Anticipatory blood pressure responses to exercise are associated with leftventricular mass in Finnish men - Kuopio Ischemic Heart Disease Risk Factor Study

Background-Exaggerated cardiovascular reactivity to psychological demands m ay contribute to the development of left ventricular (LV) hypertrophy. We e xamined the cross-sectional association between anticipatory blood pressure (BP) responses to bicycle exercise and LV mass in the Kuopio Ischemic Hear t Disease Risk Factor Study, a population-based epidemiological sample. Methods and Results-Among 876 men from 4 age cohorts (ages 42, 48, 58, and 64 years), we collected echocardiographic assessments of LV mass along with measures of BP response taken before bicycle ergometry testing. Anticipato ry BP responses were positively associated with LV mass, with significant a ssociations only among younger (age <50 years) subjects with elevated resti ng pressures (3-way interactions for anticipatory BP x age x resting pressu re for systolic and diastolic BP, all P<0.05; for younger subjects with ele vated systolic BP, P<0.01; and for younger subjects with elevated diastolic BP, P<0.001). Among these subgroups, exaggerated anticipatory BP responses (tup quartile) were associated with an incremental increase in LV mass of 10% or greater, corrected for body surface area. Results remained significa nt after adjusting for age, education, salt consumption, and resting BP, an d the pattern of findings was maintained among men with no previous history of cardiovascular disease. Conclusions-The tendency to show exaggerated presser responses to psycholog ical demands may be a significant independent correlate of LV mass, especia lly among young men with high resting pressures. This is the first study to examine such associations in a middle-aged population sample.