Blood pressure reactivity to stress varies by hypertensive status and sex in Nigerians

Previous studies among American and European populations have demonstrated larger blood pressure responses to behavioral challenges among men and hypertensive individuals. This is the first report of cardiovascular responses to behavioral challenges in a West African population. Blood pressure and heart rate changes in mirror image tracing and speech making tasks were recorded for 787 Nigerian civil servants participating in a comprehensive blood pressure survey conducted in Benin City, Nigeria, during 1992. Similar to findings in other populations, greater task-induced increases in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were present among men than women (mean values of SBP = 22.1 vs. 18.3 mmHg, p < 0.001; and DBP means = 13.3 vs. 11.2 mmHg, p < 0.0001) and among hypertensives than normotensives (SBP means = 27.6 vs. 19.2, p < 0.0001; and DBP means = 14.1 vs. 12.1 mmHg, p < 0.05). An elevated prevalence of hypertension among men of higher staff status has been found in this population; however, higher staff status was not consistently related to cardiovascular reactivity, independent of hypertensive status. Additionally, hypertensive men who had speech-induced increases of SBP > 40 mmHg had significantly greater left ventricular mass index than did those hypertensive men with smaller SBP increases (p < 0.04). This study demonstrates that measures of cardiovascular reactivity to behavioral challenges have cross-cultural application, suggesting the need for further investigations of the interrelation of hypertension, cardiovascular reactivity, and left ventricular mass. Am J Epidemiol 1995;142:1020-8. © 1995 The Johns Hopkins University School of Hygiene and Public Health.