Is cardiovascular reactivity associated with atherosclerosis among hypertensives?
Exaggerated cardiovascular reactivity to behavioral challenges among otherwise healthy individuals has been associated with carotid atherosclerosis. We evaluated whether a similar relationship exists among hypertensives, who are at a heightened atherosclerotic risk. Untreated, hypertensive men (n=251; age range, 40 to 70 years; 197 white, 54 black) completed a standardized battery of behavioral challenges while their blood pressure responses to the battery were measured. Mean and maximum carotid intima-media thickness and the occurrence of carotid plaques were subsequently determined using B-mode ultrasonography. Although greater systolic and diastolic responses to the battery were associated with greater mean and maximum intima-media thickness in univariate analyses (P<0.01), only diastolic reactivity showed a unique association with mean and maximum carotid intima-media thickness after multivariate adjustment for age, race, socioeconomic status, smoking and alcohol use, body mass index, lipid profile, glucose and insulin concentrations, and resting blood pressure (P<0.05). Carotid plaque occurrence was associated with greater systolic reactivity (P=0.05) and was marginally associated with greater diastolic reactivity (P=0.07) in univariate analyses, but neither systolic nor diastolic reactivity was uniquely associated with the presence of carotid plaques after multivariate risk-factor adjustment. Among hypertensives, exaggerated behaviorally evoked cardiovascular reactivity appears to be uniquely associated with greater carotid intima-media thickness but not with carotid plaque occurrence.
Gianaros
Peter J
PJ
Cardiovascular Behavioral Medicine Research Program, University of Pittsburgh, Pennsylvania, USA. gianarospj@msx.upmc.edu
Bleil
Maria E
ME
Muldoon
Matthew F
MF
Jennings
J Richard
JR
Sutton-Tyrrell
Kim
K
McCaffery
Jeanne M
JM
Manuck
Stephen B
SB
D000328:Adult; D000368:Aged; D001519:Behavior; D001786:Blood Glucose; D001794:Blood Pressure; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003971:Diastole; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011930:Reaction Time; D012307:Risk Factors; D013599:Systole; D013647:Task Performance and Analysis; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids