Identifying Hypertensive Patients With Elevated Systolic Workplace Blood Pressures

The present study was designed to identify patients who had systolic work blood pressures that were substantially higher than their clinic blood pressures. Fifty-two mild and moderate hypertensive patients were assessed using clinic blood pressures and ambulatory blood pressure monitoring in their natural environment. Thirty-eight percent of these patients had systolic work blood pressures that were more than 10 mm Hg above their clinic blood pressures. These patients did not differ from other patients in terms of the demographic or clinical factors which were assessed. Need for control and anger, two core features of the Type A Coronary-prone Behavior Pattern, were shown to discriminate these patients on a statistically reliable basis. Research on cardiovascular reactivity to stress suggests that such patients with elevated systolic work blood pressures may be at greater risk for cardiac morbidity and mortality. Am J Hypertens 1990;3:544–548