Stress and hypertension: C and H type of hypertension and causes of resistance

Abstract

Background. Uncontrolled blood pressure (BP), especially in the context of stress, is associated with a fourfold increase in the risk of developing cardiovascular events compared to patients with hypertension who have reached the target BP level. Aim: to evaluate the mechanisms of the influence of stress on the development of hypertension, types of hypertension and resistance. Materials and methods. The study included 1,146 patients with resistant hypertension who were taking 3 or more antihypertensive drugs and were treated at the department of secondary and pulmonary hypertensions of the State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Aca­demy of Medical Sciences of Ukraine”. The level of office blood pressure upon admission to the department when taking 3 or more antihypertensive drugs was: systolic — 174.60 ± 0.64 mmHg, diastolic — 100.50 ± 0.38 mmHg. Patients underwent the following examinations: measurement of office blood pressure, daily blood pressure monitoring, echocardiography, measurement of nocturnal sleep apnea, general blood analysis, biochemical blood analysis, determining the levels of thyroid-stimulating hormone, triiodothyronine, thyroxine, blood renin, blood aldosterone and their ratio, urine metanephrines, blood cortisol. Results. Among patients with resistant hypertension, there were more women than men — 62.7 versus 36.7 %, respectively. In a study of people with resistant hypertension who did not reach the target level of systolic BP, significantly higher indicators of BP were observed upon admission to the hospital. They had a significantly higher blood cortisol level (155.0 ± 44.0 vs. 35.9 ± 20.8 ng/l, p = 0.026), higher left ventricular mass index (147.50 ± 3.46 vs. 135.30 ± 1.74 g/m2), obesity was more common among them (42.9 versus 37.5 %). Conclusions. Patients with resistant hypertension who did not reach the target level of blood pressure had higher level of cortisol and left ventricular mass index compared to those who achieved the target levels of blood pressure.

Impact of Vitamin E and Selenium Intake on Antioxidant Protection Indicators During Physical Exertion in Individuals With Hypertension

“…ìå éîãî çâ'ÿçîê ³ç ï³äâèùåííÿì ÀÒ àáî ae ÿê îö³íèòè ê³ëüê³ñíî éîãî ñèëó [4][5][6][7]. ²íòåíñè-ô³êàö³ÿ ïðîöåñ³â ÏÎË ó ïàö³ºíò³â ç Àà ðîçãëÿäàºòüñÿ ÿê íàäçâè÷àéíî âàaeëèâèé ìåõà-í³çì ³í³ö³àö³¿ ³ ïðîãðåñóâàííÿ çàõâîðþâàííÿ ó éîãî ðàííüîìó ïåð³îä³.…”

“…The aim of the study was to evaluate the significance of glutathione link within the thiol-disulfide system in patients with chronic obstructive pulmonary disease and hypertension. It was proved that the comorbidity, represented by both chronic obstructive pulmonary disease and arterial hypertension, led to significant changes in the glutathione chain within the thiol-disulfide system due to the decrease of its reduced intermediates (the level of reduced glutathione typical of reduced thiol groups decreases significantly) [7,21].…”

Changes in the cortisol level under the influence of physical exertion in patients with hypertension and in practically healthy individuals

“…Це зумовлене у тому числі й існуванням факторів навколишнього середовища, що потенціюють підвищен-ня артеріального тиску (АТ). Серед цих факторів одним із найважливіших є хронічний стрес, із яким часто стикається людина в сучасному суспільстві [1]. Варто відзначити, що стресового впливу зазнає та частина населення, яка є найбільш активною і праце здатною [2,3].…”

“…Залежно від характеру фактора, який його спричинив, стрес може бути нервово-психічним, фізичним, тепловим, холодовим тощо. Незалежно від причини зміни в організмі під впливом стресу мають такі ознаки: активуються симпатоадреналова і ренін-ангіотензинова системи [1].…”

Optimized treatment of elderly patients with type 2 diabetes mellitus and hypertension in general practice

“…Given the prevalence of chronic and acute exposure to stress, it represents a potentially attractive target for population-health interventions [9]. It is also known that with age, there is an increase in sensitivity to humoral influences (in particular, adrenaline), which leads to increased sensitivity of the myocardium of older people to stressors [10]. Also, improvements in the circadian rhythm of blood pressure under the influence of treatment that improve the quality of sleep have been noted [11].…”