title: Impact of mental and physical stress on blood pressure and pulse pressure under normobaric versus hypoxic conditions.
abstract: OBJECTIVE
  Hypobaric hypoxia, physical and psychosocial stress may influence key cardiovascular parameters including blood pressure (BP) and pulse pressure (PP). We investigated the effects of mild hypobaric hypoxia exposure on BP and PP reactivity to mental and physical stress and to passive elevation by cable car.
  
  
  METHODS
  36 healthy volunteers participated in a defined test procedure consisting of a period of rest 1, mental stress task (KLT-R), period of rest 2, combined mental (KLT-R) and physical task (bicycle ergometry) and a last period of rest both at Graz, Austria (353 m asl) and at the top station Dachstein (2700 m asl). Beat-to-beat heart rate and BP were analysed both during the test procedures at Graz and at Dachstein and during passive 1000 m elevation by cable car (from 1702 m to 2700 m).
  
  
  RESULTS
  A significant interaction of kind of stress (mental vs. combined mental and physical) and study location (Graz vs. Dachstein) was found in the systolic BP (p = .007) and PP (p = .002) changes indicating that during the combined mental and physical stress task sBP was significantly higher under hypoxic conditions whereas sBP and PP were similar during mental stress both under normobaric normoxia (Graz) and under hypobaric hypoxia (Dachstein). During the passive ascent in cable car less trivialization (psychological coping strategy) was associated with an increase in PP (p = .004).
  
  
  CONCLUSIONS
  Our data show that combined mental and physical stress causes a significant higher raise in sBP and PP under hypoxic conditions whereas isolated mental stress did not affect sBP and PP under hypoxic conditions. PP-reaction to ascent in healthy subjects is not uniform. BP reactions to ascent that represents an accumulation of physical (mild hypobaric hypoxia) and psychological stressors depend on predetermined psychological traits (stress coping strategies). Thus divergent cardiovascular reactions can be explained by applying the multidimensional aspects of the biopsychosocial concept.
authors.affiliation: Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Trapp
authors.affiliation: Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria; University Clinic of Psychiatry. Medical University of Graz, Graz, Austria.
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Trapp
authors.affiliation: Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
authors.forename: Josef W
authors.initials: JW
authors.lastname: Egger
authors.affiliation: Department of Pneumology, Medical University of Graz, Graz, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Domej
authors.affiliation: Department of Medicine, University of Perugia and Terni University Hospital, Terni, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
authors.affiliation: Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Avian
authors.affiliation: Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Rohrer
authors.affiliation: Research Unit of Behavioural Medicine, Health Psychology and Empirical Psychosomatics, Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria.
authors.forename: Nina
authors.initials: N
authors.lastname: Hörlesberger
authors.affiliation: Institute for Hypertension, Vienna, Austria.
authors.forename: Dieter
authors.initials: D
authors.lastname: Magometschnigg
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
authors.forename: Mila
authors.initials: M
authors.lastname: Cervar-Zivkovic
authors.affiliation: Department of Dermatology, Medical University of Graz, Graz, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Komericki
authors.affiliation: CTR Carinthian Tech Research, Villach/St. Magdalen, Austria.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Velik
authors.affiliation: UKSH Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Baulmann
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002320:Cardiovascular Physiological Phenomena; D018592:Cross-Over Studies; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011674:Pulse; D013315:Stress, Psychological / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D055815:Young Adult