Blood pressure increases while signing in a deaf population.

Recent technologic advances have permitted the observation of rapid and significant increases in blood pressure (BP) during verbal communication. The magnitude of the increase in BP is influenced by rate of speech, audience size, status, affective content, environmental setting, and resting BP. The current study evaluates the effect of communicating without vocalizing in 38 deaf adults. Similar to speaking individuals, deaf individuals exhibited significant increases in BP and heart rate (HR) while signing, and the magnitude of the increases were related to resting BP levels. These findings suggest that communication, independent of vocalization, has significant effects on the cardiovascular system. Further studies are needed to explore other dimensions of cardiovascular-communication relationships in deaf populations.

Neuropsychiatric dysfunction in primary Sjögren's syndrome.

Neuropsychiatric complications developed in 40 patients with primary Sjögren's syndrome, none of whom met American Rheumatologic Association criteria for systemic lupus erythematosus. Twenty-five patients had psychiatric abnormalities, the commonest of which were affective disturbances. Of 30 patients tested, 23 had an abnormal pattern in the Minnesota Multiphasic Personality Inventory, the commonest pattern being a "conversion V." In general, patients presented with hysteroid dysphoric features. Of 16 patients undergoing cognitive function testing, 7 showed mild memory impairment with attention and concentration deficits. On clinical evaluation, 27 patients had neurologic abnormalities unattributable to other causes (central and peripheral nervous system in 16 and 19 patients respectively). There was a significant correlation between psychiatric disturbances and neurologic dysfunction, suggesting a possible organic basis for psychiatric dysfunction. The diagnosis of primary Sjögren's syndrome should be considered in patients with unexplained neuropsychiatric illness.

Automated blood pressure recording: the phenomenon of blood pressure elevations during speech.

The recent development of automatic non-invasive blood pressure devices has allowed the rapid and repeated assessment of both the blood pressure and pulse rate in the clinical setting. The development of this technology has allowed us to observe a striking relationship between human communication and blood pressure. Talking produces rapid increases in their systolic, diastolic and mean arterial pressures as well as pulse rate in both normotensive and hypertensive subjects. This phenomenon has been obscured by the conventional assessment techniques of blood pressure measurement. Ignoring the pattern of verbal communication during the assessment of blood pressure can result in marked differences in recorded blood pressure and its interpretation.

The effect of status on blood pressure during verbal communication.

Blood pressures and heart rates of 40 subjects were recorded at 1-min intervals over 35 min during which subjects engaged in a variety of verbal activities with either a high-status or an equal-status experimenter. All subjects showed statistically significant increases in blood pressure and heart rate when speaking compared to when quiet. Blood pressure increases during speaking of the 20 subjects exposed to a high-status experimenter were significantly greater than those of subjects exposed to an equal-status experimenter. While the blood pressure increase was related partly to the act of speaking, the amount of increase was also related to the social distance between experimenter and subject. The results are discussed relative to behavioral interventions for the treatment of hypertension.

Blood pressure changes while talking.

Using a noninvasive automatic device to rapidly and repeatedly measure blood pressure, a striking relationship was found between talking and an increase in blood pressure and heart rate. This finding was demonstrated in a variety of experimental settings (the laboratory, medical clinic, classroom and home) in both children and adults and in both normotensive and hypertensive individuals. A significant positive correlation was also observed between the level of resting pressure and the magnitude of increase in pressure while talking. These findings point toward an important link between human communication and blood pressure control that has previously been overlooked. They also suggest a new conceptual approach to the understanding and treatment of hypertension.

Interpersonal aspects of blood pressure control.

Recent observations of large, consistent increases in blood pressure during human communication prompted a reassessment of the role of interpersonal factors in the behavioral control of hypertension. It was noted that the conceptual framework around which earlier behavioral studies have been carried out, as well as in the physical methods of pressure determination themselves, have contributed to a general lack of information about the role of interpersonal interactions in hypertension. An awareness of the relationship between speaking and pressure elevations has led to the development of a new conceptual approach to understanding the etiology and treatment of hypertension. Using techniques developed out of transactional psychophysiology, hypertensive patients have been able to observe the importance of interpersonal communications in the regulation of their own blood pressure. Evidence from the clinical use of such information suggests that a new way can be developed to help patients lower their blood pressure.

The effects of talking on the blood pressure of hypertensive and normotensive individuals.

The use of a recently developed noninvasive automated blood-pressure device has revealed a striking relationship between human communication and elevations in blood pressure in both normotensive and hypertensive individuals. Individuals with higher resting baseline pressures tended to show greater increases during talking than did those with lower pressures. In some hypertensive individuals increases blood pressure greater than 25-40% occurred within 30 sec after the initiation of human speech. Links between difficulties surrounding human communication and elevations in blood pressure are discussed.

Human speech and blood pressure.

The recent development of a noninvasive automated blood pressure device has revealed a strong relationship between human conversation and blood pressure. Conventional techniques of pressure measurement such as the stethoscope and manometer, which require silence during the measurement, tended to obscure this important relationship. Findings from this study indicate that interpersonal communications surrounding the measurement of blood pressure can rapidly alter systolic and diastolic pressures. In certain situations, changes greater than 20 per cent in systolic and diastolic blood pressure and heart rate can occur within 30 seconds after the initiation of human speech. Such variance can be of critical significance in making clinical judgments concerning hypertension. These findings are discussed in the context of recent nonpharmacological treatment approaches being developed to help control hypertension.