Cardiovascular reactivity to stress predicts future blood pressure status.

Matthews, Karen A.; Woodall, Karen L.; Allen, Merrill J.

doi:10.1161/01.hyp.22.4.479

Cited by 368 publications

(221 citation statements)

References 17 publications

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“…Our findings are supported, however, by observations that earlier gestational age also within its normal variation is associated with adverse cardiovascular health outcomes such as the resting BP level in adult women 2 and mortality from cerebrovascular disease. 37 Together with previously described associations of BP reactivity with both resting BP level 38 and magnetic resonance imaging-diagnosed subclinical cerebral infarctions and related findings, 39 our findings suggest that these associations of pre-and perinatal conditions with adult disease are probably in part explained by associations with BP reactivity. In men, we found that lower gestational age was related to lower BP and TPR reactivity.…”

Section: Discussionsupporting

confidence: 85%

Cardiovascular reactivity to psychological stressors in late adulthood is predicted by gestational age at birth

Feldt

Räikkönen

Eriksson³

et al. 2007

J Hum Hypertens

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The relationships of body size and gestational age at birth with adult blood pressure (BP) are relatively modest compared to their stronger associations with cardiovascular disease. BP reactivity is a strong predictor of cardiovascular morbidity, and it is possible that reactivity, rather than resting level, is determined in utero. We investigated whether body size and gestational age at birth predict BP reactivity during experimentally induced psychosocial stress in late adulthood. A total of 73 men and 80 women born after 36 weeks' gestation in Helsinki, Finland, during 1934-1944 underwent the Trier Social Stress Test (TSST); a standardized psychosocial stress test consisting of a public speech and an arithmetic task. Changes in BP were monitored continuously by a non-invasive finger photoplethysmography (Finometer, FMS, Amsterdam, The Netherlands). The results showed that the most robust early determinant of BP reactivity was gestational age; however, with opposite relationships between the sexes (P for interaction o0.001). A 1-week increase in gestational age was associated with a 3.1 mm Hg (95% confidence interval (CI), 0.2 to 6.0) and 1.2 mm Hg (95% CI, À0.1 to 2.6) decreases in systolic and diastolic BP reactivity in women, but with 5.2 mm Hg (95% CI, 1.9 to 8.4) and 2.3 mm Hg (95% CI, 0.9 to 3.8) increases in men. In conclusion, normal variation in gestational age at birth predicts cardiovascular stress reactivity in later adulthood. Given that hypothalamic-pituitary-adrenal axis contributes to the regulation of autonomic nervous system function and the timing of parturition, and shows well-established sex differences, we speculate a role for early programming of this axis in explaining the findings.

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Section: Discussionsupporting

confidence: 85%

Cardiovascular reactivity to psychological stressors in late adulthood is predicted by gestational age at birth

Feldt

Räikkönen

Eriksson³

et al. 2007

J Hum Hypertens

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“…[2][3][4][5][6][7][8][9] This supports the reactivity hypothesis, which states that exaggerated physical or psychological responses to stress identify subgroups with increased cardiovascular risk. 10 However, there are some controversies regarding whether this represents a casual relationship.…”

