Effects of experimental emotional stress and physical exercise on the circulation in hypertensive patients and control subjects.

Heart rate, intra-aortal blood pressure, cardiac output and peripheral vascular resistance were registered in 11 hypertensive and 11 normotensive subjects during exercise (up to 80 W on a bicycle ergometer), a semi-standardized interview concerning personal life situations, exposure to slides showing parents and marriage partners of the subjects, and during pressure on a hand ergometer. The blood pressure in all subjects increased during all these experimental conditions. During exercise this was associated with increases in heart rate and cardiac output and a decrease in peripheral resistance (hyperkinetic reaction). During the interview the heart rate and cardiac output also increased but to a lesser degree and in 15 of the 22 cases the peripheral resistance rose (predominantly hypertonic reaction). During the slide viewing the effects were similar to those of the interview but less marked. During the hand ergometer test the subjects showed a combination of the hyperkinetic and hypertonic response. Although there was a difference in their basal blood pressure and total peripheral resistance, these haemodynamic reaction patterns showed no difference between the hypertensive and normotensive subjects. These results support the hypothesis that essential hypertension is a quantitative 'exaggeration' of the same physiological processes which regulate the blood pressure in different situations in normotensive individual.