Division of Nephrology and Hypertension, New York Presbyterian Hospital, Weill Cornell Medical College, 424 East 70th Street, Hypertension CenterNew York, NY, 10021, USA.
Division of Nephrology and Hypertension, Kidney Health Research Institute, Geisinger Medical Center, 100 N Academy Avenue, Danville, PA, 17822, USA.
Curr Hypertens Rep. 2022 Sep;24(9):353-359. doi: 10.1007/s11906-022-01198-1. Epub 2022 Jun 6.
To review the clinical characteristics of paroxysmal hypertension (pseudopheochromocytoma), its previously unsuspected cause, and effective treatment approaches.
Patients with paroxysmal hypertension experience recurrent, sudden, unprovoked, symptomatic, and severe elevations of blood pressure that occur independently of current stress or perceived emotional distress. Recent findings point to a previously unsuspected psychosomatic etiology, linked in most to a past history of abuse, trauma, or prolonged severe stress, often with repression of pertinent emotions, or to a repressive coping style. Consistent with this understanding, treatment with an antidepressant is thus far the only pharmacologic intervention demonstrated to be effective in preventing recurrent paroxysms, and is effective in most patients. Other treatment approaches are discussed, including medications to acutely lower blood pressure during paroxysms, and, in some cases, the possibility of emotional healing. Recent findings indicate that paroxysmal hypertension is a psychosomatic disorder frequently linked to a past history of trauma or prolonged severe stress, usually with longstanding repression of pertinent emotions. Data strongly encourage treatment with an antidepressant in patients with recurrent or severe paroxysms. Further studies are needed.
回顾阵发性高血压（假性嗜铬细胞瘤）的临床特征、以前未被怀疑的病因，以及有效的治疗方法。
阵发性高血压患者反复出现突发、无明显诱因、有症状且严重的血压升高，这些发作与当前的压力或感知到的情绪困扰无关。最近的研究结果表明，存在一种以前未被怀疑的心身病因，在大多数情况下与过去的虐待、创伤或长期严重的压力有关，通常伴有相关情绪的压抑，或压抑的应对方式。根据这一认识，到目前为止，抗抑郁药治疗是唯一被证明能有效预防阵发性高血压复发的药物治疗方法，对大多数患者有效。还讨论了其他治疗方法，包括在发作期间使用药物降低血压，以及在某些情况下，进行情绪治疗的可能性。最近的研究结果表明，阵发性高血压是一种心身障碍，常与过去的创伤或长期严重的压力有关，通常伴有相关情绪的长期压抑。数据强烈鼓励在有反复发作或严重发作的患者中使用抗抑郁药治疗。还需要进一步的研究。
