Blood Pressure Reactions to Acute Mental Stress and Future Blood Pressure Status: Data From the 12-Year Follow-Up of the West of Scotland Study

Objective: To test the reactivity hypothesis using blood pressure data collected 12 years after baseline. This study examined whether blood pressure reactions to acute mental stress predicted future blood pressure resting levels, as well as the temporal drift in resting blood pressure, and whether the prediction was affected by sex, age, and socioeconomic status. Methods: Resting blood pressure was recorded at an initial baseline and in response to a mental stress task. Twelve years later, resting blood pressure was again assessed. Data were available for 1196 participants (645 women, 551 men), comprising, at the time of stress testing, 439 who were aged 24 years; 503, aged 44; and 254, aged 63. The participants included 531 who were from manual occupational households and 661 from nonmanual occupational households. Results: In multivariate linear regression models, adjusting for a number of potential confounders, systolic blood pressure (SBP) reactivity positively predicted future resting SBP, as well as the upward drift in SBP over the 12 years (beta = 0.10, p <.001 in both cases). The effect sizes were smaller than those reported from an earlier 5- year follow-up. The analogous associations for diastolic blood pressure reactivity were not statistically significant. In multivariate logistic regression, high SBP reactivity was associated with an increased risk of being hypertensive 12 years later (odds ratio - 1.03, 95% confidence interval - 1.01-1.04, p <.001). Conclusions: The present findings that greater reactivity is associated with higher future resting blood pressure, more upward drift in resting blood pressure, and future hypertension provide support for the reactivity hypothesis.