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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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“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]
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“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]
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“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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Metadata
- 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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