Stress-induced cardiovascular reactivity and atherogenesis in adolescents

Objective: To examine the association between cardiovascular reactivity to a set of psychological stressors and carotid artery intima-media thickness, a marker of subclinical cardiovascular disease in healthy adolescents. Methods: Participants were 25 boys and 23 girls age 14.2 + 0.9 years who were measured for heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure reactivity to mirror-tracing, reaction time, speech preparation and ad lib speech tasks and for common carotid artery intima-media thickness. Sequential regression analyses were used to establish the incremental increase in R(2) (R(inc)(2)) for the prediction of intima-media thickness due to cardiovascular reactivity independent of age, BMI percentile, sex, socioeconomic status, and resting HR or BP. Results: SBP reactivity while preparing (beta = 0.0019, R(inc)(2) = 0.09) and giving the speech (beta = 0.0014, R(inc)(2) = 0.10) and an aggregate reactivity score based on all 4 tasks (beta = 0.0026, R(inc)(2) = 0.11) independently predicted (p <= 0.05) mean carotid artery intima-media thickness. Neither DBP reactivity nor HR reactivity during any task were independent predictors of intima-media thickness. Conclusion: Stress-induced cardiovascular reactivity, and especially SBP reactivity, is associated with carotid intima-media thickness and the early pathogenesis of cardiovascular disease. The use of an aggregate stress reactivity index provides a more reliable reflection of trait SBP reactivity to psychological stress and increases the confidence that youth with greater cardiovascular stress reactivity may indeed have greater progression of subclinical cardiovascular disease. (C) 2011 Elsevier Ireland Ltd. All rights reserved.