Pressor reactions to psychological stress accounted for only 1% of the variance in follow-up systolic blood pressure, providing minimal independent prediction over initial resting blood pressure.
Cohort (n=1,003)
Yes
Does blood pressure reactivity to psychological stress predict future blood pressure in normotensive middle-aged men?
Pressor reactions to psychological stress provide minimal independent prediction of future blood pressure beyond initial resting blood pressure, challenging the clinical utility of reactivity testing.
Effect estimate: r=0.22
p-value: p=<0.01
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, P<0.01). The dominant correlate of follow up blood pressure was blood pressure at initial screening (r=0.60; P<0.01 between initial and follow up systolic blood pressure; r=0.59, P<0.01 between initial and follow up diastolic blood pressure). Stepwise multiple regression analysis indicated that reactions to the stressor provided minimal prediction of follow up blood pressure over and above that afforded by blood pressure at initial screening. In the case of follow up systolic blood pressure, systolic reactions to stress accounted for only 1% of follow up variance; systolic blood pressure at initial screening accounted for 34%. With regard to diastolic blood pressure at follow up, the independent contribution from diastolic reactions to stress was less than 1%. Conclusion : 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 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
Carroll et al. (Sat,) conducted a cohort in Healthy (n=1,003). Pressor reactions to psychological stress was evaluated on Systolic blood pressure at follow up screening (r=0.22, p=<0.01). Pressor reactions to psychological stress accounted for only 1% of the variance in follow-up systolic blood pressure, providing minimal independent prediction over initial resting blood pressure.