Psychophysiologische und psychologische Aspekte der milden Hypertonie

Abstract

The aetiopathogenesis of essential hypertension has been more intensively investigated in recent years mainly in genetic high-risk groups and patients with transitory and early forms of essential hypertension. A group of 29 patients with mild hypertension according to the WHO criteria were submitted to hypertensiological, psychological and psychophysiological specification in this study. Twenty-four hour blood measurements were performed for this purpose. The group could thus be divided into 18 patients with white-coat hypertension (WH) and 11 patients with real mild hypertension (H). Contrary to expectations, mild hypertensives had weaker systolic (p < 0.05) and diastolic (p < 0.01) blood pressure reactions to mental stress than white-coat hypertensives. Their cardiovascular recovery was not reduced after stress. Psychological differences between the groups were only found with respect to irritability (FP1: H 6.9 sd 2.1, WH 5.2 sd 2.1 stanine) and hypertensives compared to the reference random sample on the FPI scale emotional instability (6.5 stanine). Other psychosomatic studies should replicate the results obtained in this study in larger patient populations with white-coat and mild hypertension.

Neuroendocrinological and Epigenetic Mechanisms Subserving Autonomic Imbalance and HPA Dysfunction in the Metabolic Syndrome

“…Specifically, genes regulating renal function toward sodium excretion with the cytochrome enzyme class P450 ( CYP11B2, CYP4A11, CYP3A5 , see also Section Obesity: Lipid Transport and Storage) via aldosterone synthesis, and dopamine-receptor-1-mediated salt excretion, have been associated to blood pressure lowering in hypertensive rodents. Salt consumption and sodium levels related to essential hypertension have been substantiated for several decades (Svetkey et al, 1987 ; Deter et al, 1996 , 2002 , 2007a , b ; Buchholz et al, 1999 ), and been found to be influenced by emotional arousal (anger, anxiety) involving sympathetic outflow. A recent epidemiological study quantified the explained variance for trait anxiety upon high blood pressure to 6% (Lemche et al, 2016 ) in MetS.…”

Veränderungen der Publikationspraxis der psychosomatischen/psychotherapeutischen und der medizinpsychologischen Lehrstuhlinhaber

“…Veröffentlichten in den Jahren 1992 ± 1996 immerhin sieben Autoren weniger als zwei Aufsätze, so war es diesmal nur ein Fachvertreter, der in den Jahren 1998 ± 2002 gar nicht publizierte. [18,19,27], Rüger [23], Reimer [10], Liedtke [12], Cierpka [13], Hoffmann [33,48,50], Herzog [25,42], Joraschky [34], von Rad [29, 30, 38, 72 ± 74], Senf [40,63], Fikentscher [41], Overbeck [64], Rudolf [52,53], Lamprecht [56,57], und Zepf [76]. Von den Medizinpsychologen nutzten Strauû [2,8,11,55,66 ± 68], Brähler [7,8,16,17,58,62], Neuser [20], Lang [44], Koch [59 ± 61] und Balck [75] die PPmP zur Veröffentlichung ihrer wissenschaftlichen Arbeiten.…”