Cardiovascular reactivity to stress predicts future blood pressure in adolescence.
OBJECTIVE
This study evaluated the prospective relationship between cardiovascular reactivity to psychological stress and increases in resting blood pressure across a 3-year period among a multiethnic pediatric sample (N = 149).


METHODS
Systolic and diastolic blood pressure; EKG heart rate, pre-ejection period, and mean successive difference of R to R intervals; and impedance-derived measures of cardiac output, stroke volume, and total peripheral resistance were collected during performance of four tasks that elicited different hemodynamic response patterns. Changes from baseline to each task were standardized and averaged to form eight composite scores. Analyses adjusted for time 1 baseline blood pressure and age, body mass index at baseline and change to follow-up, and duration of follow-up.


RESULTS
Rises in SBP over the follow-up period were independently predicted by SBP (beta = 0.161, p =.009), DBP (beta = 0.132, p =.02), and CO (beta = 0.144, p =.02) composite measures of reactivity. Rises in DBP over the follow-up period were predicted by DBP (beta = 0.292, p =.003, respectively), and MSD (beta = -0.176, p <.03) composite measures of reactivity. TPR reactivity was not related prospectively to blood pressure rises.


CONCLUSIONS
This study adds to the pediatric literature documenting an association between cardiovascular reactivity to stress and subsequent risk for hypertension. It is the first to show that impedance-derived measures of myocardial function during stress are related to future blood pressure levels.
Matthews
Karen A
KA
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. matthewska@msx.upmc.edu
Salomon
Kristen
K
Brady
Sonya S
SS
Allen
Michael T
MT
D000222:Adaptation, Physiological; D000293:Adolescent; D001741:Black or African American; D017668:Age of Onset; D001794:Blood Pressure; D015992:Body Mass Index; D002307:Cardiography, Impedance; D003080:Cold Temperature; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011942:Receptors, Adrenergic, alpha / Q000502:physiology; D011943:Receptors, Adrenergic, beta / Q000502:physiology; D012737:Sex Factors; D013315:Stress, Psychological / Q000503:physiopathology*; D014655:Vascular Resistance; D044465:White People
D011942:Receptors, Adrenergic, alpha; D011943:Receptors, Adrenergic, beta