July 1, 2006
View Full PaperPsychosocial, Hemostatic, and Inflammatory Correlates of Delayed Poststress Blood Pressure Recovery
Key Result
Delayed poststress systolic BP recovery (averaging 6.19 ± 9.6 mm Hg above baseline) was associated with lower socioeconomic status, social isolation, and delayed hemostatic recovery.
Study Design
Type
Observational (n=228)
Structured PICO
Are psychosocial risk factors and delayed recovery of inflammatory and hemostatic variables associated with delayed poststress systolic blood pressure recovery in middle-aged adults?
P
Population
228 middle-aged men and women from the Whitehall Psychobiology study assessed for poststress cardiovascular and hemostatic recovery.
E
Exposure
Mental stress tasks (color/word and mirror-tracing tasks)
O
Outcome
Systolic blood pressure recovery (difference between baseline and levels recorded 40 to 45 minutes poststress)surrogate
Delayed systolic blood pressure recovery after mental stress is associated with psychosocial risk factors and prolonged hemostatic responses, highlighting a potential mechanism linking psychosocial stress to cardiovascular disease pathogenesis.
Abstract
OBJECTIVE: Delayed poststress cardiovascular recovery has been associated with cardiovascular disease risk. This study assessed relationships between systolic blood pressure (BP) recovery, psychosocial risk factors, and delayed recovery of inflammatory and hemostatic variables. METHOD: Data were analyzed from 228 middle-aged men and women from the Whitehall Psychobiology study who performed color/word and mirror-tracing tasks. Systolic BP recovery was assessed as the difference between baseline and levels recorded 40 to 45 minutes poststress. Associations were analyzed with socioeconomic markers (grade of employment, education, income), psychosocial factors (social isolation, hostility, mental health, financial strain), and recovery of heart rate, heart rate variability, von Willebrand factor, factor VIII clotting activity, plasma fibrinogen, and plasma viscosity. RESULTS: Systolic BP was on average 6.19 +/- 9.6 mm Hg higher on recovery than baseline. Delayed BP recovery was associated with lower grade of employment, lower education and lower income independently of age, gender, and systolic BP stress reactivity. Delayed BP recovery was related to social isolation and poor mental health independently of age, gender, socioeconomic position, and task reactivity. Delayed systolic BP recovery was also associated with delayed recovery in diastolic BP, heart rate, factor VIII, and plasma viscosity but not delayed heart rate variability recovery, independently of age, gender, body mass, and task reactivity. CONCLUSION: Socioeconomic and psychosocial risk factors for cardiovascular disease are related to delays in poststress recovery. Delayed systolic BP recovery may be a marker for prolonged responses in hemostatic variables that have a direct influence on cardiovascular disease pathogenesis.