Walther Lisa-Marie, von Känel Roland, Heimgartner Nadja, Zuccarella-Hackl Claudia, Ehlert Ulrike, Wirtz Petra H
Biological Work and Health Psychology, University of Konstanz, 78457 Konstanz, Germany.
Centre for the Advanced Study of Collective Behaviour, University of Konstanz, 78457 Konstanz, Germany.
J Clin Med. 2021 Jun 19;10(12):2714. doi: 10.3390/jcm10122714.
Essential hypertension is associated with increased sympathetic and diminished parasympathetic activity as well as impaired reactivity to sympathetic stimulation. However, reactivity and recovery from parasympathetic stimulation in hypertension are unknown. We investigated reactivity and recovery to primarily parasympathetic stimulation by Cold Face Test (CFT) in essential hypertension. Moreover, we tested whether chronic stress modulates CFT-reactivity dependent on hypertension status. The CFT was conducted by applying a cold face-mask for 2 min in 24 unmedicated, otherwise healthy hypertensive men and in 24 normotensive controls. Systolic and diastolic blood pressure (BP) and heart rate (HR) were measured repeatedly. Chronic stress was assessed with the Trier-Inventory-for-Chronic-Stress-Screening-Scale. Hypertensives did not exhibit diastolic BP decreases after CFT-cessation ( = 0.59) as did normotensives ( = 0.002) and failed to show HR decreases in immediate response to CFT ( = 0.62) when compared to normotensives ( < 0.001). Systolic BP reactivity and recovery patterns did not differ between hypertensives and normotensives ( = 0.44). Chronic stress moderated HR ( = 0.045) but not BP CFT-reactivity ('s > 0.64) with chronically stressed normotensives showing similar HR reactivity as hypertensives. Our findings indicate impaired diastolic BP and HR reactivity to and recovery from CFT in hypertensives and a moderating effect of chronic stress on HR reactivity potentially reflecting reduced relaxation ability of the cardiovascular system.
原发性高血压与交感神经活动增强、副交感神经活动减弱以及对交感神经刺激的反应性受损有关。然而，高血压患者副交感神经刺激的反应性和恢复情况尚不清楚。我们通过冷脸试验（CFT）研究了原发性高血压患者对主要副交感神经刺激的反应性和恢复情况。此外，我们还测试了慢性应激是否根据高血压状态调节CFT反应性。对24名未用药的健康高血压男性和24名血压正常的对照者应用冷面罩2分钟进行CFT。反复测量收缩压和舒张压（BP）以及心率（HR）。用特里尔慢性应激筛查量表评估慢性应激。与血压正常者相比，高血压患者在CFT停止后未出现舒张压下降（P = 0.59），而血压正常者出现了舒张压下降（P = 0.002），并且在对CFT的即时反应中未能显示心率下降（P = 0.62），而血压正常者心率下降（P < 0.001）。高血压患者和血压正常者的收缩压反应性和恢复模式没有差异（P = 0.44）。慢性应激调节了心率（P = 0.045），但未调节血压CFT反应性（P值> 0.64），慢性应激的血压正常者显示出与高血压患者相似的心率反应性。我们的研究结果表明，高血压患者对CFT的舒张压和心率反应性及恢复受损，慢性应激对心率反应性有调节作用，这可能反映了心血管系统舒张能力降低。
