on June 21, 2004
Published online before print June 21, 2004, doi: 10.1161/01.CIR.0000133415.37578.E4
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Submitted on August 25, 2003
From the University of Pittsburgh, Pittsburgh, Pa (K.A.M.); University of Alabama, Birmingham (C.R.K., H.M., S.Z.); University of California, San Francisco (M.A.W.); and University of Michigan, Ann Arbor (D.R.W.). * To whom correspondence should be addressed. E-mail: matthewska{at}upmc.edu.
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 >4100 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 Conclusions--Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.
Revised on January 21, 2004
Accepted on March 13, 2004
Blood Pressure Reactivity to Psychological Stress Predicts Hypertension in the CARDIA Study
Karen A. Matthews PhD*,
140/90 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 (P<0.0001 to <0.01). 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.
Key words: hypertension • risk factors • stress
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