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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To examine the effect of stressful life events and chronic emotional distress in the development of hypertension (HT), we have compared the blood pressure (BP) of 1150 Israelis (aged 50-80 years) who immigrated from Europe before the Second World War with 2159 Israelis who survived the Holocaust and came to Israel after the Second World War. Most of the subjects were examined as part of a periodical health examination offered by their employers. There were only minor differences in age, height, country of origin and level of education between the two groups. There was no difference in the prevalence of HT (lying systolic > or = 160 mmHg and/or diastolic > or = 95 mmHg and/or on antihypertensive medications) between the two immigration groups and a similar percentage of both groups were receiving treatment. Analyses of variance showed that age, sex and degree of obesity were the main factors contributing to the BP. Although the degree of emotional stress was greater in the Holocaust survivors, there was no correlation between level of emotional distress, satisfaction with life or number of psychosomatic complaints and level of BP or prevalence of HT.
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PMID:Hypertension in European immigrants to Israel: those who experienced the Holocaust and those who did not. 285 45

To examine the effect of stressful life events and chronic emotional distress in the development of hypertension, we compared the blood pressure of 1,150 Israelis (aged 50 to 80) who immigrated from Europe before 1939 with that of 2,159 European-born Israelis who immigrated to Israel after World War II. Most of the subjects were examined as part of a periodical health examination offered by their employers. There were only minor differences in age, height, country of origin and level of education between the two groups. There was no difference in the prevalence of hypertension between the two immigration groups, and a similar percentage of both groups were receiving treatment. Hypertension was defined as any one or more of the following: supine systolic greater than or equal to 160 mm Hg, diastolic greater than or equal to 95 mm Hg, or treatment with antihypertensive medications. Analysis of variance showed that age, sex and degree of obesity were the main factors contributing to the blood pressure. Although the degree of emotional stress was greater in the Holocaust survivors, there was no correlation between level of emotional distress, satisfaction with life or number of psychosomatic complaints and level of blood pressure or prevalence of hypertension.
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PMID:Hypertension in European immigrants to Israel--the possible effect of the holocaust. 362 84

The author conducted this comparative study to better understand women's body experiences during pregnancies complicated by pregnancy-induced hypertension (PIH). Specifically, the study sought to determine whether women who had PIH differed from women with normal pregnancies based on their descriptions and evaluations of weight, appetite, activity, and mood experiences for four sequential time intervals of pregnancy. Using a convenience sampling strategy and semistructured interview technique, data were collected from 38 women with PIH and 23 women with normal pregnancies. The body change data were analyzed using log-linear procedures with all statistical tests conducted at the p < .05 level. Study findings indicated the pregnancies of women with PIH differed from normal pregnancy. In the context of study findings, PIH pregnancy was explored as a consequence of (a) unmet maternal dependency needs, (b) the imposition of the childbearing developmental task on an unresolved adolescent developmental phase, and (c) the binding of maternal emotional distress through selective and often dependency-symbolic body change modes and responses.
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PMID:Body experience differences of women with pregnancy-induced hypertension. 788 56

In most patients with severe and symptomatic paroxysmal hypertension, a pheochromocytoma or other medical cause is rarely identified. This article presents the psychosocial assessment of 10 such patients, in whom the absence of any emotional distress preceding paroxysms had discouraged consideration of any psychological basis. However, a causative role of repressed unreported emotions was strongly suggested by 1) a history of unusually severe emotional trauma in 8 of 10 patients, 2) the absence of feelings related to the trauma, and 3) the prompt and sustained response of 3 patients to psychotherapeutic or psychopharmacologic intervention. These observations suggest that some cases of unexplained paroxysmal hypertension have a psychosomatic etiology and result from repressed rather than perceived and reported emotions. Treatment options are explored.
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PMID:Severe paroxysmal hypertension. An automatic syndrome and its relationship to repressed emotions. 882 24

