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A Brain Phenotype for Stressor‐Evoked Blood Pressure Reactivity

Gianaros, Peter J. and Sheu, Lei K. and Uyar, Fatma and Koushik, Jayanth and Jennings, J. Richard and Wager, Tor D. and Singh, Aarti and Verstynen, Timothy D. (2017) A Brain Phenotype for Stressor‐Evoked Blood Pressure Reactivity. Journal of the American Heart Association, 6 (9). pp. 1-15. ISSN 2047-9980

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Individuals who exhibit large‐magnitude blood pressure (BP) reactions to acute psychological stressors are at risk for hypertension and premature death by cardiovascular disease. This study tested whether a multivariate pattern of stressor‐evoked brain activity could reliably predict individual differences in BP reactivity, providing novel evidence for a candidate neurophysiological source of stress‐related cardiovascular risk.
Methods and Results
Community‐dwelling adults (N=310; 30–51 years; 153 women) underwent functional magnetic resonance imaging with concurrent BP monitoring while completing a standardized battery of stressor tasks. Across individuals, the battery evoked an increase systolic and diastolic BP relative to a nonstressor baseline period (M ∆systolic BP/∆diastolic BP=4.3/1.9 mm Hg [95% confidence interval=3.7–5.0/1.4–2.3 mm Hg]). Using cross‐validation and machine learning approaches, including dimensionality reduction and linear shrinkage models, a multivariate pattern of stressor‐evoked functional magnetic resonance imaging activity was identified in a training subsample (N=206). This multivariate pattern reliably predicted both systolic BP (r=0.32; P<0.005) and diastolic BP (r=0.25; P<0.01) reactivity in an independent subsample used for testing and replication (N=104). Brain areas encompassed by the pattern that were strongly predictive included those implicated in psychological stressor processing and cardiovascular responding through autonomic pathways, including the medial prefrontal cortex, anterior cingulate cortex, and insula.
A novel multivariate pattern of stressor‐evoked brain activity may comprise a phenotype that partly accounts for individual differences in BP reactivity, a stress‐related cardiovascular risk factor.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Gianaros, Peter
Sheu, Lei K.
Uyar, Fatma
Koushik, Jayanth
Jennings, J.
Wager, Tor D.
Singh, Aarti
Verstynen, Timothy
Date: 23 August 2017
Date Type: Publication
Journal or Publication Title: Journal of the American Heart Association
Volume: 6
Number: 9
Publisher: Wiley Open Access
Page Range: pp. 1-15
DOI or Unique Handle: 10.1161/jaha.117.006053
Schools and Programs: Dietrich School of Arts and Sciences > Psychology
Refereed: No
ISSN: 2047-9980
Official URL:
Article Type: Research Article
Date Deposited: 11 May 2020 14:53
Last Modified: 11 May 2020 14:53


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