Effects of different stress settings on cardiovascular parameters and their relationship to daily life blood pressure in normotensives, borderline hypertensives and hypertensives.

The aim of this study was to compare a traditional stress setting, consisting of two mental arithmetic tasks and two Stroop test modifications, and a stress setting of varying task demand and decision latitude according to Karasek's job strain model, with respect to their feasibility to elicit differences in cardiovascular reactivity and recovery in 20 normotensives, 20 borderline hypertensives, and 20 non-medicated hypertensives, carefully selected by means of World Health Organization criteria. In addition, the relationship between laboratory and everyday blood pressure was investigated. All subjects were tested under both stress settings in counterbalanced order. Blood pressure was recorded both intermittently from the brachial artery (Riva-Rocci) and continuously from the finger (Finapres). Heart rate and electrodermal activity were continuously measured as well. Furthermore, daily life blood pressure recorded by means of 24 h ambulatory monitoring during a normal working day served as criterion for the re-classification of the blood pressure groups by means of discriminant analysis using physiological recordings from baseline, test phases and rest phases. The groups did not show significant differences in their reactivity to the various mental stressors including the Karasek-model oriented ones but marked differences in their behaviour occurred during the 10 min of recovery following each stress setting. Both systolic and diastolic blood pressure in hypertensives failed to recover during this period. The results also showed the superiority of the Finapres method with respect to reflecting the dynamics of physiological recovery processes. None of the stress settings showed an advantage in predicting blood pressure in daily life. In general, the results question the validity of mental laboratory stressors for the prediction of cardiovascular changes in daily life but point to a possible role of recovery processes after stress in the development of essential hypertension.

[1]  G. Weidner,et al.  The effects of task demand and decision latitude on cardiovascular reactivity to stress. , 1993, Behavioral medicine.

[2]  T. Kristensen.  The demand-control-support model: Methodological challenges for future research. , 1995 .

[3]  K. Matthews,et al.  Do cardiovascular responses to laboratory stress relate to ambulatory blood pressure levels?: Yes, in some of the people, some of the time. , 1992, Psychosomatic medicine.

[4]  A. Steptoe,et al.  Cardiovascular stress reactivity and job strain as determinants of ambulatory blood pressure at work , 1995, Journal of hypertension.

[5]  D. Carroll,et al.  Cardiovascular and metabolic activity at rest and during psychological and physical challenge in normotensives and subjects with mildly elevated blood pressure. , 1990, Psychophysiology.

[6]  M. Fredrikson.  Behavioral Aspects of Cardiovascular Reactivity in Essential Hypertension , 1986 .

[7]  M. Fredrikson,et al.  Electrodermal responsivity in young hypotensive and hypertensive men. , 1990, Psychophysiology.

[8]  S. Boschi,et al.  Factors associated with the development of stable hypertension in young borderline hypertensives , 1996, Journal of hypertension.

[9]  A. Sherwood,et al.  A Conceptual and Methodological Overview of Cardiovascular Reactivity Research , 1992 .

[10]  C. Pieper,et al.  Measurement reliability of cardiovascular reactivity change scores: a comparison of intermittent and continuous methods of assessment. , 1993, Journal of psychosomatic research.

[11]  U. de Faire,et al.  Job strain and ambulatory blood pressure profiles. , 1991, Scandinavian journal of work, environment & health.

[12]  Pamela L. Perrewé,et al.  THE MODERATING EFFECTS OF ACTIVITY LEVEL AND LOCUS OF CONTROL IN THE PERSONAL CONTROL-JOB STRESS RELATIONSHIP , 1987 .

[13]  K. H. Wesseling,et al.  The Measurement of Continuous Finger Arterial Pressure Noninvasively in Stationary Subjects , 1986 .

[14]  A. Sherwood,et al.  Cardiovascular reactivity assessment: effects of choice of difficulty on laboratory task responses. , 1992, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[15]  K. Thierauch,et al.  Prostaglandins and their receptors: II. Receptor structure and signal transduction. , 1994, Journal of hypertension.

[16]  Robert Karasek,et al.  Job decision latitude and mental strain: Implications for job redesign , 1979 .

[17]  Daniel C. Ganster,et al.  Effects of stressful job demands and control on physiological and attitudinal outcomes in a hospital setting. , 1993, Academy of Management journal. Academy of Management.

[18]  M. Allen,et al.  Stability of cardiovascular reactivity to laboratory stressors: a 2 1/2 yr follow-up. , 1987, Journal of psychosomatic research.

[19]  A. Sherwood,et al.  Physiological determinants of hyperreactivity to stress in borderline hypertension. , 1995, Hypertension.

[20]  K. Matthews,et al.  Cardiovascular Responses to Behavioral Stress and Hypertension: a Meta-Analytic Review , 1990 .

[21]  Robert Karasek,et al.  Physiology of Stress and Regeneration in Job Related Cardiovascular Illness , 1982 .

[22]  N. Fineberg,et al.  Race and gender influence hemodynamic responses to psychological and physical stimuli. , 1990, Journal of hypertension.

[23]  T. Pickering,et al.  Cardiovascular Reactivity in the Laboratory and the Role of Behavioral Factors in Hypertension: a Critical Review , 1990 .

[24]  M. Fredrikson,et al.  Cardiovascular responses in the laboratory and in the natural environment: is blood pressure reactivity to laboratory-induced mental stress related to ambulatory blood pressure during everyday life? , 1989, Journal of psychosomatic research.