EXAGGERATED BLOOD-PRESSURE RESPONSES DURING MENTAL STRESS ARE ASSOCIATED WITH ENHANCED CAROTID ATHEROSCLEROSIS IN MIDDLE-AGED FINNISH MEN -FINDINGS FROM THE KUOPIO ISCHEMIC-HEART-DISEASE STUDY

Background Exaggerated cardiovascular reactivity to mental stress is h ypothesized to increase atherosclerotic risk. We examined this hypothe sis using cross-sectional data from the Kuopio Ischemic Heart Disease study, a population-based epidemiological sample. Methods and Results 901 Eastern Finnish men from four age cohorts (age, 42 to 60 years) we re administered a standardized testing battery to assess cardiovascula r reactivity to mental stress. Ultrasound measures of intima-medial th ickness (IMT) and plaque height from the common carotid arteries were used as noninvasive markers of atherosclerosis. Diastolic blood pressu re (DBP) responses to mental stress were significantly associated with mean IMT (b=.021, P=.006), maximum IMT (b=.026, P=.013), and mean pla que height (b=.017, P=.041). Significant associations were also shown between stress-related systolic blood pressure (SEP) reactivity and me an IMT (b=.0151, P=.042). When examined separately by age, association s with IMT were significant only in the youngest half of the sample (a ge, 46 and 52 years, n=433; for mean IMT, DBP b=.033, P=.0002, SEP b=. 0266, P=.003; for maximum IMT, DBP b=.039, P=.002, SEP b=.032, P=.011) . Results remained significant in the younger subjects after adjustmen t for smoking, lipid profiles, fasting glucose, and resting blood pres sure (b=.024, P=.011); results also remained significant in a subgroup of unmedicated younger subjects without symptomatic cardiovascular di sease (n=135; for SEP reactivity, b=.031, P=.036; for DBP, b=.037, P=. 007). Conclusions The tendency to show exaggerated presser responses t o mental stress is a significant independent correlate of atherosclero sis in this population sample of Finnish men. The effect does not appe ar to be accounted for by the confounding influence of other risk fact ors or preexisting clinical disease.