Independence of pressure reactivity from pressure levels in Tecumseh, Michigan.

Abstract

The relation between blood pressure level and reactivity to mental arithmetic and isometric exercise was investigated in 169 men and 120 women (average age, 32.3 years) from the village of Tecumseh, Mich. In the entire population, the correlation between baseline blood pressure and blood pressure response to both stressors was not significant. Blood pressure reactivity to both stressors was not increased in participants with borderline hypertension (one clinic reading of more than 140 mm Hg systolic and/or 90 mm Hg diastolic). When subjects were classified according to blood pressure response (below and above the 80th percentile), the hyperreactors to mental and physical stress had normal baseline blood pressure values. The hyperreactors also had clinic-to-home blood pressure differences similar to those of the rest of the population. Participants who had borderline hypertension at age 32 years had significantly elevated blood pressures at ages 5, 8, 12, 21, and 22 years. Those who were hyperreactors at age 32 years had normal blood pressures as children and young adults. Results of the present study lend no support to an association between higher blood pressures and blood pressure hyperreactivity. Study participants in Tecumseh will be recalled for future examinations. The independence of blood pressure levels from blood pressure reactivity offers a unique opportunity to prospectively evaluate their separate effects on cardiovascular morbidity.

Increased response to physical and mental stress in men with hypertensive parents.

“…41 A psychological, stress-induced sodium and fluid retention has been reported in subjects at high risk for primary hypertension. 14 In an epidemiological study by Julius et al, 39 hyperreactivity to stress was not found to be a predictor of future hypertension. Another study focusing on the importance of stress and the sympathetic nervous system in the development of hypertension and atherosclerosis has recently been reviewed.…”

“…Other studies have shown that subjects with borderline hypertension had blood pressure responses similar to those of normotensive subjects. 39 Such differences have been demonstrated as an effect of information about blood pressure levels 40 and may also be attributable to different degrees of habituation to the investigative procedures used. In the present study it must be remembered that both groups have been examined several but equally many times and followed up for 5 years and that the baseline blood pressure and heart rate did not differ between subjects with and without positive family histories of hypertension.…”

Effect of home blood pressure and gender on estimates of the familial aggregation of blood pressure. The Tecumseh Blood Pressure Study.

“…11 Data from Framingham 12 and the Australian Trial in Mild Hypertension Study 13 illustrate some of the artifacts inherent in using clinic BP readings, since repeat measures from these populations demonstrate the overestimation of BP by a single walk-in clinic reading. These studies showed later, repeated BP measures, subsequent to the initial readings, exhibited marked regression toward a true mean.…”

Idiodynamic profiles of cardiovascular activity: A P-technique approach

“…The S-R reactivity hypothesis does not apply nomothetically because a universal association between reactivity and CV disease across individuals and CV variables has not been found (cf. Carroll et al, 1995;Ewart & Kolodner, 1992;Foflick et al, 1990;Gerin et al, 1994;Julius et al, 1991;Pickering & Gerin, 1990;Sheffield & Carroll, 1994;van Doornen et al, 1998). This finding is not surprising in view of the myriad pathways to CV disease.…”

“…This approach has been central in testing the "reactivity hypothesis", which links large CV responses to stress with disease risk, and has generated voluminous research, much of it supportive (Blascovitch & Katkin, 1991;Krantz & Manuck, 1984;Manuck, 1994;Rozanski, Blumenthal, & Kaplan, 1999). However, conspicuous negative results suggest that this model cannot explain fully the link between CV responding and disease (Carroll, Smith, Sheffield, Shipley, & Marmot, 1995;Foflick et al, 1990;Gerin, Rosofsky, Pieper, & Pickering, 1994;Julius et al, 1991;Pickering & Gerin, 1990;van Doornen, Snieder, & Boomsa, 1998). Accordingly, calls for new approaches to reactivity have been made (Light, 2001;Linden, Gerin, & Davidson, 2003;Thayer, 1998).…”