Fontaine R, Boisvert D
Psychother Psychosom. 1982;38(1):165-72. doi: 10.1159/000287624.
Anxious patients have a higher incidence than the general population for cardiovascular disorders and sudden death. Several studies have emphasized abnormal pulse rate, abnormal heart response conditioning, high incidence of arrhythmia, and abnormal blood pressure. Essential hypertension has been studied in relation to stress, and chronic hypotension ('low blood pressure syndrome') has been clinically recognized for decades, but rarely systematically studied. We investigated these abnormal blood pressures in anxious patients, during controlled trials with 80 patients having generalized anxiety disorder as defined in DSM III, for at least 6 months duration, and of moderate to severe intensity. They were randomly assigned to placebo, or bromazepam, 18 mg/day. Blood pressure, pulse, and several other measurements were taken on a weekly basis for 2 months (washout phase--1 week, treatment phase--4 weeks, and withdrawal phase--3 weeks). One third of these patients had an abnormal blood pressure (hypertension or hypotension) while untreated, and this is statistically significant when compared to a matched control group of nonanxious patients. Bromazepam improved several patients having either hypertension or chronic hypotension. These findings are relevant for long-term treatment of anxious patients, since cardiovascular psychosomatic complications are a major health problem.
焦虑症患者患心血管疾病和猝死的发生率高于普通人群。多项研究强调了心率异常、心脏反应调节异常、心律失常的高发生率以及血压异常。原发性高血压已被研究与压力的关系，而慢性低血压（“低血压综合征”）在临床上已被认可数十年，但很少进行系统研究。我们在一项对照试验中，对80名符合《精神疾病诊断与统计手册》第三版（DSM III）定义的广泛性焦虑症患者进行了至少6个月、中度至重度的研究，以调查这些焦虑症患者的血压异常情况。他们被随机分配接受安慰剂或每天18毫克的溴西泮治疗。在2个月内每周测量血压、脉搏和其他几项指标（洗脱期1周、治疗期4周、撤药期3周）。这些患者中有三分之一在未治疗时血压异常（高血压或低血压），与匹配的非焦虑症患者对照组相比，这具有统计学意义。溴西泮改善了一些患有高血压或慢性低血压的患者。这些发现与焦虑症患者的长期治疗相关，因为心血管心身并发症是一个主要的健康问题。
