LETTERS TO THE EDITOR by iasiatube.news


									288                                                                                                        J Epidemiol Community Health 2001;55:288

                                                      It seems equally probable that the non-             underestimated sex diVerences in reactivity.
                                                   manual and manual groups may have experi-              She also speculates that the low reactivity in
        LETTERS TO                                 enced the stressor in very diVerent ways.              the non-manual group might have reflected
                                                   Thus, for example, the lower reactivity in the         disengagement from the task.
        THE EDITOR                                 manual group could easily reflect lesser                   We have no information on the subjective
                                                   engagement with the task in this group.                impact of mental arithmetic in our study, but
                                                   Indeed, in the absence of any plausible                given the general tendency for men to be less
                                                   biological mechanism to suggest that higher            declarative than women when it comes to
                                                   socioeconomic groups should show more                  negative aVect,4 one can guess that women
Measuring demographic                              cardiovascular reactivity to stress, an explana-       might respond more negatively. It remains to
                                                                                                          be determined, however, what impact such
group diVerences in                                tion based on diVering subjective reactions to
                                                                                                          reporting tendencies have on cardiovascular
                                                   the arithmetic task seems far more probable.
cardiovascular reactivity                          Without data on subjective experience of the           reactivity. It would be rash to assume, as Dr
                                                                                                          Pollard does, that they have a substantial
to stress using a mental                           test, I suggest that general conclusions about
                                                                                                          impact. I have spent a number of years
                                                   demographically defined diVerences in
challenge in the                                   cardiovascular reactivity to stress are diYcult        exploring cardiovascular reactions to chal-
                                                                                                          lenges such as mental arithmetic and have yet
laboratory: problems of                            to justify from the data presented; the
                                                                                                          to find inter-individual correlations between
                                                   conclusions should be limited to a descrip-
interpretation                                     tion of responses to a mental arithmetic test.         subjective report and magnitude of reaction.
                                                                                                          My experience is far from unique.
EDITOR,—In their recent paper Carroll et al1                                  TESSA M POLLARD                We do have data on performance; women
showed that men and women in non-manual              Department of Anthropology, University of Durham,    did less well in mental arithmetic than men,
occupations exhibited greater diastolic blood                   43 Old Elvet, Durham DH1 3HN, UK          and manual did less well than non-manual
pressure and heart rate responses to a mental      Correspondence to: Dr Pollard                          groups. If the latter finding is considered
arithmetic test than did people in manual          (t.m.pollard@durham.ac.uk)                             consistent with the disengagement hypoth-
occupations, a finding that they contrasted                                                                esis, so must the former. Dr Pollard cannot
with known socioeconomic patterning of                                                                    have it both ways. Indeed, controlling for per-
cardiovascular disease. They also demon-            1 Carroll D, Harrison LK, Johnston DW, et al.         formance variations attenuated the sex diVer-
strated lower systolic blood pressure and              Cardiovascular reactions to psychological
                                                       stress; the influence of demographic variables. J   ences in reactivity. I am not unsympathetic to
heart rate reactivity to the test in women,                                                               the notion that social class diVerences in
                                                       Epidemiol Community Health 2000;54:876–7.
which they considered more consistent with          2 Stoney CM, Davis M, Matthews KA. Sex                reactivity stem, at least in part, from diVer-
sex diVerences in cardiovascular disease. It           diVerences in physiological responses to stress    ences in task engagement, even though they
does indeed seem likely that lower catecho-            and in coronary heart disease. Psychophysiology
                                                                                                          survived adjustment for performance in the
lamine and blood pressure reactivity to stress
                                                    3 Girdler SS, Light KC. Hemodynamic stress            present analyses. However, at the very least,
in women is one of the explanations for their
lower rates of cardiovascular disease, an eVect        responses in men and women examined as a           our data suggest that could we equate
                                                       function of female menstrual cycle phase. Int J    engagement, by using a task that is less likely
that has been ascribed largely to the eVects of        Psychophysiol 1994;17:233–48.
oestrogen.2                                                                                               to privilege higher social class participants,
                                                    4 Girdler SS, Jamner LD, Jarvik M, et al. Smoking
   However, I suggest that Carroll et al cannot        status and nicotine administration diVerentially   lower social class participants would still not
claim to have tested cardiovascular reactivity         modify hemodynamic stress reactivity in men        show higher reactions and, thus, our conclu-
to stress, but only cardiovascular reactivity to       and women. Psychosom Med 1997;59:294–306.          sion remains appropriate. Finally, it is worth
a mental arithmetic test. Presumably the                                                                  pointing out that cardiovascular reactions to
authors’ aim was to use a mental arithmetic                                                               mental arithmetic are correlated with reac-
task to cause feelings of stress among partici-    Author’s reply                                         tions to other commonly used stress chal-
pants, but they provide no information on                                                                 lenges,5 and that our participants were tested
whether this was indeed the eVect of the task,     EDITOR,—In analyses of three large age                 at home and not “in the laboratory”.
and, most crucially, whether its eVects were       cohorts of men and women, we found that                                           DOUGLAS CARROLL
the same in all the demographic groups             women showed lower cardiovascular reac-                   School of Sport and Exercise Sciences, University of
tested. Girdler and Light3 showed that             tions to a mental arithmetic challenge than                        Birmingham, Birmingham B15 2TT, UK
women reported greater feelings of helpless-       men and manual lower reactions than non-
ness than men in response to a variety of          manual social class groups.1 We concluded
laboratory stressors, but particularly after a     that diVerences in cardiovascular disease
mental arithmetic task, as well as reporting                                                               1 Carroll D, Harrison LK, Johnston DW, et al.
                                                   among men and women could be mediated                      Cardiovascular reactions to psychological
being less calm after all tasks, despite being     by variations in cardiovascular reactivity, but            stress: the influence of demographic variables. J
more satisfied with their performance. In a                                                                    Epidemiol Community Health 2000;54:876–7.
                                                   that this sort of mechanism was unlikely to
diVerent sample, Girdler et al4 showed that                                                                2 Girdler SS, Light KC. Hemodynamic stress
                                                   underlie diVerences in the prevalence of                   responses in men and women examined as a
women reported significantly more tension
during a mental arithmetic task than did           cardiovascular disease among diVerent social               function of female menstrual cycle phase. Int J
                                                   class groups. Dr Pollard challenges these                  Psychophysiol 1994;17:233–48.
men. It is certainly possible that similar                                                                 3 Girdler SS, Jamner LD, Jarvik M, et al. Smoking
eVects may have occurred in the experiments        conclusions, largely on the basis of our use of            status and nicotine administration diVerentially
conducted by Carroll et al, in which case we       mental arithmetic as a stress task. She cites              modify hemodynamic stress reactivity in men
might be even more impressed by the fact           scattered findings by Girdler and colleagues2 3             and women. Psychosom Med 1997;59:294–306.
                                                   that women feel more helpless after but                 4 Niven CA, Carroll D, eds. The health psychology
that women showed less cardiovascular re-                                                                     of women. Reading: Harwood, 1993.
sponse, and more likely to ascribe this to bio-    tenser during mental arithmetic, and argues             5 Turner JR. Inter-task consistency: An integra-
logical diVerences between men and women.          that our study may have, if anything,                      tive review. Psychophysiology 1988;25:235–8.


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