Anxiety, Anger, and Neurogenic Tone At Rest and in Stress in Patients with Primary Hypertension
Anxiety, Anger, and Neurogenic Tone At Rest and in Stress in Patients with Primary Hypertension
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原发性高血压患者在休息和应激状态下的焦虑、愤怒和神经源性紧张
DOI：
10.1161/01.hyp.3.6_pt_2.ii-119
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发表时间：
1981
期刊：
影响因子：
8.3
通讯作者：
J. Bornheimer
中科院分区：
文献类型：
--
作者：
P. Sullivan;S. Schoentgen;V. Dequattro;W. Procci;D. Levine;J. V. Meulen;J. Bornheimer
摘要 为了确定高血压患者的基础血压或升压反应是否与交感神经张力或心理因素有关，我们通过自填问卷、等长握力练习 (IHE) 和连续减法的精神压力对 15 名高血压患者和 13 名正常血压患者进行了研究。在 IHE 和精神压力之前和结束时测量血浆去甲肾上腺素 (NE)、肾上腺素 (E)、血压 (BP) 和心率 (HR)。更多的高血压患者抑制了愤怒（p < 0.01），并且在焦虑特质（p < 0.01）和抑郁特质（p < 0.05）上得分更高。高血压患者的预应激（IHE 和精神）BP 和 NE 值显着更高（所有 p < 0.01）。在 IHE 期间，两组患者的 BP、HR 和 NE 均显着升高（均 p < 0.01），但 E 仅在高血压患者中升高（p < 0.05）。 IHE 期间两组的 BP、HR、NE 和 E 的百分比变化相似。 BP和HR的变化与NE或E无关。精神应激期间，两组HR（p <0.01）和E（p <0.05）均增加。然而，血压（收缩压和舒张压）仅在非注意治疗中升高（p < 0.01）。两组血浆NE含量均无变化。焦虑特质与收缩压（p < 0.05）、舒张压（p < 0.05）、NE（p < 0.05）和E（p < 0.05）呈显着正相关。尽管高血压患者的神经源性紧张可能与内心的愤怒和焦虑有关，但神经源性紧张和血压对 IHE 的反应百分比与血压正常的人相当。连续减法的挑战并未引起高血压患者进一步的去甲肾上腺素能或升压反应。通过增加基础神经源性张力而抑制的愤怒和焦虑可能是某些原发性高血压患者的致病因素。 （高血压 3（增补 II）：II-119-11-123，1981）
SUMMARY To determine whether basal blood pressure or pressor responses to stress are related to sympathetic nerve tone or to psychological factors in hypertensives, 15 hypertensives and 13 normotensives were studied by means of a self-administered questionnaire, Isometric handgrip exercise (IHE), and the mental stress of serial subtraction. Plasma norepinephrine (NE), epinephrine (E), blood pressure (BP) and heart rate (HR) were measured before and at the end of IHE and mental stress. A greater number of hypertensives had suppressed anger (p < 0.01) and scored higher on anxiety trait (p < 0.01) and depression (p < 0.05). Prestress (IHE and mental) BP and NE values were significantly greater in hypertensives (all p < 0.01). During IHE, both groups had a significant increase of BP, HR, and NE (all p < 0.01) but E rose in hypertensives only (p < 0.05). The percentage change of BP, HR, NE, and E during IHE was similar in both groups. The changes of BP and HR were not related to NE or E. During mental stress, HR (p < 0.01) and E (p < 0.05) increased in both groups. However, BP (systolic and diastolic) increased in nonnotensives only (p < 0.01). Plasma NE contents were unchanged In both groups. There were significant positive correlations of anxiety trait with systolic BP (p < 0.05), diastolic BP (p < 0.05), and NE (p < 0.05) and E (p < 0.05). Although hypertensives had increased neurogenic tone related perhaps to inward anger and anxiety, the percentage responses of neurogenic tone and BP to IHE were equivalent to those of normotensives. The challenge of serial subtraction did not elicit further noradrenergic or pressor responses in hypertensives. Suppressed anger and anxiety, via increased basal neurogenic tone, may be pathogenic factors in some patients with primary hypertension. (Hypertension 3 (suppl II): II-119-11-123, 1981)