Matthews Karen A, Katholi Charles R, McCreath Heather, Whooley Mary A, Williams David R, Zhu Sha, Markovitz Jerry H
University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, USA.
Circulation. 2004 Jul 6;110(1):74-8. doi: 10.1161/01.CIR.0000133415.37578.E4. Epub 2004 Jun 21.
A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults.
We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of >4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges--cold pressor, star tracing, and video game tasks--were measured. Hypertensive status was defined as use of antihypertensive medication or measured BP > or =140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred (P<0.0001 to <0.01). The systolic BP effect for the cold pressor task was apparent for women and for whites in race- and gender-specific models, whereas the diastolic BP effect for the video game was apparent for men.
Young adults who show a large BP response to psychological stress may be at risk for hypertension as they approach midlife.
一个长期存在但存在争议的假设是，在心理压力期间血压（BP）频繁大幅升高的个体有患原发性高血压的风险。我们测试了心理压力期间的血压变化是否能预测年轻成年人患高血压的情况。
我们使用生存分析来预测参加CARDIA研究的4100多名血压正常的黑人和白人男性及女性（入组年龄18至30岁）在13年随访期间的高血压状态。测量了对三种心理挑战——冷加压、星形追踪和视频游戏任务——的血压反应。高血压状态定义为使用抗高血压药物或测量血压≥140/90 mmHg。在对种族、性别、协变量（教育程度、体重指数、年龄和静息血压）及其显著交互作用进行调整后，对这三项任务中每一项的血压反应越大，高血压出现得越早（P<0.0001至<0.01）。在种族和性别特异性模型中，冷加压任务对女性和白人的收缩压影响明显，而视频游戏对男性的舒张压影响明显。
对心理压力有较大血压反应的年轻成年人在接近中年时可能有患高血压的风险。
