Blood pressure and fibrinogen responses to mental stress as predictors of incident hypertension over an 8-year period

Steptoe, A., Kivimäki, M., Lowe, G., Rumley, A. and Hamer, M. (2016) Blood pressure and fibrinogen responses to mental stress as predictors of incident hypertension over an 8-year period. Annals of Behavioral Medicine, 50(6), pp. 898-906. (doi: 10.1007/s12160-016-9817-5) (PMID:27401000) (PMCID:PMC5126198)

Abstract

Background: Heightened blood pressure (BP) responses to mental stress predict raised BP levels over subsequent years, but evidence for associations with incident hypertension is limited, and the significance of inflammatory responses is uncertain. Purpose: We investigated the relationship between BP and plasma fibrinogen responses to stress and incident hypertension over an average 8-year follow-up. Method: Participants were 636 men and women (mean age 59.1 years) from the Whitehall II epidemiological cohort with no history of cardiovascular disease and hypertension. They performed standardized behavioral tasks (color/word conflict and mirror tracing), and hypertension was defined by clinic measures and medication status. Results: Of participants in the highest systolic BP reactivity tertile, 29.3 % became hypertensive over the follow-up period compared with 16.5 % of those in the lowest tertile, with an odds ratio of 2.02 (95 % CI 1.17–3.88, p = 0.012) after adjustment for age, sex, grade of employment, body mass index, smoking, alcohol consumption, physical activity, follow-up time, subjective stress response, perceived task difficulty, perceived task engagement, and baseline BP. Similar associations were observed for diastolic BP reactivity (odds ratio 2.05, 95 % CI 1.23–3.40, p = 0.006) and for impaired systolic BP post-stress recovery (odds ratio 2.06, 95 % CI 1.19–3.57, p = 0.010). Fibrinogen reactions to tasks also predicted future hypertension in women (odds ratio 2.64, 95 % CI 1.11–6.30, p = 0.029) but not men. Conclusions: These data suggest that heightened cardiovascular and inflammatory reactivity to mental stress is associated with hypertension risk, and may be a mechanism through which psychosocial factors impact on the development of hypertension.

• Item Type: Articles
• Additional Information: This research was supported by the British Heart Foundation (RG/10/005/28296).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Rumley, Dr Ann and Lowe, Professor Gordon
• Authors: Steptoe, A., Kivimäki, M., Lowe, G., Rumley, A., and Hamer, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Annals of Behavioral Medicine
• Publisher: Springer
• ISSN: 0883-6612
• ISSN (Online): 1532-4796
• Published Online: 11 July 2016
• Copyright Holders: Copyright © 2016 The Authors
• First Published: First published in Annals of Behavioral Medicine 50(6): 898-906
• Publisher Policy: Reproduced under a Creative Commons license