To assess whether variation in the rate of cardiovascular recovery following exposure to acute psychological stress predicts changes in blood pressure longitudinally, independently of blood pressure at baseline and ot...To assess whether variation in the rate of cardiovascular recovery following exposure to acute psychological stress predicts changes in blood pressure longitudinally, independently of blood pressure at baseline and other covariates. Design: A 3- year longitudinal study. Participants: A total of 209 men and women aged 45- 59 years at baseline, with no history of cardiovascular disease including hypertension. Method: Measurement of blood pressure, heart rate, heart rate variability, cardiac index and total peripheral resistance at rest, during two moderately stressful behavioural tasks and up to 45 min post-stress. Stress reactivity was defined as the difference in values between tasks and baseline, and post-stress recovery as the difference between recovery levels and baseline. Outcome measures: Resting blood pressure measured at baseline and 3 years later. Seven individuals had been prescribed hypertensive medication on follow-up. Results: Increases in systolic blood pressure(SBP) were predicted by impaired post-stress recovery of SBP(P< 0.001), diastolic blood pressure(DBP)(P< 0.001) and total peripheral resistance(P=0.003), independently of baseline blood pressure, age, gender, socio-economic status, hypertensive medication, body mass and smoking. The adjusted odds of an increase in SBP ≥ 5mmHg were 3.50[95% confidence interval(CI) 1.19 to 10.8] for individuals with poor compared with effective post-stress recovery of SBP. Three year increases in diastolic pressure were predicted by impaired recovery of SBP(P< 0.001) and DBP(P=0.009) pressure and by heart rate variability during tasks(P=0.002), independently of covariates. Conclusions: Impaired post-stress recovery and less consistently heightened acute stress reactivity may index disturbances in the regulation of cardiovascular stress responses that contribute to longitudinal changes in blood pressure in middle-aged men and women.展开更多
社会经济地位和心血管病预后的关系已有研究,但财富的纵向变化是否与心血管健康状况相关尚未阐明。本文旨在评估中年财富流动性与心血管事件风险的关系。设计、设置和受试者:该项纵向回顾性队列研究纳入参与健康和退休研究(health and r...社会经济地位和心血管病预后的关系已有研究,但财富的纵向变化是否与心血管健康状况相关尚未阐明。本文旨在评估中年财富流动性与心血管事件风险的关系。设计、设置和受试者:该项纵向回顾性队列研究纳入参与健康和退休研究(health and retirement study)的年龄≥50岁的美国成年人。初步分析中的受试者无心血管病史,在3个年龄段(50~<55,55~<60和60~<65岁)中至少对其中两个进行观察,并在65岁后进行随访。展开更多
文摘To assess whether variation in the rate of cardiovascular recovery following exposure to acute psychological stress predicts changes in blood pressure longitudinally, independently of blood pressure at baseline and other covariates. Design: A 3- year longitudinal study. Participants: A total of 209 men and women aged 45- 59 years at baseline, with no history of cardiovascular disease including hypertension. Method: Measurement of blood pressure, heart rate, heart rate variability, cardiac index and total peripheral resistance at rest, during two moderately stressful behavioural tasks and up to 45 min post-stress. Stress reactivity was defined as the difference in values between tasks and baseline, and post-stress recovery as the difference between recovery levels and baseline. Outcome measures: Resting blood pressure measured at baseline and 3 years later. Seven individuals had been prescribed hypertensive medication on follow-up. Results: Increases in systolic blood pressure(SBP) were predicted by impaired post-stress recovery of SBP(P< 0.001), diastolic blood pressure(DBP)(P< 0.001) and total peripheral resistance(P=0.003), independently of baseline blood pressure, age, gender, socio-economic status, hypertensive medication, body mass and smoking. The adjusted odds of an increase in SBP ≥ 5mmHg were 3.50[95% confidence interval(CI) 1.19 to 10.8] for individuals with poor compared with effective post-stress recovery of SBP. Three year increases in diastolic pressure were predicted by impaired recovery of SBP(P< 0.001) and DBP(P=0.009) pressure and by heart rate variability during tasks(P=0.002), independently of covariates. Conclusions: Impaired post-stress recovery and less consistently heightened acute stress reactivity may index disturbances in the regulation of cardiovascular stress responses that contribute to longitudinal changes in blood pressure in middle-aged men and women.
文摘社会经济地位和心血管病预后的关系已有研究,但财富的纵向变化是否与心血管健康状况相关尚未阐明。本文旨在评估中年财富流动性与心血管事件风险的关系。设计、设置和受试者:该项纵向回顾性队列研究纳入参与健康和退休研究(health and retirement study)的年龄≥50岁的美国成年人。初步分析中的受试者无心血管病史,在3个年龄段(50~<55,55~<60和60~<65岁)中至少对其中两个进行观察,并在65岁后进行随访。
