Abstract
Exaggerated blood pressure (BP) response to mental stress has been known to be a prognostic factor for cardiovascular disease. It has been argued that such unusual vascular reactivity to mental stress may arise from insulin resistance. To examine the vascular responses to mental stress, we evaluated the stress-related changes in BP and the augmentation index (AI), an index of arterial stiffness, in normotensive young males. Changes in late systolic BP (SBP2) representing central aortic pressure were also examined. Subjects were 86 males (21±2 years), 13 of whom were classified as obese (≥25 kg/m2). AI was obtained from the radial arterial waveform as a ratio of the height of the late systolic peak to that of the first peak. Blood pressure and AI measurements were taken before, during and after a simple mental arithmetic test (MAT) lasting 3 min. Systolic BP (baseline 125±13, during MAT 133±13, post-MAT 124±11 mmHg; p<0.001) and heart rate (74±12, 81±13, 74±11 beats/min; p<0.001) were significantly increased during the MAT, whereas AI showed a slight reduction. In a separate analysis, the opposite response was observed between obese subjects showing increased AI (54±11, 56±13, 52±11%) and non-obese subjects who showed reduced AI (54±12, 51±12, 53±12%; p=0.032). The responses in SBP and SBP2 (obese 103±14, 117±12, 104±12; non-obese 98±13, 104±12, 97±12 mmHg; p=0.007) were also larger in the obese subjects. Stress-related transient increases in arterial stiffness may be involved in the exaggerated responses in aortic pressure in obese subjects.
Similar content being viewed by others
Article PDF
References
Matthews KA, Woodall KL, Allen MT : Cardiovascular reactivity to stress predicts future blood pressure status. Hypertension 1993; 22: 479–485.
Carroll D, Smith GD, Sheffield D, Shipley MJ, Marmot MG : Pressor reactions to psychological stress and prediction of future blood pressure: data from the Whitehall II Study. BMJ 1995; 310: 771–776.
Jennings JR, Kamarck TW, Everson-Rose SA, Kaplan GA, Manuck SB, Salonen JT : Exaggerated blood pressure responses during mental stress are prospectively related to enhanced carotid atherosclerosis in middle-aged Finnish men. Circulation 2004; 110: 2198–2203.
Matthews KA, Owens JF, Kuller LH, Sutton-Tyrrell K, Lassila HC, Wolfson SK : Stress-induced pulse pressure change predicts women’s carotid atherosclerosis. Stroke 1998; 29: 1525–1530.
Waldstein SR, Siegel EL, Lefkowitz D, et al: Stress-induced blood pressure reactivity and silent cerebrovascular disease. Stroke 2004; 35: 1294–1298.
Grossman E, Oren S, Garavaglia GE, Schmieder R, Messerli FH : Disparate hemodynamic and sympathoadrenergic responses to isometric and mental stress in essential hypertension. Am J Cardiol 1989; 64: 42–44.
Sung BH, Wilson MF, Izzo JL Jr, Ramirez L, Dandona P : Moderately obese, insulin-resistant women exhibit abnormal vascular reactivity to stress. Hypertension 1997; 30: 848–853.
Rockstroh JK, Schmieder RE, Schachinger H, Messerli FH : Stress response pattern in obesity and systemic hypertension. Am J Cardiol 1992; 70: 1035–1039.
Kohara K, Tabara Y, Oshiumi A, Miyawaki Y, Kobayashi T, Miki T : Radial augmentation index: a useful and easily obtainable parameter for vascular aging. Am J Hypertens 2005; 18: 11S–14S.
Tabara Y, Nakura J, Kondo I, Miki T, Kohara K : Orthostatic systolic hypotension and the reflection pressure wave. Hypertens Res 2005; 28: 537–543.
Takazawa K, Kobayashi H, Shindo N, Tanaka N, Yamashina A : Relationship between radial and acentral arterial pulse wave and evaluation of central aortic pressure using the radial arterial pulse wave. Hypertens Res 2007; 30: 219–228.
Pauca AL, Kon ND, O’Rourke MF : The second peak of the radial artery pressure wave represents aortic systolic pressure in hypertensive and elderly patients. Br J Anaesth 2004; 92: 651–657.
Takazawa K, Tanaka N, Takeda K, Kurosu F, Ibukiyama C : Underestimation of vasodilator effects of nitroglycerin by upper limb blood pressure. Hypertension 1995; 26: 520–523.
Vlachopoulos C, Alexopoulos N, Panagiotakos D, O’Rourke MF, Stefanadis C : Cigar smoking has an acute detrimental effect on arterial stiffness. Am J Hypertens 2004; 17: 299–303.
Examination Committee of Criteria for ‘Obesity Disease’ in Japan, Japan Society for the Study of Obesity : New criteria for ‘obesity disease’ in Japan. Circ J 2002; 66: 987–992.
Nichols WW : Clinical measurement of arterial stiffness obtained from noninvasive pressure waveforms. Am J Hypertens 2005; 18 ( Suppl): 3S–10S.
Wilkinson IB, MacCallum H, Flint L, Cockcroft JR, Newby DE, Webb DJ : The influence of heart rate on augmentation index and central arterial pressure in humans. J Physiol 2000; 525: 263–270.
Kamarck TW, Everson SA, Kaplan GA, et al: Exaggerated blood pressure responses during mental stress are associated with enhanced carotid atherosclerosis in middle-aged Finnish men: findings from the Kuopio Ischemic Heart Disease Study. Circulation 1997; 96: 3842–3848.
Mahmud A, Feely J : Effect of smoking on arterial stiffness and pulse pressure amplification. Hypertension 2003; 41: 183–187.
Nichols W, O’Rourke M : McDonald’s Blood Flow in Arteries, 4th ed. London, Edward Arnold, 1998.
da Costa LS, de Oliveira MA, Rubim VS, et al: Effects of hormone replacement therapy or raloxifene on ambulatory blood pressure and arterial stiffness in treated hypertensive postmenopausal women. Am J Cardiol 2004; 94: 1453–1456.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tabara, Y., Kohara, K., Nakagawa, S. et al. Effects of Obesity and Smoking on Mental Stress-Induced Blood Pressure and Augmentation Index Responses in Normotensive Young Males: The J-SHIPP Study. Hypertens Res 31, 1219–1224 (2008). https://doi.org/10.1291/hypres.31.1219
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1291/hypres.31.1219
Keywords
This article is cited by
-
Association of Central Systolic Blood Pressure With Intracerebral Small Vessel Disease in Japanese
American Journal of Hypertension (2010)
