PSYCHOLOGICAL AND BEHAVIORAL-CHARACTERIST ICS PREDICTING BLOOD-PRESSURE REACTIVITY TO MENTAL STRESS

This study was conducted with 58 subjects (31 males and 27 females): a sample of 37 normotensives (NT) (mean age 36 +/- 11) and a sample of 21 hypertensives (HT) without any antihypertensive medication (mean ag e 46 +/- 9). Cardiovascular reactivity was measured during a sequence of 3 computer assisted mental stress tasks (visual-motor tasks. maze t est). Before and following the stress tasks the subjects were asked to respond on the same computer to psychological test and questionnaires measuring anxiety, depression (H.A.D. inventory) type A behavior (imp atience, competition and drive for success ; Bortner's scale), locus o f control (attribution of success or failure to internal or external f actors ; Levenson's scale), and coping mechanisms used in response to everyday life stresses (Rosenzweig Picture Frustration Test, adapted b y S. Consoli and E. Albert). Measurements of systolic (SBP) and diasto lic blood pressure and heart rate were obtained automatically every mi nute during the entire computer session with a Colin Press-Mate BP 880 0 sphygmomanometer. Pressure reactivity (PR) was defined as the relati ve difference between BP measured during mental stress and BP measured during non-stress condition (the reference period). Our hypotheses we re that PR would be greater in HT than in NT, and that PR would be cor related with various psychological and behavioral characteristics. Dur ing the stress session, SBP in NT increased from 119,8 to 123,7 mmHg ( p < 0,001) and in HT from 147,4 to 152 mmHg (p < 0,05) : there was no significant difference between the two samples but in HT, SBP elevatio n persisted after the stress session, contrary to the NT, whose SBP qu ickly decreased to the reference values. There was no correlation betw een PR and age but PR was higher in men, particularly for the maze tes t (p < 0,001). There was no correlation between PR and anxiety or depr ession but PR was predicted by coping mechanisms. << Ego Defense >> re actions, consistent with affective response to stress, and specificall y hostile reactions, predicted higher reactivity to mental stress, con trary to reactions characterized by the cognitive treatment of stress (i.e. problem focusing and problem solving oriented reactions). Type A subjects were more reactive only when their locus of control was exte rnal. These type A subjects were characterized by having a strong need for competition plus a lack of self confidence. Hostile subjects and those with more depressive symptomatology showed a persistent PR follo wing mental stress. These results support the value of standardized me ntal stress testing using a computer and demonstrate that mental stres s reactions can be predicted by certain psychological and behavioral c haracteristics.