supporting

confidence: 71%

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

et al. 2008

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Abstract-In the present study we hypothesized that arterial catecholamine concentrations during rest and 2 laboratory stress tests were independent predictors of blood pressure at an 18-year follow-up. At entry, blood pressure, heart rate, and arterial plasma epinephrine and norepinephrine concentrations were measured in 99 healthy men (age: 19.3Ϯ0.4 years, meanϮSD) at rest, during a mental arithmetic test, and during a cold pressor test. After 18.0Ϯ0.9 years of follow-up, resting blood pressure was measured. The norepinephrine and epinephrine concentrations during the mental arithmetic explained 12.7% of the variation of future systolic blood pressure after adjusting for initial resting blood pressure, family history, body mass index, and systolic blood pressure during the stress test in a multiple regression analysis (adjusted R 2 ϭ0.651; PϽ0.001). To conclude, the present study shows that sympathetic nervous activity during mental arithmetic predicts future blood pressure, indicating a possible causal factor in the development of essential hypertension independent of the initial blood pressure. (Hypertension. 2008;52:336-341.)Key Words: blood pressure Ⅲ stress reactivity Ⅲ catecholamines Ⅲ cold pressor test Ⅲ epinephrine Ⅲ mental stress Ⅲ norepinephrine H ypertension and other cardiovascular diseases develop slowly over decades, and although the disease process starts early, clinical manifestations do not usually appear until late middle age. Interestingly, the classical risk factors, like family history, obesity, smoking, diabetes, and hypercholesterolemia, are able to predict only Ϸ50% of future cardiovascular diseases. 1 Thus, much effort has been made to identify other risk factors, and increased reactivity to stress is believed to be one of them.Although previous prospective studies on reactivity as a predictor of future hypertension have given conflicting results, 1 studies with a follow-up of Ͼ5 years tend to show a strong association between cardiovascular hyperreactivity and future hypertension. [2][3][4][5][6][7][8][9] This supports the reactivity hypothesis, which states that exaggerated physical or psychological responses to stress identify subgroups with increased cardiovascular risk. 10

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“…Most of them have observed a relation between an exaggerated response of BP to mental stress tasks and subsequent BP status after a few years of follow-up. [12][13][14][15][16][17][18][19] An important study published by Carroll et al, 20 found that the response of BP to mental stress task Figure 3 Changes of BP during mental arithmetic task in subjects who developed SH or who did not.…”

Section: Discussionmentioning

confidence: 99%

“…11 A relation between an exaggerated response of BP to mental stress tasks and subsequent BP status has been observed in some prospective studies. [12][13][14][15][16][17][18][19] However, other prospective studies did not find these results: a recent published study has shown that pressure reactions to stress provide only a minimal independent contribution of BP at follow-up. 20 The objective of this study was to assess the independent contribution of BP response to mental stress tasks in the development of sustained hypertension (SH) in untreated mildly hypertensive subjects, after 5 years of follow-up.…”

Section: Introductionmentioning

confidence: 92%

Blood pressure reactivity to mental stress task as a determinant of sustained hypertension after 5 years of follow-up

et al. 2003

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Previous studies have reported an increased risk of developing sustained hypertension (SH) in borderline or mildly hypertensive subjects showing an exaggerated response of blood pressure (BP) to mental stress. The aim of this study was to assess if the response of BP to mental stress tasks is an independent predictor of SH. A total of 89 patients with grade 1 hypertension, aged 18-64 years, 62% males, were included. The mean of follow-up was 5.3 years (s.d. 2.1 years). SH was defined as the development of grades 2-3 hypertension (Systolic BPX160 mmHg or diastolic BPX100 mmHg) or to be in antihypertensive treatment after follow-up. Two mental stress tasks: mental arithmetic stress task and a stressful interview (SI) were applied at entry. The subjects were classified as hyper-reactors when BP increase was greater than 35 mmHg for systolic BP or greater than 21 mmHg for diastolic BP, according to the results obtained previously in a normotensive control group. In the univariate analysis, the factors associated with the development of SH were age (P ¼ 0.0007), office diastolic BP (P ¼ 0.014) and hyper-reactivity of BP during a stressful interview (P ¼ 0.003). In the Cox regression model, after adjusting for gender, age, and office BP, the hyper-reactivity of BP during SI was an independent predictor of development of SH. In conclusion, the response of BP to mental stress tasks is useful in predicting SH in young and middle-aged subjects with grade 1 hypertension.

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Cardiovascular reactivity to stress predicts future blood pressure status.

Cited by 368 publications

References 17 publications

Cardiovascular reactivity to psychological stressors in late adulthood is predicted by gestational age at birth

Cardiovascular reactivity to psychological stressors in late adulthood is predicted by gestational age at birth

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

Blood pressure reactivity to mental stress task as a determinant of sustained hypertension after 5 years of follow-up

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