Blood Pressure Reactivity to Psychological Stress Predicts Hypertension in the CARDIA Study

Matthews, Karen A.; Katholi, Charles R.; McCreath, Heather; Whooley, Mary A.; Williams, David R.; Zhu, Sha; Markovitz, Jerry H.

doi:10.1161/01.cir.0000133415.37578.e4

Cited by 361 publications

(289 citation statements)

References 27 publications

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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: 72%

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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supporting

confidence: 72%

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

et al. 2008

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“…Since greater cortisol and blood pressure reactivity to laboratory stress predict certain health risks (e.g., respiratory infections, cardiovascular disease; Cohen et al, 2002;Matthews et al, 2004), it's possible that reduced stress reactivity effects like those observed here may confer some protection against stress-related symptoms and disease risk among stressed adults (cf. Loucks et al, 2015).…”

Section: Discussionmentioning

confidence: 89%

Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial

Lindsay

Young

Smyth

et al. 2018

Psychoneuroendocrinology

162

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Objective: Mindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects. Method:In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor+Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age = 32 years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test.Results: As predicted, Monitor+Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress. Conclusions:This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.Trial Registration: Clinical Trials NCT02433431

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“…Data extracted from each article were neperian logarithm of OR and standard error (SE). One study reported the hazard ratio 21 and another reported the relative risk 22 and these measures were converted into OR 23 . When only confidence intervals were available, they were converted into SE 14 .…”

Section: Data Extractionmentioning

confidence: 99%

Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies

et al. 2009

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Studies have suggested that chronic exposure to stress may have an influence on increased blood pressure. A systematic review followed by a meta-analysis was conducted aiming to assess the effect of psychological stress on blood pressure increase. Research was mainly conducted in Ingenta, Psycinfo, PubMed, Scopus and Web of Science. Inclusion criteria were: published in any language; from January 1970 to December 2006; prospective cohort design; adults; main exposure psychological/emotional stress; outcome arterial hypertension or blood pressure increase > 3.5mmHg. A total of 2,043 studies were found, of which 110 were cohort studies. Of these, six were eligible and yielded 23 comparison groups and 34,556 subjects. Median follow-up time and loss to follow-up were 11.5 years and 21%. Results showed individuals who had stronger responses to stressor tasks were 21% more likely to develop blood pressure increase when compared to those with less strong responses (OR: 1.21; 95%CI: 1.14-1.28; p < 0.001). Although the magnitude of effect was relatively small, results suggest the relevance of the control of psychological stress to the non-therapeutic management of high blood pressure.

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Blood Pressure Reactivity to Psychological Stress Predicts Hypertension in the CARDIA Study

Cited by 361 publications

References 27 publications

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial

Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies

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