Al. Hinderliter et al., BLOOD-PRESSURE RESPONSES TO STRESS - RELATION TO LEFT-VENTRICULAR STRUCTURE AND FUNCTION, Annals of behavioral medicine, 18(1), 1996, pp. 61-66
The relations of resting blood pressure, blood pressure during standar
dized stressors, and workplace blood pressure to left ventricular stru
cture and diastolic filling were evaluated in 133 healthy young adults
(mean age = 30 +/- 7 years) without hypertension. Each subject underw
ent the following: (a) measurement of basal blood pressure at the end
of 15 minutes of rest; (b) measurement of blood pressure during a comp
etitive reaction time task (a laboratory stressor which elicits a beta
-adrenergically mediated increase in cardiac output); (c) measurement
of blood pressure during a forehead cold pressor test, which results p
rimarily in an increase in total peripheral resistance due to alpha-ad
renergic stimulation; and (d) ambulatory blood pressure monitoring dur
ing a typical workday. Left ventricular structure (indexed left ventri
cular mass and relative wall thickness! and diastolic filling (peak fi
lling velocity) were evaluated by echocardiography. All four measures
of systolic blood pressure were significantly correlated with indexed
left ventricular mass. The best predictor of indexed left ventricular
mass was the systolic blood pressure during the cold pressor test (r =
0.32, p < 0.001), and this relation was significant after correcting
for resting systolic blood pressure (p < 0.05). Relative wall thicknes
s was most closely related to the average ambulatory workplace systoli
c pressure (r = 0.23, p < 0.01), and this relation was also independen
t of resting systolic blood pressure (p < 0.05). Peak filling velocity
was inversely related to the systolic pressure in response to each st
ressor, but the correlations with stress-induced pressures were not si
gnificant after correcting for resting levels of blood pressure. These
results demonstrate an association of structural characteristics of t
he left ventricle with blood pressure responses to stress.