Effect of psychological stress on blood pressure increase: a meta-analysis of cohort studies Efeito do estresse psicológico no aumento da pressão arterial: uma metanálise de estudos de coorte

Studies have suggested that chronic exposure to stress may have an influence on increased blood pressure. A systematic review followed by a meta-analysis was conducted aiming to assess the effect of psychological stress on blood pressure increase. Research was mainly conducted in Ingenta, Psycinfo, PubMed, Scopus and Web of Science. Inclusion criteria were: published in any language; from January 1970 to December 2006; prospective cohort design; adults; main exposure psychological/emotional stress; outcome arterial hypertension or blood pressure increase > 3.5mmHg. A total of 2,043 studies were found, of which 110 were cohort studies. Of these, six were eligible and yielded 23 comparison groups and 34,556 subjects. Median follow-up time and loss to follow-up were 11.5 years and 21%. Results showed individuals who had stronger responses to stressor tasks were 21% more likely to develop blood pressure increase when compared to those with less strong responses (OR: 1.21; 95%CI: 1.14-1.28; p < 0.001). Although the magnitude of effect was relatively small, results suggest the relevance of the control of psychological stress to the non-therapeutic management of high blood pressure. Estudos sugerem que a exposição crônica ao estresse tenha influência no aumento dos níveis pressóricos. Foi realizada uma revisão sistemática seguida de metanálise com o objetivo de avaliar o efeito do estresse psicológico no aumento da pressão arterial. As principais bases de dados utilizadas foram Ingenta, Psycinfo, PubMed, Scopus e Web of Science. Os critérios de inclusão foram: publicado entre janeiro de 1970 e dezembro de 2006, delineamento de coorte prospectiva, adultos, estresse psicológico/emocional como exposição principal, hipertensão arterial ou aumento na pressão arterial > 3,5mmHg como desfecho. A busca resultou em 2.043 artigos, sendo 110 coortes. Desses, seis eram elegíveis, os quais geraram 23 grupos de comparação e 34.556 sujeitos. A mediana do tempo de seguimento e do percentual de perdas foi 11,5 anos e 21%. ...