Saito K, Kim J I, Maekawa K, Ikeda Y, Yokoyama M
First Department of Internal Medicine, Kobe University, School of Medicine, Japan.
Am J Hypertens. 1997 Feb;10(2):217-21. doi: 10.1016/s0895-7061(96)00351-2.
A major earthquake (Hanshin-Awaji earthquake) struck Kobe on January 17, 1995. We had a unique opportunity to study the effect of tremendous psychological stress on blood pressure control in 221 hypertensive patients receiving antihypertensive medication. During the 4 weeks after earthquake, on average, the mean blood pressure increased significantly for both 105 patients who were exposed (living in the area of the very severe earthquake) and 116 patients who were not exposed (living in the surrounding area) (+4.2 +/- 1.0 mm Hg, P < .001, and +/- 2.4 +/- 0.7 mm Hg, P < .005, respectively). In the exposed group, the increase in mean blood pressure peaked in the first week (+6.7 +/- 1.6 mm Hg, P < .001), declined thereafter, and returned to the baseline within 6 weeks after the disaster. The earthquake related blood pressure elevation was, however, significantly attenuated (P < .02) in patients receiving beta-blockers compared with those receiving other drugs. The results indicate that acute psychological stress associated with a sudden natural disaster causes blood pressure elevation in treated hypertensive patients, and suggest the beneficial effect of beta-blockers on such a stress-associated high blood pressure.
1995年1月17日，一场大地震（阪神-淡路大地震）袭击了神户。我们获得了一个独特的机会，来研究巨大的心理压力对221名正在接受抗高血压药物治疗的高血压患者血压控制的影响。在地震后的4周内，平均而言，105名暴露者（居住在地震极严重地区）和116名未暴露者（居住在周边地区）的平均血压均显著升高（分别为+4.2±1.0 mmHg，P<.001，和+2.4±0.7 mmHg，P<.005）。在暴露组中，平均血压的升高在第一周达到峰值（+6.7±1.6 mmHg，P<.001），此后下降，并在灾难发生后6周内恢复到基线水平。然而，与接受其他药物治疗的患者相比，接受β受体阻滞剂治疗的患者与地震相关的血压升高明显减轻（P<.02）。结果表明，与突发自然灾害相关的急性心理压力会导致接受治疗的高血压患者血压升高，并提示β受体阻滞剂对这种与压力相关的高血压具有有益作用。
