Blood pressure reactivity to mental stress is related to daily blood pressure variability in postmenopausal hypertensive women

Abstract Objective: This study aimed to investigate the relationship between blood pressure (BP) responses during a mental stress test with 24-hour ambulatory BP (ABPM) and its variability (BPV) in postmenopausal hypertensive women. Methods: BP reactivity under mental stress and ABPM were evaluated in 75 postmenopausal hypertensive women between 50 and 70 years, on non-consecutive days. We used the values of the variation (∆) of systolic BP (SBP) and diastolic BP from the reactivity test as independent variables, and the BPV indexes Average Real Variability (ARV), 24-hour SD, and SDdn (standard deviation weighted by daytime and nighttime duration) as dependent variables. In the multiple linear regression analysis, three models were tested: 1) without adjustment; 2) adjusted for time since menopause; and 3) adjusted for both nocturnal BP dipping classification and time since menopause. Results: The ARV index showed a significant association with ∆SBP variation in all models (model 1,2 and 3: β coefficient: 0.04, CI 95%: [0.00;0.08]). Conclusion: In conclusion, blood pressure variation during the mental stress test is related to ambulatory blood pressure variation, specifically to ARV in postmenopausal hypertensive women. These findings suggest that systolic blood pressure responses to mental stress may be a relevant predictor of daily blood pressure variability.