Long-Term Stability of Cardiovascular and Catecholamine Responses to Stress Tests

Abstract

Abstract-Cardiovascular (CV) hyperreactivity to stress must be reasonably stable if it is considered to be important in the development of hypertension and CV disease. The aim of the present study was to assess long-term stability of blood pressure, heart rate, epinephrine, and norepinephrine responses to a cold pressor test and a mental arithmetic stress test. Eighty-one subjects selected from the first (nϭ30), 50th (nϭ30), and 95th to 99th (nϭ39) percentiles of the mean blood pressure distribution at a military draft procedure were tested on 2 occasions 18 years apart. Stress responses were measured during a cold pressor test (hand immersed in ice water for 1 minute) and during a mental stress test (subtraction for 5 minutes). Intra-arterial blood pressure measurements and arterial catecholamine samples were taken at the initial examination. At follow-up, noninvasive Finapres beat-to-beat blood pressure measurements and venous plasma catecholamine samples were used. The 18-year correlations of the CV and epinephrine absolute responses during mental stress ranged from 0.6 to 0.8. The entry/follow-up correlation of systolic blood pressure during the mental stress test (95% CI: 0.69 to 0.86) was significantly higher than during the cold pressor test (95% CI: 0.30 to 0.65), and responses to mental stress overall appeared to be more stable than responses to the cold pressor test. Our study suggests that CV and sympathoadrenal reactivity, specifically to mental stress, are relatively stable individual characteristics. These results support one of the necessary preconditions to consider hyperreactivity involved in the development of hypertension and CV disease. Key Words: physiological stress reactivity Ⅲ stability Ⅲ cold pressor test Ⅲ mental stress Ⅲ epinephrine Ⅲ norepinephrine Ⅲ blood pressure T he reactivity hypothesis suggests that subjects with an exaggerated response to stress are at risk of later developing hypertension and cardiovascular (CV) disease. 1 The validity and the importance of the hypothesis have been discussed extensively for some decades. 2 According to Treiber et al, 3 there is reasonable evidence to suggest that CV reactivity can predict the development of some preclinical states, that is, hypertension and left ventricular hypertrophy. To consider hyperreactivity as a contributing factor in the development of CV diseases, an important precondition needs to be addressed; the reactivity of an individual must show a reasonable stability in the long term. 4 A meta-analysis from 1996 summarizing important testretest studies assessing reactivity found mean Pearson correlation r values of heart rate to equal 0.56, whereas it was 0.41 for systolic and 0.35 for diastolic blood pressures (BPs). 5 Most of the studies included were on the basis of test-retest intervals of days to months, and there were few studies with intervals of more than a year. They concluded that the reproducibility of systolic BP and heart rate declined as the test-retest interval increased, questioning the importance of hyperreac...

Personality traits modulate emotional and physiological responses to stress

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Heart rate reactivity is associated with future cognitive ability and cognitive change in a large community sample

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Circulatory and Central Nervous System Responses to Different Types of Mental Stress

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