Borghi C, Bacchelli S, Degli Esposti D, Boschi S, Immordino
V, Veronesi M, Costa FV, Ambrosioni E
15-year development of stable hypertension in borderline
hypertension with abnormal pressor response to mental
stress
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:146A 1997
The identification of subjects at risk for the subsequent development
of hypertension is difficult although the presence of a family history
of hypertension increases one's risk. The response to mental stress of
various types has been studied for many years as a method to study the
relationship between hemodynamic factors and mental stress, the
hypothesis being that subjects destined to become hypertensive display
an exaggerated blood pressure response to mental stress.
This Italian group studied 70 young borderline hypertensive patients
by monitoring their blood pressure response to mental arithmetic and
then classified them into two groups; normal reactors and
hyper-reactors. A group of 20 normotensives were also studied. The
authors then determined the prevalence of established hypertension in
these subjects after 15 years. They found that hyper-reactors had a
higher rate of progression (49%) to established hypertension than the
normal reactors (24%) or normotensives (25%). The authors say that the
predictive power was not related to baseline blood pressure, BMI, age
or family history of hypertension. The subjects with the hyper-reactor
pattern also had higher cholesterol levels.
Comment: These findings are very exciting and may point to a
simple and non invasive way to detect at risk subjects for
hypertension. Such subjects may benefit from aggressive lifestyle
modification which hopefully may delay or prevent the onset of
hypertension. (George Mansoor, M.D., University of
Connecticut)
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12th Annual ASH Meeting
H: Exam and lab tests :
White coat hypertension