Moseley Janine V, Linden Wolfgang
University of British Columbia, Department of Psychology, Vancouver, British Columbia, Canada.
Psychosom Med. 2006 Nov-Dec;68(6):833-43. doi: 10.1097/01.psy.0000238453.11324.d5.
We examined whether cardiovascular reactivity and recovery after laboratory-induced stress is useful in predicting 3-year and 10-year ambulatory blood pressure (BP) and heart rate (HR) among 330 initially normotensive individuals.
At baseline, BP and HR measurements were recorded during three 5-minute laboratory challenges and three 5-minute recovery periods after each challenge. Measurements of systolic BP, diastolic BP, and HR were collected throughout this baseline protocol and also at 3-year and 10-year follow up by ambulatory monitoring.
After adjustment for traditional biologic predictors, reactivity was found to explain significant variance in follow-up data across all 3-year indices and two of the 10-year indices. Recovery, entered in a following step after reactivity, was found to explain additional significant variance across all 3-year indices but none of the 10-year indices. Family hypertension history data were not found to be significantly associated with reactivity or recovery nor were they predictive of longitudinal ambulatory data after adjustment for initial resting cardiovascular levels.
Overall, from a hierarchical regression model perspective, the data support the use of both reactivity and recovery in clinical predictions of proximal BP and HR and generally support the use of reactivity (but not recovery) in long-term BP predictions.
我们研究了在330名初始血压正常的个体中，实验室诱发应激后的心血管反应性和恢复情况是否有助于预测3年和10年的动态血压（BP）及心率（HR）。
在基线时，在三次5分钟的实验室挑战期间以及每次挑战后的三个5分钟恢复期记录血压和心率测量值。在整个基线方案期间以及3年和10年随访时通过动态监测收集收缩压、舒张压和心率的测量值。
在对传统生物学预测因素进行调整后，发现反应性可解释所有3年指标以及10年指标中的两个指标在随访数据中的显著差异。在反应性之后进入下一步分析的恢复情况，被发现可解释所有3年指标中的额外显著差异，但不能解释任何10年指标中的差异。未发现家族高血压病史数据与反应性或恢复情况有显著关联，在对初始静息心血管水平进行调整后，它们也不能预测纵向动态数据。
总体而言，从分层回归模型的角度来看，数据支持在近端血压和心率的临床预测中同时使用反应性和恢复情况，并且总体上支持在长期血压预测中使用反应性（而非恢复情况）。
