Symptom correlates of blood pressure: a replication and reanalysis

Although normative studies have traditionally found that blood pressure (BP) fluctuations are asymptomatic, recent research by Pennebaker et al. [(1982). Psychophysiology 19: 201-210] has suggested that systolic blood pressure (SBP) changes are, in fact, highly correlated with idiosyncratic patterns of symptoms within individuals. The present study was designed as a conceptual replication of those findings and as an initial attempt to develop a standardized clinical procedure for assessing symptom-BP relationships. Eleven normotensive male subjects participated in a series of 16 brief tasks. The first eight tasks were "mental" stressors (e.g., WAIS-R subtests), while the second eight were "physical" stressors (e.g., breath-holding, running in place). Following each task or baseline, blood pressure was measured and subjects rated the degree to which they were experiencing each of nine symptoms (e.g., racing heart, sweaty hands). For each subject, simple symptom-BP correlations were computed across the 16 measurement periods. High symptom-SBP correlations were obtained only for the physical task period. It is argued that the magnitudes of the correlations reported by Pennebaker et al. (1982) were spuriously inflated by the inclusion of strenuous physical exercise, and a reanalysis of the data from that study supports this contention. The clinical value of assessing idiosyncratic symptom-blood pressure relationships seems doubtful.