Cardiovascular Reactivity to Psychological Stress in Healthy Children

Murphy, Joseph K.; Alpert, Bruce S.; Willey, Elaine S.; Somes, Grant W.

doi:10.1111/j.1469-8986.1988.tb00977.x

Cited by 59 publications

(30 citation statements)

References 40 publications

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“…The ambulatory blood pressure recordings were performed after baseline casual blood pressure measurements, completion of a 3-day diet record and short activity questionnaire, cardiovascular reactivity testing with a video game procedure, and a maximal exercise test. 8 - 10 The subject was seated and the ambulatory blood pressure recorder (Spacelabs model 5200, Spacelabs Inc., Redlands, Washington) applied and calibrated. To calibrate the ambulatory blood pressure recorder, the recorder was connected to a mercury column, and then it was determined if three simultaneous readings of the ambulatory blood pressure recorder and those of a technician using the mercury column and a stethoscope agreed to within ±3 mm Hg for both systolic and diastolic blood pressures.…”

Section: Methodsmentioning

confidence: 99%

“…Subjects were recruited from churches, schools, and social organizations as described previously. 8 - 10 Of these, 199 (88%) successfully completed the 24-hour protocol. The remaining adolescents either did not have a successful calibration (see below) or did not have a successful recording (e.g., greater than 25% of the readings during the recording were artifacts or subjects had less than 20 hours of data).…”

Section: Subjectsmentioning

confidence: 99%

“…Casual blood pressure and heart rate measurements were obtained with the Dinamap blood pressure monitor (model 1846SX, Critikon, Tampa, Florida) before the ambulatory blood pressure recording procedure as part of the overall protocol. 8 - 10 The casual measurements were the average of three readings taken while the subject was in the seated position after 5 minutes of sitting quietly. …”

Section: Subjectsmentioning

confidence: 99%

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Race and gender influence ambulatory blood pressure patterns of adolescents.

et al. 1989

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The purpose of this study was to examine ambulatory blood pressure and heart rate patterns in healthy, normotensive adolescents and to determine the influence of race and gender on these patterns. Ambulatory blood pressure recordings were performed on 199 adolescents; 42 were black males, 55 were white males, 65 were black females, and 37 were white females. The mean age (±SD) was 13±2 years. Blood pressure readings were obtained with an automatic, noninvasive recorder. Black adolescents and white adolescents had similar blood pressures while awake (116/69 vs. 116/69 mm Hg), with boys having higher levels of systolic blood pressure (118 vs. 114 mm Hg) and comparable levels of diastolic blood pressure (69 vs. 69 mm Hg) relative to girls. The patterns while the adolescents were asleep, however, were different. White boys (106 mm Hg), white girls (105 mm Hg), and black girls (105 mm Hg) had similar systolic blood pressures during sleep. Black boys (112 mm Hg), however, had significantly higher systolic blood pressures while asleep. Black adolescents, as a group, had significantly higher diastolic blood pressures than white adolescents while asleep (64 vs. 61 mm Hg). Changes in blood pressure from awake to asleep were not related to changes in heart rate. Results of this study indicate that both race and gender are important determinants of the diurnal pattern of blood pressure and heart rate in adolescents. (Hypertension 1989;14:598-603)

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Section: Methodsmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

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Race and gender influence ambulatory blood pressure patterns of adolescents.

et al. 1989

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“…14 The 10-minute video game stressor "Break Out" (Atari Inc) was presented under a monetary incentive challenge based on the protocol of Murphy et al 15 Hemodynamic readings were obtained during minutes 1, 3, 5, 7, and 9 of the video game task. The video game controller was secured at a position comfortable for use with the subject's right hand, even if they were left-handed.…”

