Blood Pressure Reactivity to Psychological Stress Predicts Hypertension in the CARDIA Study

Top Cited Papers
Publisher Website
Google Scholar
Abstract
Background— A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults. Methods and Results— We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of >4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges—cold pressor, star tracing, and video game tasks—were measured. Hypertensive status was defined as use of antihypertensive medication or measured BP ≥140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred ( P Conclusions— Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.