title: Attributional styles and stress-related atherogenic plasma lipid reactivity in essential hypertension.
abstract: OBJECTIVE
  Hypertension and an atherogenic lipid profile are known risk factors for coronary heart disease (CHD). Hypertensives show greater changes in atherogenic plasma lipids to acute stress than normotensives. In this study, we investigated whether attribution of failure is associated with lipid stress reactivity in hypertensive compared with normotensive men.
  
  
  METHODS
  18 normotensive and 17 hypertensive men (mean±SEM; 45±2.2 years) underwent an acute standardized psychosocial stress task that can be viewed as a situation of experimentally induced failure. We assessed external-stable (ES), external-variable (EV), internal-stable (IS), and internal-variable (IV) attribution of failure and psychological control variables (i.e. extent of depression and neuroticism). Moreover, total cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), and norepinephrine were measured immediately before and several times after stress.
  
  
  RESULTS
  ES moderated TC- and LDL-C-stress reactivity in hypertensives as compared to normotensives (interaction mean arterial pressure [MAP]-by-ES for TC: F=3.71, p=.015; for LDL-C: F=3.61, p=.016). TC and LDL-C levels were highest in hypertensives with low ES immediately after stress (p≤.039). In contrast, hypertensives with high ES did not differ from normotensives in TC and LDL-C immediately after stress (p's>.28). Controlling for norepinephrine, depression, and neuroticism in addition to age and BMI did not significantly change results. There were no significant associations between lipid baseline levels or aggregated lipid secretion and IS, IV, or EV (p's>.23).
  
  
  CONCLUSIONS
  Our data suggest that ES may independently protect from elevated lipid stress reactivity in hypertensive individuals. ES thus might be a protective factor against CHD in hypertension.
authors.affiliation: Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kuebler
authors.affiliation: Institute of Biomedical Ethics, University of Zurich, Zurich, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Trachsel
authors.affiliation: Division of Psychosomatic Medicine, Department of General Internal Medicine, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.affiliation: Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
authors.forename: Elvira
authors.initials: E
authors.lastname: Abbruzzese
authors.affiliation: Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
authors.affiliation: Biological and Health Psychology, University of Bern, Bern, Switzerland. Electronic address: petra.wirtz@psy.unibe.ch.
authors.forename: Petra H
authors.initials: PH
authors.lastname: Wirtz
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000097:blood* / Q000523:psychology*; D001794:Blood Pressure; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000150:complications; D000075222:Essential Hypertension; D005260:Female; D006184:Habits; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D012307:Risk Factors; D013315:Stress, Psychological / Q000097:blood*
chemical_list: D008078:Cholesterol, LDL; D009638:Norepinephrine
keywords: Attributional styles; Cholesterol; Hypertension; Low-density-lipoprotein cholesterol; Plasma lipids; Psychosocial stress; Trier Social Stress Test