Sullivan P, Schoentgen S, DeQuattro V, Procci W, Levine D, Van der Meulen J, Bornheimer J
Hypertension. 1981 Nov-Dec;3(6 Pt 2):II-119-23. doi: 10.1161/01.hyp.3.6_pt_2.ii-119.
To determine whether basal blood pressure or pressor responses to stress are related to sympathetic nerve tone or to psychological factors in hypertensives, 15 hypertensives and 13 normotensives were studied by mean of a self-administered questionnaire, isometric handgrip exercise (IHE), and the mental stress of serial subtraction. Plasma norepinephrine (NE), epinephrine (E), blood pressure (BP) and heart rate (HR) were measured before and at the end of IHE and mental stress. A greater number of hypertensives had suppressed anger (p less than 0.01) and scored higher on anxiety trait (p less than 0.01) and depression (p less than 0.05). Prestress (IHE and mental) BP and NE values were significantly greater in hypertensives (all p less than 0.01). During IHE, both groups had a significant increase of BP, HR, and NE (all p less than 0.01) but E rose in hypertensives only (p less than 0.05). The percentage change of BP, HR, NE, and E during IHE was similar in both groups. The changes of BP and HR were not related to NE or E. During mental stress, HR (p less than 0.01) and E (p less than 0.05) increased in both groups. However, BP (systolic and diastolic) increased in normotensives only (p less than 0.01). Plasma NE contents were unchanged in both groups. There were significant positive correlations of anxiety trait with systolic BP (p less than 0.05), diastolic BP (p less than 0.05), and NE (p less than 0.05) and E (p less than 0.05). Although hypertensives had increased neurogenic tone related perhaps to inward anger and anxiety, the percentage responses of neurogenic tone and BP to IHE were equivalent to those of normotensives. The challenge of serial subtraction did not elicit further noradrenergic or pressor responses in hypertensives. Suppressed anger and anxiety, via increased basal neurogenic tone, may be pathogenic factors in some patients with primary hypertension.
为了确定高血压患者的基础血压或应激时的升压反应是否与交感神经张力或心理因素有关，我们通过自行填写问卷、等长握力运动（IHE）和连续减法的心理应激对15名高血压患者和13名血压正常者进行了研究。在IHE和心理应激前后测量血浆去甲肾上腺素（NE）、肾上腺素（E）、血压（BP）和心率（HR）。更多的高血压患者存在愤怒抑制（p<0.01），且焦虑特质得分更高（p<0.01），抑郁得分也更高（p<0.05）。高血压患者应激前（IHE和心理应激）的BP和NE值显著更高（均p<0.01）。在IHE期间，两组的BP、HR和NE均显著升高（均p<0.01），但仅高血压患者的E升高（p<0.05）。两组在IHE期间BP、HR、NE和E的变化百分比相似。BP和HR的变化与NE或E无关。在心理应激期间，两组的HR（p<0.01）和E（p<0.05）均升高。然而，仅血压正常者的BP（收缩压和舒张压）升高（p<0.01）。两组的血浆NE含量均未改变。焦虑特质与收缩压（p<0.05）、舒张压（p<0.05）、NE（p<0.05）和E（p<0.05）之间存在显著正相关。虽然高血压患者的神经源性张力增加可能与内心的愤怒和焦虑有关，但神经源性张力和BP对IHE的反应百分比与血压正常者相当。连续减法的应激并未在高血压患者中引发进一步的去甲肾上腺素能或升压反应。愤怒抑制和焦虑通过增加基础神经源性张力，可能是一些原发性高血压患者的致病因素。
