Pressor reactions to psychological stress and prediction of future blood pressure: data from the Whitehall II study

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Abstract
Objective: To examine whether reactions of blood pressure to psychological stress predict future blood pressure. Design: Blood pressure was recorded at a medical screening examination after which pressor reactions to a psychological stress task were determined. Follow up measurement of blood pressure was undertaken, on average, 4.9 years later. Setting: 20 civil service departments in London. Subjects: 1003 male civil servants aged between 35 and 55 years at entry to the study. Main outcome measure: Blood pressure at follow up screening. Results: Reactions of systolic blood pressure to stress correlated positively with systolic blood pressure at follow up screening (r=0.22, PConclusion: Pressor reactions to psychological stress provide minimal independent prediction of blood pressure at follow up. Measurement of reactivity is not a useful clinical index of the course of future blood pressure. Key messages Reactions of blood pressure to psychological stress are less predictive of future blood pressure than either resting laboratory or casual blood pressure Reactions of blood pressure to psychological stress afford minimal prediction of future blood pressure independently of initial blood pressure Reactions of blood pressure to stress cannot be advocated as a useful clinical index of the course of future blood pressure Reactions of blood pressure to psychological stress may have little or no role in the aetiology of hypertension