STRESS-INDUCED LABORATORY BLOOD-PRESSURE IN RELATION TO AMBULATORY BLOOD-PRESSURE AND LEFT-VENTRICULAR MASS AMONG BORDERLINE HYPERTENSIVE AND NORMOTENSIVE INDIVIDUALS

Our primary aim in the present study was to investigate the associatio n between blood pressure measured in the laboratory and in the ambulat ory state in a group of middle-aged borderline hypertensive men and ag e-matched normotensive control subjects. In addition, we examined the relation between stress-induced blood pressure measurements and left v entricular mass. Blood pressure and heart rate were measured noninvasi vely during a standardized laboratory stress protocol and four times p er hour throughout 24 hours. Borderline hypertensive subjects had sign ificantly higher systolic and diastolic pressures than normotensive su bjects during both the daytime (systolic pressure, 141.1 +/- 9.7 versu s 130.9 +/- 8.6 mm Hg; diastolic pressure, 88.8 +/- 7.0 versus 79.4 +/ - 6.2 mm Hg, P<.001) and nighttime (systolic pressure, 114.0 +/- 9.9 v ersus 107.1 +/- 8.3 mm Hg; diastolic pressure, 71.5 +/- 7.5 versus 64. 6 +/- 7.2 mm Hg, P<.001). The borderline hypertensive group also displ ayed increased systolic pressure reactivity in the laboratory compared with the normotensive group. The groups did not differ significantly in left ventricular mass (index). In both borderline hypertensive and normotensive individuals, blood pressure levels during stress testing were closely related to ambulatory blood pressure levels (r=.51 to .82 ). Furthermore, stress-induced blood pressure levels were significantl y correlated to left ventricular mass in borderline hypertensive (r=.3 3 to .40) but not normotensive subjects. Since stress-induced blood pr essure levels were significantly associated with both ambulatory blood pressure levels and left ventricular mass in borderline hypertensive subjects, the addition of standardized stress testing to casual blood pressure measurements may improve risk estimation.