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Enhanced blood pressure response to regular daily stress in urban hypertensive men
1Department of Preventive Medicine, National Cardiovascular Center, Osaka, Japan.
Insights
Hypertensive men exhibit hyperreactive blood pressure responses to daily stress compared to normal individuals. Clinic blood pressure readings are less reliable than ambulatory monitoring for assessing hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Ambulatory Blood Pressure Monitoring
Background:
- Clinic blood pressure measurements may not accurately reflect true blood pressure levels during daily activities.
- Hypertension is a significant risk factor for cardiovascular disease.
Purpose of the Study:
- To compare ambulatory blood pressure monitoring (ABPM) with clinic blood pressure measurements in hypertensive and normotensive men.
- To investigate the impact of daily stress on blood pressure in hypertensive individuals.
Main Methods:
- Ambulatory blood pressure monitoring was used to assess blood pressure in 28 untreated hypertensive men and 26 normotensive controls during daily activities.
- Echocardiography was performed on normotensive individuals to assess left ventricular wall thickness.
Main Results:
- Clinic blood pressure was significantly higher in hypertensives compared to home readings, while normotensives showed lower clinic readings.
- Hypertensives displayed significantly higher blood pressure during work compared to home readings, indicating hyperreactivity to stress.
- Blood pressure decreased similarly in both groups during sleep.
- Left ventricular wall thickness in normotensives correlated with blood pressure during work and at home.
Conclusions:
- Ambulatory blood pressure monitoring provides a more accurate assessment of blood pressure than clinic readings, especially in hypertensive individuals.
- Hypertensive individuals exhibit exaggerated blood pressure responses to everyday stressors.
- Elevated blood pressure during daily activities, particularly work, may be associated with cardiac structural changes in normotensive individuals.
Abstract:
Twenty-eight urban untreated hypertensive men (mean age: 54 years; systolic (SBP)/diastolic (DBP) blood pressure at clinic: 148/96 mmHg] and 26 age- and sex-matched normal controls (54 years, 118/78 mmHg) were examined during normal daily activities by ambulatory blood pressure monitoring. When compared with home blood pressures, clinic blood pressures were 8/10% (SBP/DBP) higher in the hypertensives, but 1/3% lower in the normotensives. The values were significantly different for both groups (P less than 0.01 for SBP; P less than 0.001 for DBP). In contrast, the blood pressures fell in a similar manner in both groups during sleep. On working days, the blood pressures during work were 10/9% higher than the corresponding home blood pressures in the hypertensives and only 3/3% higher in the normotensives. These differences were significant (P less than 0.01 for both SBP and DBP). The results show that the blood pressures of hypertensives were hyperreactive to casual daily stress. In the normotensives, left ventricular wall thickness determined by echocardiography was correlated significantly with the blood pressures during work (r = 0.5, P less than 0.05 for SBP and DBP) and at home (r = 0.4, P less than 0.05 for SBP).