Old ideas, new directions: re-examining the predictive utility of the hemodynamic profile of the stress response in healthy populations.

The 'reactivity hypothesis' has a long and fruitful history in health psychology and behavioural medicine, with elements of its thesis taken as core and others lost in the plethora of research on its utility as a theory of psychosomatic disease. One such thesis is that the underlying hemodynamic profile of the stress response may be particularly revealing when detailing the impact of psychological stress on the development of cardiovascular disease. This paper re-examines old ideas surrounding the hemodynamic profile of the stress response, asking why its health-predictive properties were never fully explored. Further, this paper reviews the evidence that a vascular profile of stress responding may be especially predictive of disease development, particularly in the case of hypertension. In addition, measurement of hemodynamic profile, as well as its known psychosocial moderators, is reviewed including how examination of patterns of cardiovascular stress response adaptation may extend the field. This paper highlights that the extension of the reactivity hypothesis to include both hemodynamic profile and patterns of cardiovascular stress response adaptation may hold much explanatory power in detailing the impact of how stress responding and stress tolerance promotes disease development.