[Response of arterial pressure to mental stress in young patients with high or mild arterial hypertension. Does it reflect the changes in arterial pressure observed during its ambulatory monitoring?].

BACKGROUND

The use of cardiovascular reactivity tests in the laboratory is based on their probable capacity to predict blood pressure response in stress situations of everyday life. These responses may be estimated from the values obtained by out patient monitorization or blood pressure (OPMBP).

METHODS

OPMBP was carried out over 24 hours by Spacelabs 90202 monitor in 57 subjects from 18-40 years of age with high or slightly high blood pressure (mean blood pressure diagnosed 143 +/- 12/91 +/- 8 mmHg) with a Quetelet index of 25.8 +/- 9 kg/m2. Two mental stress tests were applied: the mental arithmetic test (MAT) and a structured interview (SI) in 38 patients with high or slightly high blood pressure (HBP) and to 18 healthy normotense subjects of the same age group.

RESULTS

The increases in systolic BP (SBP) and diastolic BP (DBP) observed during MAT and SI were similar: r = 0.88 and r = 0.68, respectively (p < 0.0001, both). The percentage of hyperreactive subjects, defined as those presenting an absolute increase in SBP > or = 25 mmHg and/or an increase of DBP > or = 15 mmHg was greater between those with slightly high blood pressure (70%) and high blood pressure (43%) in both tests than among the normotense subjects of the control groups (28%) (p < 0.05). Upon study of the relation between response to BP during the mental stress tests and the values of BP obtained with OPBPM, a positive correlation was found between the increase in DBP in MAT and the SI and mean 24 hour DBP (r = 0.39 and r = 0.45, p < 0.025 and p < 0.01, respectively).

CONCLUSIONS

The correlation of the absolute increase in systolic and diastolic blood pressure during two different mental stress tests in young subjects with high or slightly high blood pressure is very high. The correlation between the increase in blood pressure to mental stress in the laboratory and the blood pressure values obtained during non invasive out patient monitorization was found to be only intermediate for diastolic blood pressure nad null for systolic blood pressure in this study.