WHITE COAT HYPERTENSION--PSYCHOBEHAVIORAL MECHANISMS

这项拟议研究的总体目标是调查心理学 以及可能导致白大褂的行为机制 高血压。根据临床观察研究的证据，AS 以及与大量心理学文献或初级心理学文献的明显相似之处 重点将放在压力和经典条件作用上。要探索 压力和经典条件反射在白大衣中的可能作用 高血压，我们提出了一个结合了三个方面的研究计划 互补性研究：1)关系的纵向相关研究 心理行为变量与白大褂高血压之间的关系 高血压病患者心血管反应的实验研究 应激与条件反射；3)两组对照临床研究 基于压力和经典条件反射的实验操作 理论。将有三组(n=150/组)受试者(50%为女性) 招募人员：a)经临床确认为白大褂的个人 高血压(WCHT组)，b)临床确诊为有高血压的个人 中度既往高血压(EH组)，c)被确认为 血压正常(NT组)。具体目标1：调查 白大衣高血压与心理、心理因素的关系 源自应激和经典条件反射理论的行为因素。 具体目标3：检验压力和经典压力之间的因果关系 白大衣高血压的条件性预测因子。拟议的研究 将是第一个同时研究压力的贡献的人 和经典的条件反射对白大衣高血压的现象。 对这些机制的更好理解可能有助于为 针对这一人群制定有效的干预措施，包括 具体的心理行为干预。此外，该方案还包括 研究可能有助于澄清关于 白大衣高血压的潜在致病后果。

The overall goal of the proposed research is to investigate psychological and behavioral mechanisms that may be responsible for white coat hypertension. Based on the evidence from clinical observation studies, as well as the clear parallels to a vast psychology literature, or primary focus will be on stress and classical conditioning. To explore the possible roles of stress and classical conditioning in white coat hypertension, we propose a program of research that combines three complementary studies: 1) a longitudinal correlational study of relations between psychobehavioral variables and white coat hypertension; 2) an experimental study of cardiovascular responses to laboratory models of stress and conditioning; 3) a controlled clinical study of two experimental manipulations based on stress and classical conditioning theory. Three groups (n=150/group) of subjects (50% women) will be recruited: a) individuals clinically identified as having white coat hypertension (WCHT-Group), b) individuals clinically identified as having moderate established hypertension (EH-Group), c) individuals identified as being normotensive (NT-Group). Specific Aim 1: To investigate the relationships between white coat hypertension and psychological, and behavioral factors derived from stress and classical conditioning theory. Specific Aim 3: To test the causal relations between stress and classical conditioning predictors of white coat hypertension. The proposed research will be the first to concurrently investigate the contributions of stress and classical conditioning to the phenomenon of white coat hypertension. A greater understanding of those mechanisms may help provide guidance for the development of effective interventions with this population, including specific psychobehavioral interventions. Furthermore, the program of research may help to clarify the conflicting literature concerning potential pathogenic consequences of white coat hypertension.