Response of Renin–angiotensin–aldosterone System to Emotional Stress in Patients with Various Forms of Essential Hypertension

Pervichko, E.I.; Ostroumova, O.D.; Zinchenko, Y.P.; Guseva, T.F.

Авторы: Pervichko E.I., Ostroumova O.D., Zinchenko Yu P., Guseva T.F.
Журнал: International Journal of Psychophysiology
Том: 108
Год издания: 2016
Издательство: Elsevier BV
Местоположение издательства: Netherlands
Первая страница: 162
DOI: 10.1016/j.ijpsycho.2016.07.465
Аннотация: Background. Correlation of sympathetic-adrenal system and renin–angiotensin–aldosterone system (RAAS) indicates one of the central psychophysiological mechanisms, responsible for increase in blood pressure (BP) of patients with essential hypertension (EH). At the same time, there is poorly understanding of the RAAS contribution to the pathogenesis of stress-induced EH. The study was aimed to analyze RAAS reaction within experimental simulation of emotional stress in patients with ‘Hypertension at work’ and patients, whose BP on working days and days off were equal. Methods. Simulation of emotional stress employed the procedure of assessment of the aspiration level. BP values, the level of renin (R) and angiotonin I (А1) in blood plasma were taken before and after the experiment. The 16PF Questionnaire (Cattell, Mead, 2008) was introduced to examine personality traits. There were examined 85 patients with ‘Hypertension at work’ (mean age was 45.9±2.8 years), and 85 patients with the ‘classical’ of EH (mean age was 47.4±4.5 years). Results. Patients with ‘Hypertension at work’, when compared with those of ‘classical’ EH had a significant higher increase of systolic BP (SBP) in response to stress loads (16.1±1.9 mmHg and 4.1±0.7 mmHg; p<0.001). Initial eхaminations showed significantly lower (p<0.05) values of R (1.04±0.21ngr/ml)/day) and A1 (1.14±0.13 (ngr/ml)/day in the group of ‘Hypertension at work’ patients, when compared with patients of the ‘classical’ EH (R (0.86±0.21 (ngr/ml)/day) и А1 (1.26±0.09 (ngr/ml)/day). After the experiment R and А1 values in the group of patients with ‘Hypertension at work’ showed a considerable decrease (ΔR=(-0.2) (ngr/ml)/day, p<0.05; ΔА1=(-0.18) (ngr/ml)/day, p<0.05), as for the second group, they significantly increased (ΔR=0.4 (ngr/ml)/day, p<0.05; ΔА1=0.09 ngr/ml)/day). The study of personality factors revealed significant (p<0.05) divergence of results for patients with ‘Hypertension at work’ and ‘classical’ EH on A, C, F, O, Q1, and Q4 scales in 16 PF. The trait profile of the former showed personality ambivalence and emotional tension coupled with continence in expression of emotions. Discussion. Obtained results make it clear that most of the patients with ‘Hypertension at work’ demonstrate no ‘pre-run alert’ of sympathetic nervous system, crucial to effectively enter and cope with a stressful situation; they may also testify to the chronic character of stress reactions among the EH patients, which is marked by signs of psychophysiological exhaustion. Such an interpretation is verified by data of personality traits of the patients. Conclusion. Results of the present research expand the very notion of etiology and pathogeny of EH.
Добавил в систему: Первичко Елена Ивановна

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