Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men
Abstract
Background— Hemodynamic reactions to mental stress may contribute to atherosclerosis. We previously observed cross-sectional relationships between blood pressure reactions to a standardized stress battery and carotid intima-media thickness (IMT) in the Kuopio Ischemic Heart Disease (KIHD) study. These are the first prospective results on this relationship. Methods and Results— Men from 4 age cohorts (42 to 60 years old at study onset) were challenged with a standardized mental stress battery, and heart rate and blood pressure reactions were assessed. Ultrasound measures of common carotid IMT were collected at this time and 7 years later as noninvasive markers of atherosclerosis. Data were collected from a sample of 756 men at both times. Systolic blood pressure reactions to mental stress at study onset were positively related to mean carotid IMT 7 years later (β=0.035, P =0.001, by blood pressure quartile, IMT=0.91, 0.93, 0.96, 1.00 mm) and to the progression of IMT (β=0.020, P =0.006, by blood pressure quartile, ΔIMT=0.08, 0.09, 0.11, 0.11 mm). Similar significant relations were shown for maximal IMT and plaque height. Diastolic blood pressure responses were less strongly related to carotid IMT than were systolic responses. Heart-rate responses were unrelated. Adjustment for standard risk factors did not substantially reduce the relation between systolic blood pressure reactivity and the progression of mean carotid IMT (standardized β=0.059, P =0.026), maximal carotid IMT (standardized β=0.084, P =0.006), or plaque height (standardized β=0.093, P =0.008). Conclusions— The degree of systolic blood pressure reactivity to mental challenge is prospectively related to carotid IMT in middle-aged and older men, independent of known risk factors.
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Exaggerated cardiovascular reactivity is an independent predictor of future hypertension in prospective studies.
“Several prospective studies have established exaggerated cardiovascular reactivity as an independent predictor of future hypertension (8,(14)(15)(16)(17)(18), in some cases, as much as 36 y later (3).”
From A high fat meal increases cardiovascular reactivity to psychological stress in healthy young adults (2007) · cites this paper as [3]
High reactors to acute stressors have more extensive arterial plaques and more aggressive plaque growth.
“Furthermore, recent prospective studies have shown that high reactors to acute stressors have more extensive arterial plaques and more aggressive plaque growth (3,20).”
From A high fat meal increases cardiovascular reactivity to psychological stress in healthy young adults (2007) · cites this paper as [3]
The reactivity hypothesis states exaggerated responses to stress cause pathophysiologic events leading to sustained blood pressure increases.
“Specifically, the reactivity hypothesis states that exaggerated responses to stress cause a cascade of pathophysiologic events that can eventually lead to sustained increases in blood pressure (1,3,10-12).”
From A high fat meal increases cardiovascular reactivity to psychological stress in healthy young adults (2007) · cites this paper as [3]
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- Authors
- Jennings, J. R., Kamarck, T. W., Everson-Rose, S. A., Kaplan, G. A., Manuck, S. B., & Salonen, J. T.
- Affiliations
- Rush University Medical Center (US)
- From the Departments of Psychiatry and Psychology, University of Pittsburgh, Pa (J.R.J., T.W.K., S.B.M.); the Department of Preventive Medicine and Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Ill (S.A.E.-R.); the Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor (G.A.K.); and the Research Institute of Public Health and Department of Community Health and General Practice, University of Kuopio, Finland,...
- Venue
- Circulation
- Published
- 2004-10-12
- Volume
- 110
- Issue
- 15
- Pages
- 2198-2203
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2160202245
- Cited by
- 229
- References
- 35
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 5 · 2023: 5 · 2022: 10 · 2021: 7 · 2020: 11 · 2019: 6 · 2018: 22 · 2017: 6 · 2016: 11 · 2015: 5 · 2014: 10 · 2013: 11 · 2012: 16
- FWCI
- 8.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Academy of Finland
- National Heart, Lung, and Blood Institute (HL-44199, R01HL044199)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD047861)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- psychological stress, blood pressure reactivity, carotid intima-media thickness, carotid atherosclerosis, carotid plaque, systolic blood pressure, heart rate, middle-aged men, cardiovascular risk factors
- MeSH terms
- Adult, Blood Pressure, Carotid Artery Diseases, Cross-Sectional Studies, Disease Susceptibility, Finland, Follow-Up Studies, Heart Rate, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Stress, Psychological, Ultrasonography, Cohort Studies, Tunica Intima, Tunica Media
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