Published Online
on September 30, 2002

A more recent version of this article appeared on November 1, 2002

This Article Full Text (PDF) All Versions of this Article: 40/5/742    most recent 01.HYP.0000035707.57492.EBv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gianaros, P. J. Articles by Manuck, S. B. Search for Related Content PubMed PubMed Citation Articles by Gianaros, P. J. Articles by Manuck, S. B. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Carotid Artery Disease High Blood Pressure Related Collections Risk Factors Hypertension - basic studies Imaging Autonomic, reflex, and neurohumoral control of circulation

Submitted on June 4, 2002
Revised on June 21, 2002

Is Cardiovascular Reactivity Associated With Atherosclerosis Among Hypertensives?

Peter J. Gianaros^*; Maria E. Bleil; Matthew F. Muldoon; J. Richard Jennings; Kim Sutton-Tyrrell; Jeanne M. McCaffery; and Stephen B. Manuck

From the Cardiovascular Behavioral Medicine Research Program (P.J.G.), Department of Psychology (M.E.B., S.B.M.), Department of Medicine (M.F.M.), Departments of Psychiatry and Psychology (J.R.J.), and Department of Epidemiology (K.S.-T.), University of Pittsburgh, Pennsylvania; and Department of Psychiatry (J.M.M.), Brown University, Providence, RI.

^* To whom correspondence should be addressed. E-mail: gianarospj{at}msx.upmc.edu.

Abstract—Exaggerated cardiovascular reactivity to behavioral challenges among otherwise healthy individuals has been associated with carotid atherosclerosis. We evaluated whether a similar relationship exists among hypertensives, who are at a heightened atherosclerotic risk. Untreated, hypertensive men (n=251; age range, 40 to 70 years; 197 white, 54 black) completed a standardized battery of behavioral challenges while their blood pressure responses to the battery were measured. Mean and maximum carotid intima-media thickness and the occurrence of carotid plaques were subsequently determined using B-mode ultrasonography. Although greater systolic and diastolic responses to the battery were associated with greater mean and maximum intima-media thickness in univariate analyses (P<0.01), only diastolic reactivity showed a unique association with mean and maximum carotid intima-media thickness after multivariate adjustment for age, race, socioeconomic status, smoking and alcohol use, body mass index, lipid profile, glucose and insulin concentrations, and resting blood pressure (P<0.05). Carotid plaque occurrence was associated with greater systolic reactivity (P=0.05) and was marginally associated with greater diastolic reactivity (P=0.07) in univariate analyses, but neither systolic nor diastolic reactivity was uniquely associated with the presence of carotid plaques after multivariate risk-factor adjustment. Among hypertensives, exaggerated behaviorally evoked cardiovascular reactivity appears to be uniquely associated with greater carotid intima-media thickness but not with carotid plaque occurrence.

Key words: atherosclerosis • cardiovascular reactivity • carotid intima-media thickness • carotid plaque • stress

This article has been cited by other articles:

				P. J. Gianaros, J. R. Jennings, L. K. Sheu, S. W.G. Derbyshire, and K. A. Matthews Heightened Functional Neural Activation to Psychological Stress Covaries With Exaggerated Blood Pressure Reactivity Hypertension, January 1, 2007; 49(1): 134 - 140. [Abstract] [Full Text] [PDF]

				J. R. Jennings, M. F. Muldoon, C. Ryan, J. C. Price, P. Greer, K. Sutton-Tyrrell, F. M. van der Veen, and C. C. Meltzer Reduced cerebral blood flow response and compensation among patients with untreated hypertension Neurology, April 26, 2005; 64(8): 1358 - 1365. [Abstract] [Full Text] [PDF]

				P. J. Gianaros, J. C. May, G. J. Siegle, and J. R. Jennings Is There a Functional Neural Correlate of Individual Differences in Cardiovascular Reactivity? Psychosom Med, January 1, 2005; 67(1): 31 - 39. [Abstract] [Full Text] [PDF]

				M. E. Bleil, J. M. McCaffery, M. F. Muldoon, K. Sutton-Tyrrell, and S. B. Manuck Anger-Related Personality Traits and Carotid Artery Atherosclerosis in Untreated Hypertensive Men Psychosom Med, September 1, 2004; 66(5): 633 - 639. [Abstract] [Full Text] [PDF]