(Circulation. 2000;102:1394.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Anticipatory Blood Pressure Responses to Exercise Are Associated With Left Ventricular Mass in Finnish Men
Kuopio Ischemic Heart Disease Risk Factor Study
From the Departments of Psychology and Psychiatry (T.W.K., J.R.J., S.B.M.), University of Pittsburgh, Pittsburgh, Pa; the Department of Epidemiology, School of Public Health (S.A.E., G.A.K.), University of Michigan, Ann Arbor; and the Research Institute of Public Health and Department of Community Health and General Practice (J.E., J.T.S.), University of Kuopio, Kuopio, Finland.
Correspondence to Dr Thomas W. Kamarck, Departments of Psychology and Psychiatry, University of Pittsburgh, 520 Bellefield Professional Bldg, 130 N Bellefield Ave, Pittsburgh, PA 15260. E-mail tkam+{at}pitt.edu
Background—Exaggerated cardiovascular reactivity to psychological demands may contribute to the development of left ventricular (LV) hypertrophy. We examined the cross-sectional association between anticipatory blood pressure (BP) responses to bicycle exercise and LV mass in the Kuopio Ischemic Heart Disease Risk Factor Study, a population-based epidemiological sample.
Methods and Results—Among 876 men from 4 age cohorts (ages 42, 48, 58, and 64 years), we collected echocardiographic assessments of LV mass along with measures of BP response taken before bicycle ergometry testing. Anticipatory BP responses were positively associated with LV mass, with significant associations only among younger (age <50 years) subjects with elevated resting pressures (3-way interactions for anticipatory BPxagexresting pressure for systolic and diastolic BP, all P<0.05; for younger subjects with elevated systolic BP, P<0.01; and for younger subjects with elevated diastolic BP, P<0.001). Among these subgroups, exaggerated anticipatory BP responses (top quartile) were associated with an incremental increase in LV mass of 10% or greater, corrected for body surface area. Results remained significant after adjusting for age, education, salt consumption, and resting BP, and the pattern of findings was maintained among men with no previous history of cardiovascular disease.
Conclusions—The tendency to show exaggerated pressor responses to psychological demands may be a significant independent correlate of LV mass, especially among young men with high resting pressures. This is the first study to examine such associations in a middle-aged population sample.
Key Words: cardiovascular diseases • epidemiology • exercise • stress
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