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Type D personality is associated with low cardiovascular reactivity to acute mental stress in heart failure patients
Nina Kupper1, Johan Denollet, Jos Widdershoven
1CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical & Clinical Psychology, Tilburg University, The Netherlands.
Insights
Individuals with distressed (Type D) personality and chronic heart failure exhibit a blunted heart rate response to mental stress. This finding suggests a potential mechanism linking Type D personality to adverse cardiovascular outcomes in heart failure patients.
Area of Science:
- Cardiology
- Psychology
- Health Psychology
Background:
- Distressed (Type D) personality is linked to poor coronary heart disease outcomes.
- Mechanisms underlying this association, particularly in heart failure, require further investigation.
Purpose of the Study:
- To investigate if myocardial and hemodynamic responses to mental stress are impaired in Type D patients with chronic heart failure (HF).
Main Methods:
- 99 HF patients completed a public speech stress test.
- Heart rate (HR) and blood pressure (BP) were monitored.
- Type D personality, negative affectivity (NA), and social inhibition (SI) were assessed using the DS14.
Main Results:
- Type D personality correlated with a reduced HR response to stress, independent of medication or atrial fibrillation.
- No significant differences in BP response were observed between Type D and non-Type D HF patients.
- A significant association was found between the interaction of NA and SI scores and systolic BP response.
Conclusions:
- Chronic heart failure patients with Type D personality may display an inadequate cardiovascular response to acute social stress.
- This inadequate response is characterized by a blunted heart rate recovery.
Background:
The distressed (Type D) personality is associated with adverse coronary heart disease outcomes, but the mechanisms accounting for this association remain to be elucidated. We examined whether myocardial and hemodynamic responses to mental stress are disrupted in Type D patients with chronic heart failure (HF).
Methods:
Ninety-nine HF patients (mean age 65±12years; 75% men) underwent a public speech task, during which heart rate (HR) and blood pressure (BP) were recorded. Type D personality and its components negative affectivity (NA) and social inhibition (SI) were assessed with the DS14. General linear models with repeated measures and logistic regression were used to assess differences in stress response and recovery.
Results:
Type D personality was associated with a reduced HR response (F1,93=4.31, p<.05) independent of the use of beta adrenergic blocking agents and the presence of atrial fibrillation. There were no differences between HF patients with and without a Type D personality with respect to the BP response. Examining continuous NA and SI scores and their interaction (NA∗SI), revealed a significant association of NA∗SI with the SBP response (F1,93=4.11, p<.05), independent of BP covariates. Results with respect to HR and DBP responses were comparable to the findings using the dichotomous Type D measure. No significant associations between Type D and recovery patterns were found.
Conclusion:
HF patients with Type D personality may show an inadequate response to acute social stress, characterized by a blunted HR response.
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