Acute and Chronic Stress Associations With Blood Pressure: An Ecological Momentary Assessment Study on an App-Based Platform

Abstract

ABSTRACT Objective This study examined the within- and between-person associations of acute and chronic stress with blood pressure (BP) and heart rate (HR) using an app-based research platform. Methods We examined data from 31,964 adults (aged 18–90 years) in an app-based ecological momentary assessment study that used a research-validated optic sensor to measure BP. Results Within-person associations revealed that moments with (versus without) acute stress exposure were associated with higher systolic (SBP; b = 1.54) and diastolic BP (DBP; b = 0.79) and HR (b = 1.53; p values < .001). During moments with acute stress exposure, higher acute stress severity than usual was associated with higher SBP (b = 0.26), DBP (b = 0.09), and HR (b = 0.40; p values < .05). During moments without acute stress, higher background stress severity than usual was associated with higher BP and HR (SBP: b = 0.87, DBP: b = 0.51, HR: b = 0.69; p values < .001). Between-person associations showed that individuals with more frequent reports of acute stress exposure or higher chronic stress severity had higher SBP, DBP, and HR (p values < .05). Between-person chronic stress severity moderated within-person physiological responses to stress such that individuals with higher chronic stress severity had higher average BP and HR levels but showed smaller responses to momentary stress. Conclusions Technological advancements with optic sensors allow for large-scale physiological data collection, which provides a better understanding of how stressors of different timescales and severity contribute to momentary BP and HR in daily life.