Section: Reactivity Tasksmentioning

confidence: 99%

Impaired Stress-Induced Pressure Natriuresis Is Related to Left Ventricle Structure in Blacks

et al. 2002

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Abstract-The mechanisms through which stress may contribute to the racial difference in the prevalence of essential hypertension and associated target organ damage remain unclear. This study examined differences in stress-induced pressure natriuresis in 69 black and 52 white normotensives age 14 to 27 years, all with a positive family history of hypertension. Urine samples for sodium excretion were collected before and after a series of tasks (video game challenge, forehead cold stimulation). The average blood pressure across the 2 tasks and the average increase in blood pressure to the 2 tasks were calculated. Key Words: stress Ⅲ sodium Ⅲ race Ⅲ blood pressure Ⅲ echocardiography Ⅲ hypertension, essential T he prevalence and consequences of essential hypertension are much greater in blacks than in whites. 1 The mechanisms through which stress might contribute to these differences remains unclear. The vast majority of studies to date examined and provided support for the "reactivity hypothesis" (reviews 2-4 ). This hypothesis postulates that blacks show exaggerated blood pressure (BP) responses to stress, which produce vascular damage underlying the premature development of essential hypertension and associated target organ damage. However, the physiological response to stress is dynamic and includes both the response to the stressor per se and the changes that restore BP to prestress levels. This is accomplished in part through natriuresis, which reduces blood volume and therefore BP. 5 This part of the stress response is understudied but represents an alternative hypothesis to explain how stress may contribute to the racial differences. 4,6 -8 Our "pressure natriuresis" hypothesis postulates that stress-induced impaired sodium regulation leads to an extended period of elevated BP in blacks. The resulting increased BP load leads to the early development of hypertension and its sequelae. The pressure natriuresis hypothesis is particularly appealing because of the well-known greater sensitivity of BP to sodium in blacks (reviews 9 -11 ).The purpose of this study was to begin to test this hypothesis by examining racial differences in urinary sodium excretion (U Na V) and BP during a series of stressors. We then examined the relationship of the patterns to left ventricular (LV) structure to examine the possible clinical significance of this response pattern. Methods SubjectsAll procedures were approved by the Human Assurance Committee of the Medical College of Georgia, and the procedures were followed in accordance with the institutional guidelines. Informed consent and both parental consent and assent of the child (if Ͼ18 years) were obtained before testing. The 121 healthy normotensive subjects are part of ongoing longitudinal study that examines the precursors to the development of hypertension in high-risk youths. All of the subjects have a physician-verified family history of essential hypertension in 1 or both biological parents and Ն1 grandparents, as described previously. 12,13 The subject characteristics ar...

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“…7 The greater reactivity of black children may relate to the greater prevalence of hypertension among black adults.…”

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confidence: 99%

Race and cardiovascular reactivity. A replication.

et al. 1988

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SUMMARY In a previous study, we reported that black children demonstrated greater cardiovascular reactivity than did white children to the psychological stress of a television video game. Reliance on urban volunteers and the wide age range of the children may have limited conclusions concerning the generalizability of those results. In the present study, 481 of 484 children enrolled in the third grade of the public schools of an entire rural county in Tennessee were examined with the same video game procedure used previously. Results indicated greater heart rate and blood pressure reactivity among black children than among white children. Thus, the previous results were replicated. The greater prevalence of hypertension among black adults may relate to the greater reactivity among black children; reactivity may be either a marker or a mechanism in the development of hypertension. (Hypertension 11: 308-311, 1988) KEY WORDS • hypertension • cardiovascular reactivity • psychological stress racial differences • children K CENT longitudinal studies have indicated that the magnitude of a child's cardiovascular (CV) reactivity to a stress procedure (e.g., cold pressor or mental arithmetic) was associated with subsequent blood pressure (BP) and hypertension.1 " 3 However, results have not been consistent. 4 ' 3 A recent report from our laboratory provided cross-sectional support for the hypothesis that CV reactivity was a marker or mechanism in the development of hypertension.6 Expansion of our sample by over 100 children and utilization of different statistical procedures did little to alter our conclusion that black children compared with white children exhibited exaggerated CV reactivity. 7 The greater reactivity of black children may relate to the greater prevalence of hypertension among black adults.The present investigation was undertaken to delineate further the relationship between race and CV reac-

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Cardiovascular Reactivity to Psychological Stress in Healthy Children

Cited by 59 publications

References 40 publications

Race and gender influence ambulatory blood pressure patterns of adolescents.

Race and gender influence ambulatory blood pressure patterns of adolescents.

Impaired Stress-Induced Pressure Natriuresis Is Related to Left Ventricle Structure in Blacks

Race and cardiovascular reactivity. A replication.

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