title: Relationship of clinic, ambulatory, and laboratory stress blood pressure to left ventricular mass in overweight men and women with high blood pressure.
abstract: OBJECTIVE
  This study was designed to evaluate the relationship between left ventricular (LV) mass and blood pressure (BP) recorded in the following contexts: in the clinic, using standard auscultatory procedures, during a typical day using ambulatory BP monitoring, and in the laboratory environment during behavioral stress testing.
  
  
  METHODS
  Ninety-seven men and women with clinic systolic blood pressure (SBP) of 130 to 180 mm Hg and/or diastolic blood pressure (DBP) of 85 to 110 mm Hg and mild to moderate obesity were included in the study. Laboratory stressors included the following tasks: Public Speaking; Anger Interview; Mirror Trace; and Cold Pressor. LV mass was measured using echocardiography and adjusted for body size by dividing by height(2.7) to yield LV mass index (LVMI).
  
  
  RESULTS
  LVMI was positively correlated with clinic SBP (r = 0.24, p <.05), ambulatory SBP (r = 0.34, p <.01), and aggregated laboratory stress SBP (r = 0.28, p <.01). Of the individual stressors, only SBP responses to the Mirror Trace and Cold Pressor tasks were independently correlated with LVMI (r = 0.35 and 0.34, respectively, p values <.01). Hierarchical regression analyses revealed that laboratory stress SBP remained a significant predictor of LVMI, after controlling for BMI and clinic pressure.
  
  
  CONCLUSIONS
  These findings suggest that cardiovascular responses to behavioral stress are associated with individual differences in LVMI in men and women with high blood pressure who are overweight. Laboratory studies of behavioral stress may help promote our understanding of the pathophysiology of LVH.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. Andrew.Sherwood@duke.edu
authors.forename: Andrew
authors.initials: A
authors.lastname: Sherwood
authors.forename: Elizabeth C D
authors.initials: EC
authors.lastname: Gullette
authors.forename: Alan L
authors.initials: AL
authors.lastname: Hinderliter
authors.forename: Anastasia
authors.initials: A
authors.lastname: Georgiades
authors.forename: Michael
authors.initials: M
authors.lastname: Babyak
authors.forename: Robert A
authors.initials: RA
authors.lastname: Waugh
authors.forename: James A
authors.initials: JA
authors.lastname: Blumenthal
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000523:psychology*; D002306:Cardiac Volume / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000523:psychology; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology* / Q000523:psychology; D012931:Social Environment; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology