Psychological Factors Affecting Ambulatory Blood Pressure in a High-Stress Occupation

  • David Shapiro
  • Iris B. Goldstein
  • Larry Jamner
Part of the The Plenum Series in Behavioral Psychophysiology and Medicine book series (SSBP)


Since the first recording of indirect and direct ambulatory blood pressure (BP) in human subjects (Bevan, Honour, & Stott, 1969; Hinman, Engel, & Bickford, 1962), the advantages of recording BP in natural settings have become firmly established. Compared to BP values obtained in a doctor’s office or clinic, 24-hr ambulatory BP measurements are less likely to give inflated estimates of an individual’s BP (Burstyn, O’Donovan, & Charlton, 1981; Floras, Jones, Hassan, Osikowska, Sever, & Sleight, 1981; Mancia, 1990); they also offer a more precise means of evaluating the efficacy of antihypertensive medications (Des Combes, Porchet, Waeber, & Brunner, 1984; Rion, Waeber, Graf, Jaussi, Porchet, & Brunner, 1985) and provide a better predictor of the development of cardiovascular morbidity and mortality (Cheung & Weber, 1988; Harshfield, Pickering, Kleinert, Blank, & Laragh, 1982; Pessina, Palatini, Di Marco, Mormino, Fazio, Libardoni, Mos, Casiglia, & Dal, 1986). These advantages derive from the fact that the 50–100 readings typically obtained in a single 24-hr ambulatory recording yield a considerably more stable mean level of BP compared to the two or three readings obtained in an office examination. The multiple readings also offer a good means of estimating BP variability in the individual, another significant correlate of target-organ damage (Parati, Pomidossi, Albini, Malaspina, & Manda, 1987).


Coping Style Ambulatory Blood Pressure Ambulatory Blood Pressure Monitoring Psychosomatic Medicine Diastolic Blood Pressure Level 
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Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • David Shapiro
    • 1
  • Iris B. Goldstein
    • 1
  • Larry Jamner
    • 2
  1. 1.Department of PsychiatryUniversity of California at Los AngelesLos AngelesUSA
  2. 2.University of CaliforniaIrvineUSA

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