Additive pressor effects of caffeine and stress in male medical students at risk for hypertension.
Additive pressor effects of caffeine and stress in male medical students at risk for hypertension.
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咖啡因和压力对有高血压风险的男性医学生的附加升压作用。
DOI：
10.1016/s0895-7061(99)00217-4
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发表时间：
2000
影响因子：
3.2
通讯作者：
Lovallo,WR
中科院分区：
文献类型：
--
作者：
Shepard,JD;al'Absi,M;Whitsett,TL;Passey,RB;Lovallo,WR
研究了高血压和低血压风险医学生在工作压力升高时咖啡因对血压和皮质醇分泌的影响。在31名经常服用咖啡因的男性医学生中，20名被认为是高血压的低风险（父母病史阴性，所有筛查BP < 125/78 mm Hg），11名根据流行病学标准被认为是高风险（父母病史阳性，平均筛查BP在125/78和139/89 mm Hg之间）。在一项随机、双盲、交叉试验中，在两次讲座（低工作压力）和两次考试（高工作压力）期间，测量了有和没有咖啡因的皮质醇水平和动态血压。咖啡因摄入量和考试压力增加了两组的皮质醇分泌（P<0.05）。两组血压均随咖啡因或考试压力升高，分别为低风险组和高风险组（咖啡因：+ 5/4vs+ 3/3 mmHg;压力：+ 4/1vs+ 7/3 mmHg;P<0.05）。压力和咖啡因的结合导致血压的叠加增加（低风险+ 9/5 mm Hg，高风险+ 10/6 mm Hg），因此46%的高风险参与者的平均收缩压≥ 140 mm Hg。压力和咖啡因对血压的综合影响表明，高血压高危人群避免使用含咖啡因的饮料可能是有益的，特别是在工作要求和伴随的压力很高的时候。出于同样的原因，在接受血压测量以诊断高血压的患者中，应控制近期咖啡因的摄入。
The effects of caffeine on blood pressure (BP) and cortisol secretion were examined during elevated work stress in medical students at highversuslow risk for hypertension. Among 31 male medical students who were regular consumers of caffeine, 20 were considered at low risk for hypertension (negative parental history and all screening BP < 125/78 mm Hg) and 11 at high risk based on epidemiologic criteria (positive parental history and average screening BPs between 125/78 and 139/89 mm Hg). Cortisol levels and ambulatory BP were measured with and without caffeine during two lectures (low work stress) and two exams (high work stress) in a randomized, double-blind, crossover trial. Caffeine consumption and exam stress increased cortisol secretion in both groups (P< .05). BP increased with caffeine or exam stress in both groups, lowversushigh risk, respectively (Caffeine: + 5/4vs+ 3/3 mm Hg; Stress: + 4/1vs+ 7/3 mm Hg;P< .05). The combination of stress and caffeine caused additive increases in BP (Low Risk + 9/5 mm Hg, High Risk + 10/6 mm Hg) such that 46% of high-risk participants had average systolic BP ≥ 140 mm Hg. This combined effect of stress and caffeine on BP suggests that it may be beneficial for individuals at high risk for hypertension to refrain from the use of caffeinated beverages, particularly at times when work demands and attendant stressors are high. For the same reasons, recent intake of caffeine should be controlled in patients undergoing BP measurement for the diagnosis of hypertension.