Papers by Martti T Tuomisto
Health Psychology, 2005
Increased blood pressure (BP) reactivity to subtypes of psychological stimuli may differentially ... more Increased blood pressure (BP) reactivity to subtypes of psychological stimuli may differentially predict the development of future BP elevation or hypertension. The authors present the 9-12-year follow-up results of 82 (86%) of 95 male participants with different BP levels. They were healthy, untreated, and age-matched volunteers from a routine health checkup carried out on all 35-, 40-, and 45-year-olds from a medium-sized city. Intra-arterial systolic blood pressure (SBP) during the psychological tasks improved the prediction of future casual SBP and noninvasive 24-hr ambulatory SBP compared with predictions from casual diagnostic measurements. Diastolic blood pressure (DBP) was very useful when added to casual DBP in predicting the need for antihypertensive medication. Reactivity to active tasks especially predicts the need for antihypertensive medication.
PubMed, 1988
In our previous studies strenuous exercise, adrenaline infusion and surgical stress have been sho... more In our previous studies strenuous exercise, adrenaline infusion and surgical stress have been shown to evoke increased plasma thromboxane B2 (TxB2) concentrations and production by platelets. Here we report the effects of acute psychological and physical tests, during 24 h direct monitoring of blood pressure and heart rate, on plasma catecholamine levels and TxB2 production by platelets in normotensive, borderline and mild hypertensive subjects. After psychological tests plasma noradrenaline and adrenaline values in the whole material were slightly elevated as compared to the basal levels measured 24 h after the attachment of the cannula. TxB2 production remained unaltered. After physical tests both plasma noradrenaline and adrenaline were clearly increased as was also the TxB2 production by platelets. When the subjects were divided into normotensive and hypertensive ones, unexpectedly, basal plasma values of catecholamines were higher in normotensive volunteers but TxB2 production was more marked in hypertensive subjects.
PubMed, 1988
With the aid of a special questionnaire 16 healthy persons were divided to morning or evening typ... more With the aid of a special questionnaire 16 healthy persons were divided to morning or evening types of personalities. Their arterial blood pressure was registered ambulatorily for 24 hours in order to elucidate the difference of blood pressure reactions between the groups. The average maximum blood pressure occurred 3.5 hours later in evening types than in morning types. Individually there were very small differences and it seems that the blood pressure level is more affected by physical activity than by morningness or eveningness.
Graefes Archive for Clinical and Experimental Ophthalmology, Jul 11, 2006
Generalized arteriolar narrowing is one of the retinal changes influenced by systemic hypertensio... more Generalized arteriolar narrowing is one of the retinal changes influenced by systemic hypertension. The ratio of retinal arteriolar to venular diameters is often used as a marker of generalized arteriolar narrowing. There are several ways to determine the retinal arteriovenous ratio (A/V ratio). However, no comparison of retinal vascular measurements and A/V ratios determined by different formulae has been presented. Eighty-seven men participating in the Tampere Ambulatory Hypertension Study returned for a 10-year follow-up examination in which fundus photographs were taken of both eyes. The diameters of retinal arterioles and venules were measured 1 and 2 disc diameters from the optic disc edge. The A/V ratio was determined using mean arteriole and venule width, the sum of widths of arterioles and venules, the sum of squares of widths of arterioles and venules, the central retinal artery equivalent (CRAE) and the central retinal venous equivalent (CRVE). The repeatability of measurements and A/V ratios was determined. Comparison was made between A/V ratios determined by different calculation formulas. In general, determination of A/V ratios yielded lower deviation than that of diameters of arterioles and venules separately. Calculation of A/V ratios using different formulas gave different ratio levels. According to linear regression analysis, the A/V ratio calculated using the sum of squares of widths of arterioles and venules correlated best with CRAE/CRVE (R(2) 0.92) and A/V ratios calculated using the mean arteriole and venule widths or the sum of widths of arterioles and venules resulted in clearly lower associations (R(2) 0.38-0.40 and R(2) 0.41-0.48, respectively). Of all A/V ratios, CRAE/CRVE had the best repeatability. No statistically significant differences were found between measurements from right and left eyes. The high repeatability of CRAE/CRVE and sum of squares of widths of arterioles/sum of squares of widths of venules, as well as the good association of the two formulae, favor the use of these in evaluation of retinal vascular changes in systemic diseases. Our results also showed that if only one eye can be examined, it seems to suffice if fundus vascular alterations associated with systemic hypertension are evaluated.
