or their combination, remains unclear. To provide further mechanistic insight into this topic, we studied the acute effects of atenolol versus nebivolol and ivabradine on systolic blood pressure amplification (SBPA; peripheral systolic BP minus central systolic BP) in a model of sick sinus syndrome patients with a permanent dual-chamber cardiac pacemaker in a nonrandomized single-blind single-group clinical trial. Methods We determined hemodynamic indices noninvasively (Sphygmocor XCEL) before and at least 3 h after administration of oral atenolol 50 or 100 mg, nebivolol 5 mg, or ivabradine 5 or 7.5 mg during atrial pacing at a low (40 bpm), middle (60 bpm), and high (90 bpm) HR level in 25 participants (mean age 65.5 years, 12 men). Results At the low HR level, i.e., when the drugs could exert their HR-dependent and HR-independent effects on central BP, only atenolol produced a significant decrease in SBPA (mean change 0.74 ± 1.58 mmHg (95% CI, 0.09–1.40; P = 0.028)), indicating inferior central vs peripheral systolic BP change. However, we observed no significant change in SBPA with atenolol at the middle and high HR levels, i.e., when HR-dependent mechanisms had been eliminated by pacing. Conclusion The findings of our trial with a mechanistic approach to the topic imply that the inferior ability of atenolol to reduce central vs peripheral BP can be explained by the combination of its heart rate-dependent and -independent effects. This trial is registered with NCT03245996.

Heart rate reduction decreases central blood pressure in sick sinus syndrome patients with a permanent cardiac pacemaker

Increased resting heart rate (HR) contributes to higher cardiovascular mortality and morbidity in the healthy as well as in people with cardiovascular diseases, possibly due to elevated blood pressure (BP) among other mechanisms. Data on the relationship between HR and central (aortic) BP remains controversial, however, and concerning β-blockers, it has been proposed that pharmacological HR lowering is associated with augmentation of central BP. We aimed to study the role of pharmacologically unaffected HR on central BP indices in sick sinus syndrome patients with a permanent cardiac pacemaker in the HR range from 40 to 90 bpm. We included 27 subjects (mean age 65.8 ± 9.5 years, 12 men) with a dual-chamber pacemaker implanted due to sick sinus syndrome. We determined central hemodynamic indices noninvasively during an atrial pacing mode at low (40 bpm), middle (60 bpm), and high (90 bpm) HR levels with an oscillometric cuff-based device (Sphygmocor XCEL). There was no difference in central systolic BP at the middle versus the high HR level (mean 121.2 ± 13.0 and 121.2 ± 12.1 mmHg, respectively, P = 0.9), but at the low HR level, it was significantly lower than at the middle HR level (mean 117.2 ± 13.1 and 121.2 ± 13.0 mmHg, P < 0.01). Our acute study provides evidence to suggest that at a HR of <60 bpm, sick sinus syndrome patients may have a lower central BP than at a higher HR, despite the proposed augmenting effects of low HR on central BP.

PP.09.10] HEART RATE REDUCTION DOES NOT LEAD TO AN INCREASE IN CENTRAL BLOOD PRESSURE IN SICK SINUS SYNDROME PATIENTS WITH PERMANENT PACEMAKERS

