Matthews K A, Owens J F, Allen M T, Stoney C M
Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213.
Psychosom Med. 1992 Nov-Dec;54(6):686-97. doi: 10.1097/00006842-199211000-00009.
Because the correspondence between laboratory measures of blood pressure and heart rate responses to stress and ambulatory measures is less than optimal, this study tested two hypotheses: Are ambulatory measures of blood pressure elevated during periods of perceived stress, relative to no stress? Are ambulatory blood pressures elevated during perceived stress among those individuals who exhibit elevated blood pressure and heart rate responses to laboratory stress? These questions were addressed in a sample of employed, middle-aged men and premenopausal and postmenopausal women, who vary in reproductive hormone status, and in risk for coronary heart disease. All participants performed a series of laboratory studies while their physiological parameters were monitored and then wore an ambulatory blood pressure monitor for a day and a half. This monitor recorded blood pressure every half hour during the waking hours and at the same time the participants assessed their mood states. After excluding participants who reported no variability in stress levels, those who were cardiovascular reactors to a laboratory speech task exhibited elevated ambulatory blood pressure levels during periods of perceived stress. Furthermore, in general, periods of perceived stress were associated on a within subject basis with elevated ambulatory blood pressure. These results suggest that the correspondence between laboratory and field measures of blood pressure would be improved by taking into account the environmental circumstances during the ambulatory assessments and the person characteristics of reactor-nonreactor to laboratory stress.
由于实验室测量的血压和心率对应激的反应与动态测量结果之间的一致性不尽人意，本研究检验了两个假设：与无应激状态相比，在感知到应激期间，动态血压测量值是否会升高？在对实验室应激表现出血压和心率升高反应的个体中，感知到应激期间动态血压是否会升高？这些问题在一组在职的中年男性以及绝经前和绝经后的女性样本中进行了探讨，这些人在生殖激素状态以及冠心病风险方面存在差异。所有参与者在接受生理参数监测的同时进行了一系列实验室研究，然后佩戴动态血压监测仪一天半。该监测仪在清醒时间每半小时记录一次血压，与此同时参与者评估自己的情绪状态。在排除那些报告应激水平无变化的参与者后，那些对实验室言语任务有心血管反应的人在感知到应激期间动态血压水平升高。此外，总体而言，在个体内部，感知到应激的时期与动态血压升高有关。这些结果表明，通过在动态评估期间考虑环境情况以及对实验室应激有反应者与无反应者的个体特征，实验室测量与现场测量血压之间的一致性将会得到改善。
