Why the study?
Does standardized mental stress elicit a different haemodynamic response in reactive hypertensives compared to normal controls?
Does standardized mental stress elicit a different haemodynamic response in reactive hypertensives compared to normal controls?
Reactive ('white-coat') hypertensives exhibit a significantly stronger cardiac response to mental stress compared to normotensive controls, suggesting a hyperreactive haemodynamic profile.
Greater cardiac reactivity to mental stress in reactive hypertension; hypothesis-generating and should not yet change practice.
To study the haemodynamic response to a standardized mental stress, we measured ascending aorta velocity using Doppler ultrasonography in 20 reactive ("white-coat") hypertensives and 20 age and sex matched normal controls (NC) familiar with the hospital setting. Reactive hypertensives (RH) had 3 office diastolic BP recordings between 90-110 mmHg and ambulatory BP less than 140/90 mmHg. The cardiac response to mental arithmetic was greater in RH than NC (minute distance, RH: +36.7 +/- 40.2% vs NC: +10.3 +/- 19%, p less than 0.05; peak velocity, RH: +8.4 +/- 16.5% vs NC: -1.4 +/- 11.9%, p less than 0.05), and there was a different peripheral resistance response (RH: -12.2 +/- 24.2% vs NC: +6.5 +/- 22%, p less than 0.05). We suggest that subjects with reactive hypertension have a strong cardiac response to mental stress and this could be a characteristic of this condition.
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Pannarale et al. (1991) studied this question.
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