Objective: Central aortic blood pressure may be superior to brachial blood pressure in predicting cardiovascular target organ damage. Heart rate (HR) reduction with non-vasodilating beta-blockers has been associated with an unfavourable central blood pressure profile in hypertensive patients. However, the interaction between HR and central hemodynamics remains unclear. The aim of this study was to evaluate the isolated role of HR on central hemodynamics in sick sinus syndrome patients with permanent pacemakers in a range of HR-s from 40 to 90 bpm. Design and method: We included 27 subjects (mean age 66 years, 12 men) with dual-chamber pacemakers implanted due to sick sinus syndrome. We determined central blood pressure, central augmentation index (cAIx) and carotid-femoral pulse wave velocity (cf-PWV) noninvasively during AAI-pacing from low (40 bpm) to middle (60 bpm) and high (90 bpm) HR level with an oscillometric cuff-based device (Sphygmocor XCEL, AtCor Medical, Australia). Results: The mean HR-s at low, middle and high HR levels were 49, 60 and 87 bpm, respectively (p < 0.01). From the low to middle HR level, central systolic blood pressure (cSBP) increased (mean 117 and 121 mmHg, respectively, p < 0.01) in parallel with brachial systolic blood pressure (bSBP) (mean 126 and 131 mmHg, respectively, p < 0.01). From the middle to high HR level, bSBP increased (mean 131 and 133 mmHg, respectively, p = 0.09) compared to cSBP which remained unchanged (mean 121 and 121 mmHg, respectively; mean difference in pSBP-cSBP from the middle to high HR level 2 mmHg (95% CI 1.6, 2.7 mmHg, p < 0.01)). cAIx remained unchanged from the low to middle HR level but decreased thereafter. Increasing HR resulted in an increase in cf-PWV from the low to middle and from the middle to high HR level. Conclusions: Our study provides evidence to suggest that in an acute setting, sick sinus syndrome patients with HR-s below 60 bpm may have a lower central blood pressure compared to patients with higher HR-s despite the known augmenting effects of low HR on central blood pressure. However, the results need to be confirmed in a chronic setting.

Effects of Acute Stress on Decision Making.

The study examined the effects of a social stressor (Trier Social Stress Test) on 24 male and 32 female college students' affective and physiological reactivity and their subsequent performance on a decision-making task (Iowa Gambling Task). The 56 participants were randomly assigned to a social stressor or a control condition. Compared to controls, participants in the stress condition responded with higher heart rates and skin conductance responses, reported more negative affect, and on the decision-making task made less advantageous choices. An exploratory regression analysis revealed that among men higher levels of heart rate were positively correlated with riskier choices on the Iowa Gambling Task, whereas for women this relationship was curvilinear. Exploratory correlational analyses showed that lower levels of skin conductance within the stress condition were associated with greater levels of substance use and gambling. The results suggest that the presence of a stressor may generally result in failure to attend to the full range of possible consequences of a decision. The relationship pattern between the degree of stress responding and successful decision making may be different for men and women.

Abstract # 1795 Plasma levels of lipopolysaccharide-binding protein in response to psychosocial stress induction: Association with sympathetic nervous system response

Background Numerous studies have linked the gut microbiota with stress- and inflammation-related diseases, such as depression and the metabolic syndrome. It has been hypothesized that higher circulating concentrations of lipopolysaccharide (LPS), an inflammatory cell wall component of (gut residing) Gram-negative bacteria, are caused by stress-induced increases in barrier permeability, allowing the translocation of bacteria and/or LPS across the gut wall. Goal Investigate if acute psychosocial stress increases gut permeability as indicated by plasma concentrations of LPS-binding protein (LBP), a biomarker reflecting plasma exposure to LPS, and explore its relationship to inflammation and the autonomic nervous system response. Methods 12 young adults (5 women and 7 men) underwent a standardized laboratory stress test. Heart rate (HR) was measured continuously, and plasma interleukin (IL)-6 and LBP levels were measured at baseline and after the stressor (+30 min, +90 min). Results Mean IL-6 levels (p = .003), but not LBP levels were significantly increased 30 min after the stressor. After adjusting for sex and BMI, overall LBP concentrations (represented as area under the curve) were positively correlated with HR during the stress test (r = .737, p = .015). Conclusion Acute psychosocial stress does not significantly change LBP plasma levels. However, higher LBP concentrations are associated with higher HR levels after stress induction, suggesting a relationship between microbial presence and increased sympathetic nervous system reactivity.

