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(Hypertension. 2008;52:336.)
© 2008 American Heart Association, Inc.

Original Articles

Sympathoadrenal Stress Reactivity Is a Predictor of Future Blood Pressure

An 18-Year Follow-Up Study

Arnljot Flaa; Ivar K. Eide; Sverre E. Kjeldsen; Morten Rostrup

From the Cardiovascular and Renal Research Center (A.F., I.K.E., S.E.K., M.R.) and Departments of Acute Medicine (A.F., M.R.), Nephrology (I.K.E.), and Cardiology (S.E.K.), Ullevaal University Hospital, Oslo, Norway.

Correspondence to Arnljot Flaa, Department of Acute Medicine, Ullevaal University Hospital, N-0407 Oslo, Norway. E-mail arnljot.flaa{at}medisin.uio.no

In the present study we hypothesized that arterial catecholamine concentrations during rest and 2 laboratory stress tests were independent predictors of blood pressure at an 18-year follow-up. At entry, blood pressure, heart rate, and arterial plasma epinephrine and norepinephrine concentrations were measured in 99 healthy men (age: 19.3±0.4 years, mean±SD) at rest, during a mental arithmetic test, and during a cold pressor test. After 18.0±0.9 years of follow-up, resting blood pressure was measured. The norepinephrine and epinephrine concentrations during the mental arithmetic explained 12.7% of the variation of future systolic blood pressure after adjusting for initial resting blood pressure, family history, body mass index, and systolic blood pressure during the stress test in a multiple regression analysis (adjusted R²=0.651; P<0.001). To conclude, the present study shows that sympathetic nervous activity during mental arithmetic predicts future blood pressure, indicating a possible causal factor in the development of essential hypertension independent of the initial blood pressure.

Key Words: blood pressure • stress reactivity • catecholamines • cold pressor test • epinephrine • mental stress • norepinephrine

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