Psychological aspects of catecholamine response patterns to pain and mental stress in essential hypertensive patients and controls.

In an experimental study on hypertensive and healthy subjects, the role of anxiety, sex, and disease for the response of plasma epinephrine (E) and norepinephrine (NE) to pain (venipuncture) and mental stress (word alliteration) was investigated. Pain elicited higher E values than mental stress in healthy subjects and higher NE responses in both sexes, but hypertensive subjects did not respond by generally higher catecholamine values than normotensive subjects did. They were, instead, characterized by decreases of NE upon mental stress. Trait anxiety, as measured by questionnaire scores, was associated with higher E values in healthy and hypertensive subjects but mainly after physical pain and not after mental stress. NE responses to pain were significantly lower in anxious than in nonanxious hypertensive subjects, and the opposite held true for normotensive subjects. Thus, high E/low NE response emerged as an indicator of trait anxiety, as well as state anxiety. Correlations between experienced aversiveness and catecholamine levels identified NE as a hormone of successful coping on which hypertensive subjects seem to rely more than normotensive subjects do when trying to counteract their particular threat of physical pain.