Allen K, Shykoff B E, Izzo J L
Division of Clinical Pharmacology, Department of Medicine, State University of New York at Buffalo, USA.
Hypertension. 2001 Oct;38(4):815-20.
In the present study, we evaluated the effect of a nonevaluative social support intervention (pet ownership) on blood pressure response to mental stress before and during ACE inhibitor therapy. Forty-eight hypertensive individuals participated in an experiment at home and in the physician's office. Participants were randomized to an experimental group with assignment of pet ownership in addition to lisinopril (20 mg/d) or to a control group with only lisinopril (20 mg/d). On each study day, blood pressure, heart rate, and plasma renin activity were recorded at baseline and after each mental stressor (serial subtraction and speech). Before drug therapy, mean responses to mental stress did not differ significantly between experimental and control groups in heart rate (94 [SD 6.8] versus 93 [6.8] bpm), systolic blood pressure (182 [8.0] versus 181 [8.3] mm Hg), diastolic blood pressure (120 [6.6] versus 119 [7.9] mm Hg), or plasma renin activity (9.4 [0.59] versus 9.3 [0.57] ng. mL(-1). h(-1)). Lisinopril therapy lowered resting blood pressure by approximately 35/20 mm Hg in both groups, but responses to mental stress were significantly lower among pet owners relative to those who only received lisinopril (P<0.0001; heart rate 81 [6.3] versus 91 [6.5] bpm, systolic blood pressure 131 [6.8] versus 141 [7.8] mm Hg, diastolic blood pressure 92 [6.3] versus 100 [6.8] mm Hg, and plasma renin activity 13.9 [0.92] versus 16.1 [0.58] ng. mL(-1). h(-1)). We conclude that ACE inhibitor therapy alone lowers resting blood pressure, whereas increased social support through pet ownership lowers blood pressure response to mental stress.
在本研究中,我们评估了一种非评价性社会支持干预措施(养宠物)对在接受血管紧张素转换酶(ACE)抑制剂治疗之前及治疗期间血压对精神应激反应的影响。48名高血压患者在家中和医生办公室参与了一项实验。参与者被随机分为实验组,除服用赖诺普利(20毫克/天)外还被安排养宠物,或分为对照组,仅服用赖诺普利(20毫克/天)。在每个研究日,在基线以及每次精神应激源(连续减法和演讲)之后记录血压、心率和血浆肾素活性。在药物治疗前,实验组和对照组在心率(94[标准差6.8]对93[6.8]次/分钟)、收缩压(182[8.0]对181[8.3]毫米汞柱)、舒张压(120[6.6]对119[7.9]毫米汞柱)或血浆肾素活性(9.4[0.59]对9.3[0.57]纳克·毫升⁻¹·小时⁻¹)方面对精神应激的平均反应没有显著差异。赖诺普利治疗使两组的静息血压均降低约35/20毫米汞柱,但养宠物的人相对于仅接受赖诺普利治疗的人对精神应激的反应显著更低(P<0.0001;心率81[6.3]对91[6.5]次/分钟,收缩压131[6.8]对141[7.8]毫米汞柱,舒张压92[6.3]对100[6.8]毫米汞柱,血浆肾素活性13.9[0.92]对16.1[0.58]纳克·毫升⁻¹·小时⁻¹)。我们得出结论,单独使用ACE抑制剂治疗可降低静息血压,而通过养宠物增加社会支持可降低血压对精神应激的反应。