International Journal of Oral and Maxillofacial Surgery, Nov 1, 2017
The aim was to evaluate changes in the psychosocial well-being of orthognathic surgery patients (... more The aim was to evaluate changes in the psychosocial well-being of orthognathic surgery patients (n = 22) during treatment and to compare results with those of adults not requiring orthognathic treatment (n = 22). Patient data were collected before treatment (T0), after the first orthodontic examination (T1), three times during treatment (T2-T4), and 1 year after surgery (T5). In this article, only data corresponding to patient stage T5 are reported for the control subjects. Participants filled in a structured diary and the modified version of the Secord and Jourard body image questionnaire, the Orthognathic Quality of Life Questionnaire, the Rosenberg Self-Esteem Scale, and the Acceptance and Action Questionnaire II. Moreover, patients filled in the Symptom Checklist-90. After the placement of orthodontic appliances (T2), orthognathic quality of life, self-esteem, and psychological flexibility were lower and psychiatric symptoms increased. Improvements were observed from T2 to T5 in orthognathic quality of life, body image, self-esteem, psychological flexibility, and psychiatric symptoms. Treatment resulted in improvements from T0 to T5 in orthognathic quality of life, body image, and psychiatric symptoms. At T5, patient psychosocial well-being was comparable to or even better than that of control subjects. Orthognathic treatment seems to support psychological well-being, but the range of individual variation is wide.
Psychophysiology, Nov 1, 1991
ABSTRACTNeuroendocrine and cardiovascular stress reactivity was studied in healthy middle‐aged in... more ABSTRACTNeuroendocrine and cardiovascular stress reactivity was studied in healthy middle‐aged individuals whose parental history included essential hypertension and/or myocardial infarction and a control group without parental history of cardiovascular disease. All subjects completed a rest session (1 hour) and a stress session (1 hour). The stress session included behavioral (mirror image tracing, mental arithmetic, and the Stroop color word conflict test) and physical stressors (the cold pressor test and isometric exercise). Systolic and diastolic blood pressures and heart rate were recorded at baseline before and during all stressors. Specimens for determination of urinary catecholamines and cortisol were sampled after the rest and stress sessions respectively. Generally, a parental history of hypertension but not of myocardial infarction influenced neuroendocrine and cardiovascular stress reactivity. A family history of hypertension was associated with exaggerated epinephrine, norepinephrine, and cortisol excretion during stress and with enhanced heart‐rate reactivity to behavioral (mental arithmetic and mirror image tracing) but not to physical stressors (isometric exercise or the cold pressor test). We conclude that individuals with a family history of hypertension tend to display exaggerated cardiovascular and neuroendocrine reactivity to stress.
Journal of Hypertension, Mar 1, 1992
Journal of Hypertension, Jul 1, 2001
Objective To evaluate the usefulness of blood pressure and its variability in the prediction of f... more Objective To evaluate the usefulness of blood pressure and its variability in the prediction of future blood pressure and need for antihypertensive medication. Methods We used WHO criteria to classify, at baseline, 97 healthy untreated male volunteers as normotensive (n 34), borderline hypertensive (n 29) or mild hypertensive (n 34), with casual measurements before intra-arterial 24 h ambulatory blood pressure monitoring. After 10 years of follow-up, 87 of the men (90%) were available and their blood pressure was recorded using casual measurements and non-invasive ambulatory 24 h monitoring. Results During the follow-up, the blood pressure classi®cation deteriorated in 35 individuals (40%) and improved in six (7%) (McNemar test, P < 0.0001). In the borderline hypertensive group, 77% became hypertensive (P 0.03). The 24 h mean systolic blood pressure was the best predictor of follow-up casual systolic (adj.R 2 0.420) and 24 h systolic (adj.R 2 0.540) blood pressure. The 24 h mean diastolic blood pressure was the best predictor of follow-up casual diastolic (adj.R 2 0.301) and 24 h diastolic (adj.R 2 0.292) blood pressure. The baseline casual systolic blood pressure also predicted the follow-up casual systolic blood pressure relatively well (adj.R 2 0.356), but was clearly weaker for the follow-up 24 h systolic (adj.R 2 0.275) blood pressure. The prediction of follow-up casual diastolic (adj.R 2 0.259) and follow-up 24 h diastolic (adj.R 2 0.214) blood pressure by baseline casual blood pressure was even weaker. The means and variabilities of the 24 h, daytime, and night-time blood pressures were the best predictors of the need for antihypertensive medication (Cox±Snell R 2 0.399). The characteristics of the individual did not signi®cantly predict future blood pressure and the need for antihypertensive medication. Conclusions The 24 h mean blood pressure was an excellent predictor of the future blood pressure and the need for antihypertensive medication. Prediction of antihypertensive medication was further improved by also using blood pressure variability. Systolic blood pressure was more predictable than diastolic blood pressure.
