title: Delayed blood pressure recovery after psychological stress is associated with carotid intima-media thickness: Whitehall psychobiology study.
abstract: OBJECTIVE
  Delayed blood pressure (BP) recovery after psychological stress is associated with low socioeconomic status (SES) and prospectively with increases in clinic BP. We tested whether poststress BP recovery was related to carotid atherosclerosis.
  
  
  RESULTS
  Psychophysiological stress testing was performed with a healthy subgroup of the Whitehall II epidemiological cohort, and recovery systolic BP was monitored 40 to 45 minutes after stressful behavioral tasks. Carotid ultrasound scanning was conducted on 136 men and women (aged 55.3+/-2.7 years) 3 years after stress testing. Participants were divided into those whose systolic BP had returned to baseline in the recovery period (adequate recovery, n=37), and those whose BP remained elevated (delayed recovery, n=99). Systolic BP stress responses did not differ in the 2 groups. Carotid intima-media thickness (IMT) was associated with delayed recovery in lower SES (means 0.78 versus 0.65 mm) but not higher SES participants (means 0.75 versus 0.74 mm) after adjustment for age, gender, baseline systolic BP, and resting BP, smoking, body mass and fasting cholesterol at the time of ultrasound scanning (P=0.010).
  
  
  CONCLUSIONS
  Variations in poststress recovery reflect dysfunction of biological regulatory processes, and may partly mediate psychosocial influences on cardiovascular disease.
authors.affiliation: Department of Epidemiology and Public Health, Institute of Child Health, University College London, London WC1E 6BT, UK. a.steptoe@ucl.ac.uk
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
authors.forename: Ann E
authors.initials: AE
authors.lastname: Donald
authors.forename: Katie
authors.initials: K
authors.lastname: O'Donnell
authors.forename: Michael
authors.initials: M
authors.lastname: Marmot
authors.forename: John E
authors.initials: JE
authors.lastname: Deanfield
mesh_terms: D001794:Blood Pressure; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011603:Psychophysiology; D020127:Recovery of Function; D012923:Social Class; D013315:Stress, Psychological / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography