Cardiovascular psychophysiology

Both environmental and predispositional factors are of importance in the pathogenesis of cardiovascular (CV) disease. In humans, it is difficult to characterize the pathogenic environmental factors (exposures) because of the long time-span of pathogenesis. Perceived effort, control, social isolation, and absence of reward seem to increase the risk of CV diseases. It is methodologically easier to measure predispositional factors at one point in time and then record disease after some years; and there are several reports of associations between personality traits or behaviour patterns and CV disease. Recent psychophysiological research has focused on CV hyper-reactivity to challenge. Hyperreactivity seems to be common in the offspring of hypertensives. This relation may be psychophysiological rather than physiological. Several questions remain regarding the validity and reliability of the hyper-reactivity construct. Studies of social hierarchies in animals have shown that social interactions produce pronounced psychophysiological responses. The existence of several differentiated CV response patterns may explain the contradictory findings of studies that only measure one or few physiological parameters. Predisposition to behaviours and reactivity of physiological systems may be accentuated by dominance-subordinate interactions. The availability of control and the perception of mastery is crucial in terminating responding to stressors. The presence of relatively constant response patterns to social interactions suggests that social interactions must be taken into account. Focus of CV psychophysiology should shift to studies of behavioural and somatic responses during social interactions.