Social Psychiatry and Psychiatric Epidemiology, Apr 28, 2023
Purpose Public mental health services (MHS) are crucial in preventing psychiatric disability pens... more Purpose Public mental health services (MHS) are crucial in preventing psychiatric disability pensions (DP). We studied the associations between mood disorder DP risk and the characteristics of Finnish municipalities' MHS provision using the ESMS-R mapping tool and Finnish population registers, based on first-time granted mood disorder DPs between 2010 and 2015. Methods The final data set included 13,783 first-time mood disorder DP recipients and 1088 mental health service units in 104 municipalities. We focused on five different MHS types: all MHS, outpatient care provision, local services without and with gatekeeping, and centralized services. Three factors for each MHS type were studied: service resources, richness, and diversity index. Negative binomial regression models were used in the analysis. Results In all the municipalities, higher service richness and diversity regarding all MHS, outpatient care and local services with gatekeeping were associated with a lower DP risk. In urban municipalities, service richness was mainly associated with lower DP risk, and in semi-urban municipalities service diversity and resources were primarily associated with lower DP risk in outpatient care and local services with gatekeeping. In rural municipalities, DP risk indicated no association with MHS factors. Conclusion The organization and structure of MHS play a role in psychiatric disability pensioning. MHS richness and diversity are associated with lower mood disorder DP in specific societal contexts indicating their role as quality indicators for regional MHS. The diversity of service provision should be accounted for in MHS planning to offer services matching population needs.
Journal of Hypertension, Nov 1, 2001
Background Ambulatory blood pressure correlates more closely with left ventricular mass (LVM) tha... more Background Ambulatory blood pressure correlates more closely with left ventricular mass (LVM) than casual blood pressure in cross-sectional studies, but prospective evidence is very limited. Objective To evaluate the best predictors of LVM and change in LVM during 10 years of follow-up, in a prospective study. Methods At baseline, blood pressure was recorded by casual measurements and 24 h intra-arterial ambulatory monitoring. The study participants were 97 healthy, untreated, 35±45-year-old men (34 normotensive, 29 borderline hypertensive, and 34 mildly hypertensive). At 10-year follow-up, echocardiography was performed in 86 (89%) of the men; echocardiographic data were available both at baseline and at follow-up from 70 (72%) of them. Individuals who were not receiving antihypertensive medication (n 66) were included in the prediction of LVM index (LVMI), which was analysed as a continuous variable. Results The blood pressure variables that were best in predicting the LVMI were: 24 h pulse pressure (r 0.308, P 0.012), night-time pulse pressure (r 0.291, P 0.018), daytime pulse pressure (r 0.253, P 0.041), and casual systolic blood pressure (r 0.212, P 0.088). The LVMI was best predicted by a model including 24 h pulse pressure, positive family history of hypertension, body mass index, and age (adjusted coef®cients of determination (adj.R 2) 0.197; that for the casual blood pressure model was adj.R 2 0.140). During the follow-up, LVMI increased by 7.5 g/m 2 and 23 g/m 2 in individuals receiving and not receiving antihypertensive medication, respectively (P 0.015). The change in LVMI was best predicted by the change in casual pulse pressure and use of antihypertensive medication (adj.R 2 0.102). Conclusions Ambulatory blood pressure improved the prediction of future LVMI compared with that obtained from casual measurements. To our knowledge, this is the longest prospective follow-up to show that pulse pressure is the most signi®cant blood pressure parameter in predicting future LVMI and change in LVMI.
Journal of Hypertension, Jul 1, 1991
The effect of blood pressure and heart rate reactivity on respective variability in everyday life... more The effect of blood pressure and heart rate reactivity on respective variability in everyday life conditions was studied in a group of middle-aged, normotensive men (n = 22, mean age 39.3 years, range 35-45 years). Continuous intra-arterial tape recording was used to measure 24-h blood pressure and heart rate and the subjects completed a 24-h behavioural diary. The variability of blood pressure and heart rate was analysed using 30-s averages and cumulative distribution curves. The overall blood pressure and heart rate variability was calculated as the difference between the 90 and 10% levels of the cumulative distribution curves. Reactivity caused by different daily activities was calculated as the change from baseline level, defined as the 10% level determined from the cumulative distribution curve of waking hours. All regular activities were monitored. Large interindividual differences were found in variability and reactivity. The mean reactivity to different activities varied from 3.3 to 44.7 mmHg for systolic blood pressure, from 1.8 to 16.3 mmHg for diastolic blood pressure and from 2.0 to 46.0 beats/min for heart rate. The mean contribution of reactivity to variability varied between 21 and 74% for systolic blood pressure, from 19 to 58% for diastolic blood pressure and from 20 to 82% for heart rate. As expected, blood pressure and heart rate levels were significantly higher at work than at home. We conclude that the reactivity caused by daily activities has a pronounced influence on blood pressure level and variability during waking hours.