Testing for the presence of coping styles in a wild mammal

Coping styles represent alternative response patterns in reaction to a stressor. The coping style model provides a set of predictions about correlations between behavioural and neurophysiological reactions to a stressful situation. According to this model, high levels of activity should be correlated with high levels of aggressiveness at the behavioural level, and to high sympathetic reactivity, low parasympathetic reactivity (higher heart rate levels) and low hypothalamus–pituitary–adrenocortical (HPA) axis reactivity (low production of glucocorticoids in response to a stressor). More recent versions of the model, however, are challenging this view and consider the possibility of independent axes of coping style and stress reactivity. The coping style model has mainly been tested on artificially selected or inbred lines in laboratory settings. Such a situation restricts its generalization to a larger number of species and there is a need for studies testing it in the wild under more natural situations. Here, we test the predictions of the coping style model in a wild alpine marmot, Marmota marmota, population. We show that several behavioural (i.e. exploration in an open field, impulsivity and docility) and neurophysiological traits (i.e. heart rate, breathing rate and cortisol production) assumed to represent individual differences in coping style were significantly repeatable over 2–3 years. Not all the correlations between traits predicted by the coping style model were found in marmots, which supports the more recent two-axes model. Furthermore, most correlations were observed at the between-individual level, and the within-individual correlations (i.e. phenotypic plasticity) were weaker. Overall, our results support the prediction of the coping style model, but highlight the fact that the association between traits found in artificial conditions may be weaker in a more natural setting.

Neurocardiac dysregulation and neurogenic arrhythmias in a transgenic mouse model of Huntington's disease

Huntington's disease (HD) is a heritable neurodegenerative disorder, with heart disease implicated as one major cause of death. While the responsible mechanism remains unknown, autonomic nervous system (ANS) dysfunction may play a role. We studied the cardiac phenotype in R6/1 transgenic mice at early (3 months old) and advanced (7 months old) stages of HD. While exhibiting a modest reduction in cardiomyocyte diameter, R6/1 mice had preserved baseline cardiac function. Conscious ECG telemetry revealed the absence of 24-h variation of heart rate (HR), and higher HR levels than wild-type littermates in young but not older R6/1 mice. Older R6/1 mice had increased plasma level of noradrenaline (NA), which was associated with reduced cardiac NA content. R6/1 mice also had unstable R-R intervals that were reversed following atropine treatment, suggesting parasympathetic nervous activation, and developed brady- and tachyarrhythmias, including paroxysmal atrial fibrillation and sudden death. c-Fos immunohistochemistry revealed greater numbers of active neurons in ANS-regulatory regions of R6/1 brains. Collectively, R6/1 mice exhibit profound ANS-cardiac dysfunction involving both sympathetic and parasympathetic limbs, that may be related to altered central autonomic pathways and lead to cardiac arrhythmias and sudden death.

Heart Rates of Elementary Physical Education Students During the Dancing Classrooms Program

We examined how different types of dance activities, along with their duration, influenced heart rate responses among fifth-grade physical education students (N = 96) who participated in the Dancing Classrooms program. Results indicated that the overall Dancing Classrooms program elicits a moderate cardiovascular heart rate response (M = 124.4 bpm), in which 47% of class time was spent above a 60% maximal heart rate threshold. The swing dance in particular (M = 143.4 bpm) stimulated a much higher heart rate level than all other dances in the program, with a mean heart rate change of 52.6 bpm. Girls (127.3 bpm) achieved marginally higher heart rates (p = .059) than boys (121.1 bpm).

