"Stress" Polycythemia and Hypertension

Emery, Alfred C.; Whitcomb, Walter H.; Fröhlich, Edward D.

doi:10.1001/jama.1974.03230400021024

Cited by 45 publications

(11 citation statements)

References 21 publications

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“…Although hypertension is a chronic condition that is distinguished by a chronic elevation in blood pressure, studies examining "stress (or relative) polycythemia" (characterized by normal red blood cell mass and decreased plasma volume) have found that relative polycythemia is associated with hypertension (39,40), and that treatment of hypertension with antihypertensive therapy results in plasma volume expansion to near normal levels (41,42). In another study conducted in our laboratory, we found that stress-mediated changes in plasma volume were correlated with changes in blood pressure in healthy men (43).…”

Section: Discussionmentioning

confidence: 99%

Effects of acute mental stress on serum lipids: mediating effects of plasma volume.

Patterson

Gottdiener

Hecht

et al. 1993

Psychosomatic Medicine

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The present study assessed the acute effects of mental stress (mental arithmetic) on serum cholesterol, triglycerides, high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C), and the extent to which stress-induced changes are attributable to decreases in plasma volume. Total cholesterol, triglycerides, HDL-C, and LDL-C were assessed in 18 healthy men (35 +/- 7 years) during a resting baseline (30 minutes), challenging mental arithmetic (math; 10 minutes), and recovery (30 minutes). Five additional subjects served as controls receiving no stress intervention. An indirect estimation of the change in plasma volume was computed from hematocrit and hemoglobin at each time point. Results indicated significant (p < .001) increases in cholesterol, triglycerides, LDL-C, and HDL-C levels during mental arithmetic. Changes in lipid levels during stress were not related to plasma epinephrine levels or changes. Significant (p < .002) increases in hematocrit and hemoglobin levels reflected a 9.23% decrease in plasma volume during mental arithmetic. Correcting for this decreased plasma volume, changes in cholesterol, triglycerides, HDL-C, and LDL-C levels during math were no longer significant (p > .16, p > .23, p > .27, and p > .42, respectively). These results indicate that acute psychological stress can cause a rapid and substantial decrease in plasma volume, producing hemoconcentration. Thus, stress-mediated increases in circulating lipid concentrations are a secondary result of decreased plasma volume, perhaps due to vascular fluid shifts. Methodologically, stress-induced hemoconcentration during mental stress suggests that acute plasma volume decreases may need to be evaluated in studies of the biochemical effects of stress on high molecular weight substances.

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Section: Discussionmentioning

confidence: 99%

Effects of acute mental stress on serum lipids: mediating effects of plasma volume.

Patterson

Gottdiener

Hecht

et al. 1993

Psychosomatic Medicine

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“…Polycythaemia has been reported in adults as an infrequent complication of hypertension (2). Another complication of severe hypertension more common in adults than in the paediatric age group is peripheral facial palsy (4, 5 ) . We report a 14-month-old boy, with polycythaemia and peripheral facial palsy, who was found to have severe hypertension.…”

mentioning

confidence: 99%

“Stress” Polycythaemia and Peripheral Facial Palsy Complications of Severe Hypertension

Zeis¹,

Rao²,

John³

et al. 1979

Acta Paediatrica

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An 11-month-old boy had an episode of generalized convulsions followed by a right peripheral facial palsy, which resolved gradually within 3 weeks. Three months later he had another similar episode of convulsions followed by a left peripheral facial palsy. On both occasions it was found that he had polycythaemia. A careful physical examination discovered that the child had severe hypertension. Extensive laboratory investigations did not reveal a cause for his hypertension. Haematologic investigations showed that the polycythaemia was due to a contracted plasma volume as a result of the hypertension. The peripheral facial palsy most probably was due to a blood clot in the facial canal, below the origin of the nerve to m. stapedius, as audiograms were normal and lacrimation preserved. Control of the hypertension resulted in resolution of the facial palsy within 4 weeks and normal haematocrit readings within 6 weeks. It should be stressed that every patient with peripheral facial palsy should be examined for hypertension.

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“…It is reasonable to assume that an increase in the concentration of red blood cells, a situation in which Ht level is also increased, will lead to thrombosis. In practice, an increase in the concentration of red blood cells from the movement or shift of plasma from the vascular compartment into interstitial spaces is believed to be a cause of polycythemia rather than an increase in red blood cell production in the bone marrow as in stress-induced polycythemia (Emery et al, 1974, Patterson et al, 1998, de Boer et al, 2007, Austin et al, 2011). In contrast to PV, polycythemia in which only red blood cells increase has been referred to as relative polycythemia (Lawrence and Berlin, 1952) or stress polycythemia (Dameshek, 1953).…”

Section: Discussionmentioning

confidence: 99%

Persistent prevalence of polycythemia among evacuees 4 years after the Great East Japan Earthquake: A follow-up study

Sakai

Nakano

Ohira

et al. 2017

Preventive Medicine Reports

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We previously reported that the lifestyle of evacuees significantly increased the prevalence of polycythemia compared with non-evacuees at an average of 1.6 years (2011–2012) from the previous annual health checkup before the Great East Japan Earthquake (GEJE). Here we analyzed how the prolonged evacuation affected the prevalence of polycythemia an average of 2.5 years (2013–2014) after the previous data. Subjects were individuals aged 40–90 years living in the vicinity of the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture who had attended the annual health checkups since 2008. The prevalence of polycythemia and changes in its defining factors of red blood cell count (RBC), hemoglobin (Hb) level, hematocrit (Ht) level were compared between before and after the GEJE in 7713 individuals (3349 men and 4364 women) receiving follow-up examinations both 2011–2012 and 2013–2014. RBC, Hb levels and Ht levels in 2011–2012 were higher among evacuees than non-evacuees in both men and women. However, all levels in 2013–2014 were on the decline from those in 2011–2012. On the other hand, among evacuees, Hb and Ht levels continued to be higher than before the GEJE in both men and women evacuees. The prevalence of polycythemia, which was diagnosed if one of the defining factors was beyond the standard value, was significantly higher among evacuees than non-evacuees regardless of the presence or the absence of overweight/obesity, smoking, and hypertension. Therefore, prolonged evacuation is a cause of polycythemia even 3 to 4 years after the GEJE and regular health management of evacuees is important.

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"Stress" Polycythemia and Hypertension

Cited by 45 publications

References 21 publications

Effects of acute mental stress on serum lipids: mediating effects of plasma volume.

Effects of acute mental stress on serum lipids: mediating effects of plasma volume.

“Stress” Polycythaemia and Peripheral Facial Palsy Complications of Severe Hypertension

Persistent prevalence of polycythemia among evacuees 4 years after the Great East Japan Earthquake: A follow-up study

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