Reactivity of blood pressure to mental arithmetic stress test, stress-test recovery time, and ambulatory blood pressure in hypertensive and normotensive subjects.

BACKGROUND

Laboratory mental stress testing and 24 h ambulatory blood pressure monitoring may analyse reactivity of blood pressure during provoked stress and stressful situations in daily-life, respectively. OBJECTIVE: To evaluate whether the responses to a mental stress test and during the stress-test recovery time were associated with ambulatory blood pressure parameters. METHODS: Fifty-two untreated male subjects (22 normotensives and 30 hypertensives) were subjected both to mental arithmetic stress testing and ambulatory blood pressure monitoring. RESULTS: We found a positive correlation between baseline and peak-test blood pressures during the stress test and 24 h blood pressures. Maximal values of systolic and diastolic blood pressures measured during the 24 h were also correlated to the maximal systolic and diastolic blood pressures reached during the stress test ( P < 0.001). We observed no relationship between reactivity during the stress test and 24 h parameters. On the contrary, changes in diastolic blood pressure during the time of recovery from the stress test (expressed as percentage-change scores) were correlated to the 24 h diastolic blood pressure parameters, the diastolic load being the most closely associated variable. CONCLUSION: The absence of relationships between variations in blood pressure during the provoked stress and ambulatory monitoring parameters indicates that reactivity of blood pressure to an acute stress does not predict the 24 h profile. However, the correlation between the maximal blood pressure measured by ambulatory monitoring and that observed during stress testing indicates that the maximal 24 h values may show the extreme blood pressure response (like the one provoked acutely by a laboratory stress test) of an individual subject. The correlation between the percentage-change score during the recovery time of diastolic blood pressure and the 24 h diastolic load could account forr a lower than normal capacity for recovery of subjects with persistently high blood pressures.