title: Childhood socioeconomic status and serotonin transporter gene polymorphism enhance cardiovascular reactivity to mental stress.
abstract: To test the hypothesis that low socioeconomic status (SES) and the 5HTTLPR L allele are associated with increased cardiovascular reactivity (CVR) to stress in a larger sample and that SES and 5HTTLPR genotypes interact to enhance CVR to stress. CVR to mental stress has been proposed as one mechanism linking stress to the pathogenesis of cardiovascular disease. The more transcriptionally efficient long (L) allele of a polymorphism of the serotonin transporter gene promoter (5HTTLPR) has been found associated with increased risk of myocardial infarction. We found the long allele associated with larger CVR to mental stress in a preliminary study of 54 normal volunteers.
  
  
  
  Subjects included 165 normal community volunteers stratified for race, gender, and SES, who underwent mental stress testing.
  
  
  
  Childhood SES as indexed by Father's Education Level was associated with larger systolic blood pressure (SBP) (p < .05) and diastolic blood pressure (DBP) (p = .01) responses to mental stress. The L allele was associated with larger SBP (p = .04), DBP (p < .0001), and heart rate (p = .04) responses to mental stress compared with the short (S) allele. Subjects with the SS genotype and high Father's Education exhibited smaller SBP (5.2 mm Hg) and DBP (2.9 mm Hg) responses than subjects with LL genotype and low Father's Education (SBP = 13.3 mm Hg, p = .002; DBP = 9.7 mm Hg, p < .0001).
  
  
  
  Both the 5HTTLPR long allele and low SES, particularly during childhood, are associated with increased CVR to mental stress, which could account, at least in part, for the increased cardiovascular disease risk associated with these characteristics. If confirmed in further research, these characteristics could be used to identify persons who might benefit from preventive interventions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Box 3926, Duke University Medical Center, Durham, NC 27710, USA. redfordw@duke.edu
authors.forename: Redford B
authors.initials: RB
authors.lastname: Williams
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Marchuk
authors.forename: Ilene C
authors.initials: IC
authors.lastname: Siegler
authors.forename: John C
authors.initials: JC
authors.lastname: Barefoot
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Helms
authors.forename: Beverly H
authors.initials: BH
authors.lastname: Brummett
authors.forename: Richard S
authors.initials: RS
authors.lastname: Surwit
authors.forename: James D
authors.initials: JD
authors.lastname: Lane
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Kuhn
authors.forename: Kishore M
authors.initials: KM
authors.lastname: Gadde
authors.forename: Allison
authors.initials: A
authors.lastname: Ashley-Koch
authors.forename: Ingrid K
authors.initials: IK
authors.lastname: Svenson
authors.forename: Edward C
authors.initials: EC
authors.lastname: Suarez
authors.forename: Saul M
authors.initials: SM
authors.lastname: Schanberg
mesh_terms: D000328:Adult; D000368:Aged; D000483:Alleles; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000235:genetics* / Q000503:physiopathology; D004522:Educational Status; D005220:Fathers; D005260:Female; D020022:Genetic Predisposition to Disease; D006339:Heart Rate; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic; D012701:Serotonin / Q000378:metabolism*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D012923:Social Class; D013315:Stress, Psychological / Q000503:physiopathology*; D014364:Tryptophan / Q000008:administration & dosage
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin; D014364:Tryptophan