Mustacchi P
Department of Epidemiology and Biostatistics, University of California,School of Medicine, San Francisco 94143.
West J Med. 1990 Aug;153(2):180-5.
In susceptible persons emotional stress results in immediate sympathetic stimulation, with a vasomotor response that results in a high-output state and elevated blood pressure; the vasopressor response seems to be transient. There seems to be no longitudinal epidemiologic validation of the attractive hypothesis that transiently elevated blood pressures are the prelude to fixed hypertension, however. The acquisition of hypertension by populations abandoning their traditional mode of living has been attributed to the sociocultural stress inherent in westernization, but these studies usually have not taken into account concomitants of this type of acculturation, such as dietary changes and increased body weight. The inverse relationship of blood pressure levels to education could explain the development of hypertension when aspiration to upward mobility is thwarted. The severity of perceived occupational stress relates inversely to blood pressure, suggesting that familiarity with a job renders the demands made by the work environment more predictable and less threatening in terms of vasopressor response.
在易感人群中,情绪应激会导致立即的交感神经刺激,伴有血管运动反应,从而产生高输出状态和血压升高;血管加压反应似乎是短暂的。然而,关于短暂血压升高是持续性高血压先兆这一颇具吸引力的假说,似乎尚无纵向流行病学验证。放弃传统生活方式的人群中高血压的发生,被归因于西方化所固有的社会文化应激,但这些研究通常未考虑到这种文化适应的伴随因素,如饮食变化和体重增加。血压水平与教育程度呈负相关,这可以解释当向上流动的愿望受挫时高血压的发生。感知到的职业应激严重程度与血压呈负相关,这表明熟悉工作会使工作环境提出的要求在血管加压反应方面更可预测且威胁性更小。