
My current research focus is on biological, behavioral and sociocultural factors involved in the etiology and management of hypertension, coronary artery disease, and congestive heart failure. The role of stress and the sympathetic nervous system in disease onset and progression is of central interest. Current research issues being studied include: (i) Ethnicity and gender as factors related to the pathogenesis of hypertension; (ii) Mechanisms by which menopause increases the risk of cardiovascular disease in women; (iii) Mechanisms by which stress may provoke episodes of myocardial ischemia in patients with coronary artery disease; (iv) Stress biomarkers that are associated with adverse clinical outcomes in cardiac patients; (v) The development of coping skills interventions to improve prognosis and quality of life in patients with congestive heart failure; (vi) Circadian blood pressure profiles for risk stratification in patients with hypertension; (vii) Biological and behavioral factors contributing to elevated nighttime blood pressure and blunted nighttime blood pressure dipping.
Comprehensive assessments of cardiovascular regulatory systems define the daily activity in the biobehavioral research laboratory. Assessments include: (i) hemodynamic (blood pressure, cardiac output, systemic vascular resistance) and neurohumoral responses (plasma epinephrine and norepinephrine) during psychological and physical stress testing; (ii) alpha and beta adrenergic receptor function, the baroreceptor reflex, and cardiac vagal control; (iii) endothelial function, and vascular structure and compliance; (iv) left ventricular structure and function by echocardiography; (v) 24-hour ambulatory blood pressure and cardiac output monitoring; (vi) Nonivasive assessments of arterial stiffness and central aortic pressure; (vii) Psychometric assessments of personality and lifestyle characteristics related to cardiovascular disease.
A secondary research interest is in the use and development of noninvasive techniques for evaluating the cardiovascular system. Developments include an ambulatory impedance cardiography system, permitting assessment of 24-hour hemodynamics during normal daily activities, and biomarkers of cardiovascular risk obtained using ultrasound imaging.
RESINT.DOC 1/5/99
Education and Training
- University of Hull (England), Ph.D. 1972
Selected Grants and Awards
- The Effect of Reducing Posttraumatic Stress Disorder Symptoms on Cardiovascular Risk
- Exercise and Pharmacotherapy for Anxiety in Cardiac Patients
- Neurocognition, Lifestyle Modification, and Treatment Resistant Hypertension
- Facility and Web-based Approaches to Lifestyle Change in Resistant Hypertension
- Depression and Heart Failure Disease Progression
- Social Cognition and Aging
- Lifestyle, CVD Risk and Cognitive Impairment
- Stress Management and Biomarkers of Risk in Cardiac Rehabilitation
- Hostility, PTSD and Physical Health Risk Factors
- Ancillary Investigation of Mental Stress Biomarkers in Coronary Heart Disease
- Coping Skills Training in Heart Failure: Outcomes and Mechanisms
- Exercise, Depression, and Cardiac Risk
- Stress and Behavior in Health and Disease
- Behavioral Treatment of High Blood Pressure
- Depression and Autonomic Control in Post-MI Patients
- Biobehavioral Mechanisms of Blood Pressure Dipping
- Exercise Training And Depression In Older Adults
- Stress & Myocardial Ischemia: Mechanisms & Treatment
- Heart Disease in Women: Estrogen Effects on Hemodynamics
- Stress & Congestive Heart Failure:Prognosis & Mechanisms
- Caffeine Effects On Stress Reactivity
- Behavioral Treatment Of Hypertension
- Biobehavioral Mechanisms Of Blood Pressure Regulation
- Menopausal Effects In Cardiovascular Stress Responses
- Behavorial Treatment Of Hypertension
- Biobehvioral Mechanisms Of Blood Pressure Regulation
- Biobehavioral Mechanisms Of Blood Pressure Regulation
- Menopausal Effects On Cardiovascular Stress Response
- Menopausal Effects On Cardiovascular Stress Responses
- Menopausal Effects On Cardiovascular Stress Responses