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Longitudinal Association of Cardiovascular Reactivity and Blood Pressure in Samoan Adolescents

From the Department of Medicine (J.D.N., S.T.McG.), The Miriam Hospital, Brown University School of Medicine, Providence Rhode Island; and Department of Anthropology (M.S.S.), University of Washington, Seattle, Washington.

Address reprint requests to: Stephen T. McGarvey, PhD, MPH, Department of Medicine, The Miriam Hospital, 164 Summit Ave., Providence, RI 02906. E:mail: Stephen_McGarvey{at}brown.edu

OBJECTIVE: The longitudinal association between blood pressure (BP) reactivity to a video game and resting BP 3 to 4 years later was investigated in 83 Samoan adolescents from American and (Western) Samoa as part of a multidisciplinary study of cardiovascular disease (CVD) risk in modern Samoans.

METHODS: Participants ranged in age from 11 to 14 years at baseline, in 1992 to 1993, and 14 to 18 years at follow-up in 1996. Video game BP reactivity was defined as the residual score of the regression of the maximum BP during the video game on the minimum resting BP before the video game. The predictive effect of baseline video game BP reactivity on follow-up resting BP was tested using regression models with baseline resting BP, baseline body mass index (BMI), and age as covariates.

RESULTS: Systolic BP reactivity to the video game at baseline was significantly, p = .04, and independently associated with resting systolic BP 3 to 4 years later. Samoan adolescents who had higher systolic BP reactivity scores at baseline had significantly higher resting systolic BP at follow-up after adjustment for the significant effects of baseline resting systolic BP, age, and BMI. There were no interactions between sex and reactivity or between residence, American Samoa or (Western) Samoa, and reactivity in the models, indicating that the effects of systolic BP reactivity in early adolescence on later adolescent resting systolic BP were similar in the entire study sample.

CONCLUSIONS: Video game cardiovascular reactivity seems to assess aspects of psychophysiological arousal and prospective CVD risk in Samoan adolescents of both sexes residing in both Samoas, and may be useful for understanding the role of psychosocial stress and health in modernizing societies.

Key Words: cardiovascular reactivity, • blood pressure, • adolescents, • Samoans, • stress, • modernization.

Abbreviations: BP = blood pressure;; SBP = systolic blood pressure;; DBP = diastolic blood pressure;; BMI = body mass index;; CVR = cardiovascular reactivity;; CVD = cardiovascular disease;; HR = heart rate.

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