Correspondence between laboratory and ambulatory measures of cardiovascular reactivity: A multilevel modeling approach

Kamarck, Thomas W.; Schwartz, Joseph E.; Janicki, Denise L.; Shiffman, Saul; Raynor, Douglas A.

doi:10.1111/1469-8986.00069

Cited by 87 publications

(74 citation statements)

References 43 publications

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“…22 BP reactivity is related to ambulatory BP elevations in response to everyday stressful circumstances. 23,24 Although our data confirm a longstanding psychosomatic hypothesis, they do not elucidate the nature of that association. [25][26][27] One can posit direct effects of frequent BP changes on the vasculature, leading to damage and impairing arterial compliance.…”

Section: Discussioncontrasting

confidence: 85%

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

et al. 2004

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Background-A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults. Methods and Results-We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of Ͼ4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges-cold pressor, star tracing, and video game tasks-were measured.Hypertensive status was defined as use of antihypertensive medication or measured BP Ն140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred (PϽ0.0001 to Ͻ0.01). The systolic BP effect for the cold pressor task was apparent for women and for whites in race-and gender-specific models, whereas the diastolic BP effect for the video game was apparent for men. Conclusions-Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.

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Section: Discussioncontrasting

confidence: 85%

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

et al. 2004

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“…37,38 Laboratory stress responses have been found to correspond with reactivity to challenges of daily life during ambulatory blood pressure monitoring. 39 Thus, in the present context, it seems that measurements performed during situations involving elements of stress may be more useful as predictors of future blood pressure than resting measurements. 34,40 One possible mechanism explaining the actual relationship between stress reactivity and development of hypertension could be the direct effect of frequent increases in blood pressure on the vasculature.…”

Section: Flaa Et Al Sympathoadrenal Activity Predicts Blood Pressurementioning

confidence: 82%

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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“…This might be one of the reasons that the generalization of cardiovascular reactivity from standardized laboratory situations to actual real life situations is only moderate at best. 41,42 …”

Section: Discussionmentioning

confidence: 99%

Genetic influence on blood pressure measured in the office, under laboratory stress and during real life

Wang

Ding

et al. 2010

Hypertens Res

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To determine to what extent the genetic influences on blood pressure (BP) measured in the office, under psychologically stressful conditions in the laboratory and during real life are different from each other. Office BP, BP during a video game challenge and a social stressor interview, and 24-h ambulatory BP were measured in 238 European American and 186 African American twins. BP values across the two tasks were averaged to represent stress levels. Genetic model fitting showed no ethnic or gender differences for any of the measures. The model fitting resulted in heritability estimates of 63, 75 and 71% for office, stress and 24-h systolic BP (SBP) and 59, 67 and 69% for diastolic BP (DBP), respectively. Up to 81% of the heritability of office SBP and 71% of office DBP were attributed to genes that also influenced stress BP. However, only 45% of the heritability of 24-h SBP and 49% of 24-h DBP were attributed to genes that also influence office BP. Similarly, about 39% of the heritability of 24-h SBP and 42% of 24-h DBP were attributed to genes that also influence stress BP. Substantial overlap exists between genes that influence BP measured in the office, under laboratory stress and during real life. However, significant genetic components specific to each BP measurement also exist. These findings suggest that partly different genes or sets of genes contribute to BP regulation in different conditions.

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Correspondence between laboratory and ambulatory measures of cardiovascular reactivity: A multilevel modeling approach

Cited by 87 publications

References 43 publications

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

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

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

Genetic influence on blood pressure measured in the office, under laboratory stress and during real life

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