Diurnal variations in arousal: a naturalistic heart rate study in children with ADHD

Previous studies suggest an altered circadian regulation of arousal in children with attention-deficit hyperactivity disorder (ADHD) as measured by activity, circadian preference, and sleep-wake patterns. Although heart rate is an important measure to evaluate arousal profiles, to date it is unknown whether 24-h heart rate patterns differentiate between children with and without ADHD. In this study, 24-h heart rate data were collected in 30 non-medicated children with ADHD (aged 6-11) and 30 sex-, class-, and age-matched normal controls in their naturalistic home and school setting, during 5 days. Simultaneously, 24-h activity patterns were registered. Confounding effects of demographic variables (e.g., age, sex, BMI, pubertal stage) and comorbid internalizing and externalizing problems on heart rate levels were additionally assessed. Longitudinal analysis showed that heart rate levels were overall higher in the ADHD group (p < 0.01)--with the largest effects during afternoon and night--in a model controlling for age. Other factors did not significantly contribute to variations in heart rate levels. Compared to controls, children with ADHD showed higher activity levels during daytime (especially early afternoon), but not during nighttime (p < 0.05). Post hoc analyses showed that environmental effects might influence daytime variations. Findings suggest an autonomic imbalance in children with ADHD as compared to controls, with higher heart rate levels in the ADHD group. Nighttime tachycardia in this group could not be explained by nighttime activity levels or comorbid externalizing/internalizing problems. Further research on autonomic functioning in ADHD is recommended because of the major impact of higher resting heart rate on health outcomes.

Toward the Predeployment Detection of Risk for PTSD

Toward the Predeployment Detection of Risk for PTSD

Cuff inflation during ambulatory blood pressure monitoring and heart rate

Twenty four-hour ambulatory blood pressure monitoring is a clinically validated procedure in evaluation of blood pressure (BP). We hypothesised that the discomfort during cuff inflation would increase the heart rate (HR) measured with 24-h ambulatory BP monitoring compared to a following HR measurement with a 24-h Holter monitor. The study population (n = 56) were recruited from the outpatient's clinic at the Department of Nephrology, Aalborg Hospital, Aarhus University Hospital at Aalborg, Denmark. All the patients had chronic kidney disease (CKD). We compared HR measured with a 24-h Holter monitor with a following HR measured by a 24-h ambulatory BP monitoring. We found a highly significant correlation between the HR measured with the Holter monitor and HR measured with 24-h ambulatory blood pressure monitoring (r = 0.77, p < 0.001). Using the Bland-Altman plot, the mean difference in HR was only 0.5 beat/min during 24 hours with acceptable limits of agreement for both high and low HR levels. Dividing the patients into groups according to betablocker treatment, body mass index, age, sex, angiotensin-converting enzyme inhibitor treatment, statins treatment, diuretic treatment, or calcium channel blocker treatment revealed similar results as described above. The results indicate that the discomfort induced by cuff inflation during 24-h ambulatory BP monitoring does not increase HR. Thus, 24-h ambulatory BP monitoring may be a reliable measurement of the BP among people with CKD.

The Impact of Perfectionistic Self-Presentation on the Cognitive, Affective, and Physiological Experience of a Clinical Interview

Perfectionistic self-presentation is proposed as a deleterious interpersonal style that has an influence in clinical contexts that involves promoting a public image of perfection and avoiding displays and self-disclosures of imperfections. A sample of 90 clinical patients taking part in a clinical interview were assessed in terms of their levels of perfectionistic self-presentation and trait perfectionism and their affective, cognitive, and physiological reactions. Perfectionistic self-presentation dimensions were associated with (1) greater distress before and after the interview, (2) negative expectations and greater threat prior to the interview, and (3) post-interview dissatisfaction. Analyses of physiological data found that perfectionistic self-presentation was associated with higher levels of heart rate when discussing past mistakes, and, as expected, the need to avoid disclosing imperfections predicted higher levels of and greater change in heart rate when discussing past mistakes. Analyses that controlled for trait perfectionism and emotional distress showed that the need to avoid disclosing imperfections was a unique predictor of (1) appraisals of the interviewer as threatening before the interview and as dissatisfied after the interview; (2) negative pre and post self-evaluations of performance; and (3) greater change in heart rate when discussing mistakes. Perfectionistic self-presentation is discussed as an interpersonal style that can influence therapeutic alliance and treatment success.