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Predicting blood pressure and heart rate change with cardiovascular reactivity and recovery : results from 3-year and 10-year follow-up Moseley, Janine V.

Abstract

We examined whether cardiovascular reactivity to and recovery from lab-induced stress is useful in predicting 3-year and/or 10-year changes in ambulatory blood pressure (BP) and heart rate (HR) among initially normotensive, community-dwelling adults and university students. At baseline, participants completed one day of laboratory testing, which included a 20- minute baseline assessment followed by three counterbalanced five-minute laboratory challenges (mental arithmetic, speech, and handgrip). Five-minute recovery periods followed each challenge. Measurements of systolic BP, diastolic BP, and HR were collected throughout this lab protocol. Data were then collected on 10-12 hours of ambulatory monitoring at 3-year follow-up, and on 24 hours of ambulatory monitoring at 10-year follow-up. Regression analyses indicated that after adjustment for initial resting cardiovascular levels along with predictive demographic and risk factor variables, aggregate reactivity scores explained unique and significant variance in ambulatory levels for all of the 3-year indices and two of the three 10-year indices (it did not improve the 10-year HR predictor model). When aggregate recovery data were forced into the models in a later step, it was found to explain unique and significant variance in ambulatory levels above that explained by initial resting cardiovascular levels, predictive demographic and risk factor variables, and aggregate reactivity scores for all of the 3-year indices. Moreover, in these final prediction models, the recovery data appeared to be significantly more predictive than the respective reactivity data. With respect to the 10-year data, aggregate recovery data did not significantly improve prediction models, although it again was found to be more predictive than respective reactivity data in two of the three final 10-year models (the 10-year DBP model did not follow this trend). Family hypertension history data were not found to be significantly associated with reactivity or recovery data, nor was it found to be predictive of longitudinal ambulatory data after adjustment for initial resting cardiovascular levels. In conclusion, our data thoroughly support the utility of reactivity and (particularly) recovery in predicting proximal BP and HR changes, generally support the use of reactivity in long-term BP predictions, and attest to the overall superiority of the DBP model in these predictions.

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