Enhanced adrenocortical responses to stress in hypertension-prone men and women.

Hypertension risk may be associated with increased adrenocortical activity, but the extent to which this enhanced activation differs between men and women at rest and in response to psychological stress is not known. This study examined gender differences in adrenocortical responses to an extended public-speaking stressor in persons at high (resting systolic blood pressure > median; n = 21) or low risk (negative parental history and < or = median systolic blood pressure; n = 26). Salivary cortisol levels were assessed at rest and in response to public speaking in a repeated measure design on two test sessions held on separate days. Heart rate, systolic blood pressure, and diastolic blood pressure were obtained at 3-min intervals before, during, and after the task. High-risk participants showed greater cortisol, blood pressures, and heart rate responses to the public-speaking stressor than the low-risk group (ps < .01). Men showed greater cortisol concentrations than women (p < .05), independent of hypertension risk status. Cardiovascular measures during the acute stressor predicted subsequent cortisol production, but only in the high-risk group. Results suggest that hypertension risk is associated with enhanced physiological reactivity across sympathetic and adrenocortical systems, supporting the possibility that this exaggerated reactivity may represent a marker of risk in hypertension-prone men and women.