Blunted as well as exaggerated cardiovascular reactivity to stress is associated with negative health outcomes1

The reactivity hypothesis implicates exaggerated cardiovascular reactions to acute psychological stress in the development of hypertension and other cardiovascular disease outcomes. However, exaggerated cardiovascular reactivity has also been suggested as a mediator between a variety of psychosocial and behavioral risk factors and cardiovascular disease. Recent data analyses from the West of Scotland Twenty-07 study and our own group are discussed together, to show that blunted as well as exaggerated cardiovascular reactivity to stress may be associated with negative health outcomes. Blood pressure and heart rate were assessed at rest and during an acute mental arithmetic stress task. We show that depression and obesity are associated with blunted rather than exaggerated reactivity. These seemingly paradoxical results are discussed in terms of implications for the reactivity hypothesis.