Psychoneurocardiology: psychosomatic and somatopsychic approaches to hypertension research.

We introduce the field of psychoneurocardiology, and cite examples of research into psychosomatic and somatopsychic bases for hypertensive development. Beta-adrenergic hyperreactivity (a possible precursor of hypertension), as indexed by electrocardiographic T-wave amplitude suppression, was greater during active than passive coping tasks. The rise in tonic mean arterial blood pressure in normotensives over a 19-month period was a joint function of self-reported daily stress and baroreceptor-dependent pain dampening (as determined by the PRES method of noninvasive controlled carotid baroreceptor manipulation). The latter finding provides support for the learned model of hypertension. In this model, phasic blood pressure increases stimulate the baroreceptors, which in turn dampen pain and stress. The long-term effect of this relief is initially to increase the frequency of such phasic increases, and eventually to produce a tonic elevation in blood pressure.