Heart rate reactivity under mental stress as a predictor of blood pressure development in children

Since 1981 the 'Bonn Kinderstudie' has followed blood pressure (BP) development in children. In a subset of 63 healthy boys (aged 10-12 years at the beginning of the study) we examined whether cardiovascular reactivity predicts future BP development. At a 1-year interval BP and heart rate (HR) were measured during mental arithmetic and physical exercise. Ambulatory BP was assessed nine times per year. Among different reactivity scores HR reactivity to mental stress was the most stable variable. Only reactivity of systolic BP to mental stress was different between subjects with parental hypertension and subjects with a negative family history of hypertension. After 1 year high HR reactors developed about 7 mmHg higher ambulatory systolic BP levels than low HR reactors. It is concluded that besides genetic factors HR reactivity to mental stress might indicate the disposition for developing high BP.