Blood pressure reactions to acute psychological stress and future blood pressure status: A 10-year follow-up of men in the Whitehall II study

Objective: The aim of this study was to examine whether blood pressure reac tions to mental stress predicted future blood pressure and hypertension. Me thods: Blood pressure was recorded at an initial medical screening examinat ion after which blood pressure reactions to a mental stress task were deter mined. A follow-up screening assessment of blood pressure and antihypertens ive medication status was undertaken 10 years later. Data were available fo r 796 male public servants, between 35 and 55 years of age upon entry to th e study. Results: Systolic blood pressure reactions to mental stress were p ositively correlated with follow-up screening systolic blood pressure and t o a lesser extent, follow-up diastolic pressure. In multivariate tests, by far the strongest predictors of follow-up blood pressures were initial scre ening blood pressures. In the case of follow-up systolic blood pressure, sy stolic reactions to stress emerged as an additional predictor of follow-up systolic blood pressure. With regard to follow-up diastolic blood pressure, reactivity did not enter the analogous equations. The same outcomes emerge d when the analyses were adjusted for medication status. When hypertension at 10-year follow-up was the focus, both systolic and diastolic reactions t o stress were predictive. However, with correction for age and initial scre ening blood pressure, these associations were no longer statistically signi ficant. Conclusions: The results of this study provide modest support for t he hypothesis that heightened blood pressure reactions to mental stress con tribute to the development of high blood pressure. At the same time, they q uestion the clinical utility of stress testing as a prognostic device.