title: Cardiovascular reactivity patterns and pathways to hypertension: a multivariate cluster analysis.
abstract: Substantial evidence links exaggerated mental stress induced blood pressure reactivity to future hypertension, but the results for heart rate reactivity are less clear. For this reason multivariate cluster analysis was carried out to examine the relationship between heart rate and blood pressure reactivity patterns and hypertension in a large prospective cohort (age range 55-60 years). Four clusters emerged with statistically different systolic and diastolic blood pressure and heart rate reactivity patterns. Cluster 1 was characterised by a relatively exaggerated blood pressure and heart rate response while the blood pressure and heart rate responses of cluster 2 were relatively modest and in line with the sample mean. Cluster 3 was characterised by blunted cardiovascular stress reactivity across all variables and cluster 4, by an exaggerated blood pressure response and modest heart rate response. Membership to cluster 4 conferred an increased risk of hypertension at 5-year follow-up (hazard ratio=2.98 (95% CI: 1.50-5.90), P<0.01) that survived adjustment for a host of potential confounding variables. These results suggest that the cardiac reactivity plays a potentially important role in the link between blood pressure reactivity and hypertension and support the use of multivariate approaches to stress psychophysiology.
authors.affiliation: School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
authors.forename: R C
authors.initials: RC
authors.lastname: Brindle
authors.affiliation: School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.|Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Ginty
authors.affiliation: Centre for Cardiovascular Imaging, University College London Institute of Cardiovascular Science, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Jones
authors.affiliation: School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
authors.forename: A C
authors.initials: AC
authors.lastname: Phillips
authors.affiliation: Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Department of Obstetrics & Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: T J
authors.initials: TJ
authors.lastname: Roseboom
authors.affiliation: School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
authors.forename: D
authors.initials: D
authors.lastname: Carroll
authors.affiliation: Department of Obstetrics & Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: R C
authors.initials: RC
authors.lastname: Painter
authors.affiliation: Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: S R
authors.initials: SR
authors.lastname: de Rooij
mesh_terms: D001794:Blood Pressure; D002319:Cardiovascular System / Q000503:physiopathology*; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D013217:Starvation / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D013997:Time Factors