Impaired cardiovascular recovery following stress predicts 3-year increases in blood pressure

International Centre for Health and Society, Psychology Group, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
Journal of Hypertension (Impact Factor: 4.72). 03/2005; 23(3):529-36. DOI: 10.1097/01.hjh.0000160208.66405.a8
Source: PubMed


To assess whether variation in the rate of cardiovascular recovery following exposure to acute psychological stress predicts changes in blood pressure longitudinally, independently of blood pressure at baseline and other covariates.
A 3-year longitudinal study.
A total of 209 men and women aged 45-59 years at baseline, with no history of cardiovascular disease including hypertension.
Measurement of blood pressure, heart rate, heart rate variability, cardiac index and total peripheral resistance at rest, during two moderately stressful behavioural tasks and up to 45 min post-stress. Stress reactivity was defined as the difference in values between tasks and baseline, and post-stress recovery as the difference between recovery levels and baseline.
Resting blood pressure measured at baseline and 3 years later. Seven individuals had been prescribed hypertensive medication on follow-up.
Increases in systolic blood pressure (SBP) were predicted by impaired post-stress recovery of SBP (P < 0.001), diastolic blood pressure (DBP) (P < 0.001) and total peripheral resistance (P = 0.003), independently of baseline blood pressure, age, gender, socio-economic status, hypertensive medication, body mass and smoking. The adjusted odds of an increase in SBP > or = 5 mmHg were 3.50 [95% confidence interval (CI) 1.19 to 10.8] for individuals with poor compared with effective post-stress recovery of SBP. Three-year increases in diastolic pressure were predicted by impaired recovery of SBP (P < 0.001) and DBP (P = 0.009) pressure and by heart rate variability during tasks (P = 0.002), independently of covariates.
Impaired post-stress recovery and less consistently heightened acute stress reactivity may index disturbances in the regulation of cardiovascular stress responses that contribute to longitudinal changes in blood pressure in middle-aged men and women.

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    • "As physiological marker of stress, heart rate (HR) and heart rate variability (HRV) were used, both of which are independent markers of cardiovascular health risks (Hillebrand et al., 2013; Thayer and Lane, 2007). Particularly, people who show heightened HR(V) responses to stress and impaired post-stress recovery are at increased risk of cardiovascular problems (Chida and Steptoe, 2010; Steptoe and Marmot, 2005). HR is partially determined by the interplay between the sympathetic and parasympathetic branches of the autonomic nervous system (Thayer et al., 2010). "
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    • "To our knowledge, this is the first study that has examined the effects of meal content on autonomic reactivity to stress. Larger reductions in vagally-mediated heart rate variability during acute stress have been prospectively associated with increases in diastolic blood pressure three years later (Matthews, Salomon, Brady, & Allen, 2003; Steptoe & Marmot, 2005). In the present study, HF heart rate variability reactivity was not differentially affected by meals eaten two hours prior to testing. "
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    • "Longitudinal studies have yielded evidence that poor recovery is related to serious health threats such as hypertension (Hocking Schuler and O'Brein, 1997), and even cardiovascular death (Kivimäki et al., 2006). Recovery is also a better predictor of long-term increases in blood pressure than mere reactivity to stressors (Steptoe and Marmot, 2005). Therefore, recovery is seen as a vital link between acute physiological responses to job stressors and employee health (Geurts and Sonnentag, 2006). "
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