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Hypertension. 2007;49:134-140
Published online before print November 13, 2006, doi: 10.1161/01.HYP.0000250984.14992.64
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(Hypertension. 2007;49:134.)
© 2007 American Heart Association, Inc.

Original Articles

Heightened Functional Neural Activation to Psychological Stress Covaries With Exaggerated Blood Pressure Reactivity

Peter J. Gianaros; J. Richard Jennings; Lei K. Sheu; Stuart W.G. Derbyshire; Karen A. Matthews

From the Department of Psychiatry (P.J.G., J.R.J., L.K.S., K.A.M.), University of Pittsburgh, Pa; and the School of Psychology (S.W.G.D.), University of Birmingham, Edgbaston, United Kingdom.

Correspondence to Peter J. Gianaros, Department of Psychiatry, University of Pittsburgh, 3811 O’Hara St, Pittsburgh, PA 15213. E-mail gianarospj{at}upmc.edu

Individuals who show exaggerated blood pressure reactions to psychological stressors are at increased risk for hypertension, atherosclerosis, and stroke. We tested whether individuals who show exaggerated stressor-induced blood pressure reactivity also show heightened stressor-induced neural activation in brain areas involved in controlling the cardiovascular system. In a functional MRI study, 46 postmenopausal women (mean age: 68.04; SD: 1.35 years) performed a standardized Stroop color-word interference task that served as a stressor to increase blood pressure. Across individuals, a larger task-induced rise in blood pressure covaried with heightened and correlated patterns of activation in brain areas implicated previously in stress-related cardiovascular control: the perigenual and posterior cingulate cortex, bilateral prefrontal cortex, anterior insula, and cerebellum. Entered as a set in hierarchical regression analyses, activation values in these brain areas uniquely predicted the magnitude of task-induced changes in systolic ({Delta}R2=0.54; P<0.001) and diastolic ({Delta}R2=0.27; P<0.05) blood pressure after statistical control for task accuracy and subjective reports of task stress. Heightened stressor-induced activation of cingulate, prefrontal, insular, and cerebellar brain areas may represent a functional neural phenotype that characterizes individuals who are prone to show exaggerated cardiovascular reactivity.


Key Words: blood pressure • cardiovascular reactivity • cerebellum • cingulate • insula • orbitofrontal cortex • psychological stress




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