Journal of Hypertension, Dec 1, 1990
High Altitude Medicine & Biology, Dec 1, 2017
Karinen, Heikki M., and Martti T. Tuomisto. Performance, mood, and anxiety during a climb of Moun... more Karinen, Heikki M., and Martti T. Tuomisto. Performance, mood, and anxiety during a climb of Mount Everest. High Alt Med Biol. 16:000-000, 2017. Various studies have shown the deleterious effects of high-altitude hypoxia on visual, motor, somatosensory, cognitive, and emotional function and also in intelligence tests, reaction time, speech comprehension, hand steadiness, visual contrast discrimination, and word association tests. Because optimal cognitive abilities may be crucial for mountain climbers&amp;amp;#39; safety, this study was intended to evaluate the changes in cognitive performance, mood, and anxiety during an Everest expedition lasting almost 3 months. A set of physiological (Lake Louise score, oxygen saturation), cognitive (Colorado perceptual speed [CPS] test, number comparison [NC] test), and emotional measurements (Profile of Mood States, anxiety responses, psychological inflexibility) were collected from nine climbers on a partly unsupported Mount Everest expedition at various time points during the course of the expedition at Everest Base Camp (EBC). For confidence intervals we used 95% simultaneous Bonferroni corrected interval (BCI) for the differences. During this expedition, the estimates of trait anxiety decreased 13% toward the end of expedition after successful summiting (p = 0.004). Simultaneously, fatigue appeared to diminish and the CPS speed results improved 13%. Most expedition members suffered mild symptoms of acute mountain sickness during the first days in the EBC, but this did not affect the speed or the number of mistakes made in the CPS or NC tests. In CPS test the differences between pretest and the physically most demanding period (EBC4, BCI: 0.01, 4.43) and between EBC1 and EBC4 (BCI: 0.57, 4.99), between EBC2 and EBC4 (BCI: 0.45, 4.88), and between EBC3 and EBC4 (BCI: 1.12, 5.55) were significant, showing ever improving results during the expedition. The most important finding in this study was that well-motivated and trained, self-selected individuals, who volunteer for a long-duration mission, are capable of maintaining high levels of performance, steady mood state, and a good level of vigor on a Mount Everest expedition lasting nearly 3 months.
Clinical Physiology and Functional Imaging, Mar 1, 2002
An exaggerated blood pressure (BP) response to test may unmask the subjects who have a high risk ... more An exaggerated blood pressure (BP) response to test may unmask the subjects who have a high risk of developing hypertension. In this prospective 10 years of follow-up, we examined whether the predictive value of casual BP measurements on future BP level and need for antihypertensive medication could be improved by using BP responses to different physical tests. At baseline, BP was recorded by casual measurements and intra-arterial monitoring. During the intra-arterial BP recording, standardized postural and exercise tests were performed on 97 healthy, untreated men (34 normotensive, 29 borderline hypertensive, and 34 mild hypertensive). After 10 years of follow-up, 87 of them (90%) returned for casual and non-invasive 24-h BP measurements. At follow-up, 20 (23%) of the men had antihypertensive medication. The prediction of casual systolic blood pressure (SBP) was best improved by SBP at 10 min after the dynamic exercise test (adj. R2 = 0.448; adj. R2 = 0.356 for casual SBP alone). The prediction of casual diastolic blood pressure (DBP) was most improved by DBP at 10 min after the dynamic exercise test (adj. R2 = 0.282; adj. R = 0.259 for casual BP alone). SBP in the supine test best improved the prediction of 24-h SBP (adj. R2 = 0 448; adj. R2 = 0.275 for casual SBP alone). DBP in the standing test best improved the prediction of 24-h DBP (adj. R2 = 0.252; adj. R2 = 0.214 for casual DBP alone). Pre-exercise DBP and casual SBP were the best predictors of the need for antihypertensive medication (Cox-Snell R2 = 0.256; Cox-Snell R2 = 0.164 for casual SBP alone). In conclusion the prediction of future BP and need for antihypertensive medication can be improved by using BP measurements during postural and exercise tests. Future SBP is more predictable than DBP.
Suomen Lääkärilehti, 2006
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Papers by Martti T Tuomisto