This study was undertaken to see whether insulin resistant individuals, who are chronically hyperinsulinemic, have a higher heart rate (HR) than insulin sensitive, normoinsulinemic subjects. A total of 45 normotensive, nondiabetic individuals had insulin-mediated glucose disposal quantified by the insulin suppression test. In an effort to minimize variables known to modify heart rate, such as diet, exercise, and emotional distress, heart rate was continuously monitored during sleep by an electronic device measuring RR intervals. The average heart rate (as calculated by a mean of 30,720 +/- 208 beats per subject over a monitoring time of 6.9 +/- 0.6 h) was significantly related (r = 0.61; P < .001) to insulin resistance as expressed by the steady-state plasma glucose (SSPG) response to a continuous infusion of glucose, insulin and somatostatin and to the plasma insulin response to a 75 g of oral glucose challenge (r = 0.51; P < .001). These significant relationships between HR and both SSPG and plasma insulin response persisted after adjustment by stepwise regression analysis for age, gender distribution, body mass index, physical activity, and family history of either diabetes or hypertension. These results show that insulin resistant individuals, with compensatory hyperinsulinemia, have a higher nocturnal heart rate: a finding consistent with the possibility that the increased nocturnal heart rates are secondary to insulin-induced sympathetic activity.
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PMID:Enhanced sympathetic nervous system activity. The linchpin between insulin resistance, hyperinsulinemia, and heart rate. 889 54

Stress can cause hypertension through repeated blood pressure elevations as well as by stimulation of the nervous system to produce large amounts of vasoconstricting hormones that increase blood pressure. Factors affecting blood pressure through stress include white coat hypertension, job strain, race, social environment, and emotional distress. Furthermore, when one risk factor is coupled with other stress producing factors, the effect on blood pressure is multiplied. Overall, studies show that stress does not directly cause hypertension, but can have an effect on its development. A variety of non-pharmacologic treatments to manage stress have been found effective in reducing blood pressure and development of hypertension, examples of which are meditation, acupressure, biofeedback and music therapy. Recent results from the National Health and Nutrition Examination Survey indicate that 50 million American adults have hypertension (defined to be a systolic blood pressure of greater than 139 mm Hg or a diastolic blood pressure of greater than 89 mm Hg). In 95% of these cases, the cause of hypertension is unknown and they are categorized as "essential" hypertension. Although a single cause may not be identified, the general consensus is that various factors contribute to blood pressure elevation in essential hypertension. In these days of 70 hour work weeks, pagers, fax machines, and endless committee meetings, stress has become a prevalent part of people's lives; therefore the effect of stress on blood pressure is of increasing relevance and importance. Although stress may not directly cause hypertension, it can lead to repeated blood pressure elevations, which eventually may lead to hypertension. In this article we explore how stress can cause hypertension and what can be done about it.
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PMID:Stress and hypertension. 989 38

Severe, symptomatic paroxysmal hypertension always generates suspicion of a pheochromocytoma, a catecholamine-secreting tumor. However, most patients with this disorder do not have this tumor and their condition remains undiagnosed and ineffectively treated. This case series, summarizing the course of 21 such patients, suggests a cause and an effective treatment approach. All 21 patients insisted that the paroxysms were not related to stress or emotional distress, initially discouraging consideration of a link to emotions. Nevertheless, with careful psychosocial interviewing, the disorder could be attributed to emotions patients were not aware of, and, therefore, unable to report. Such emotions were related either to previous severe emotional trauma or to a general tendency to keep distressful emotions out of awareness. With treatment based on this understanding, further paroxysms were eliminated in 13 (62%) of 21 patients. Alpha- plus beta-blockade was used, combined, when necessary, with an antidepressant agent, with or without an anxiolytic agent. In 3 cases, the disorder was cured with psychotherapy alone. Because the presenting symptoms are physical rather than emotional, patients present to internists and primary care physicians rather than to psychotherapists. For this reason, more awareness of this disorder in the medical community is needed.
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PMID:Severe paroxysmal hypertension (pseudopheochromocytoma): understanding the cause and treatment. 1051 Oct

The origin of essential hypertension is believed by many to be at least partially emotion-related. A widely held paradigm is that perceived emotional distress raises blood pressure and leads eventually to sustained hypertension. However, decades of research have not provided strong or consistent support for this view. The purpose of this article is to briefly review this research, and to present a very different view of the mind-body link of hypertension. This view focuses on the role of emotions that are not consciously perceived, emotions that are unknowingly kept from conscious awareness, and largely ignored by patients, physicians and research. It suggests that the mind/body connection is often operative when we least suspect it. The evidence for this understanding, and the important implications regarding treatment of hypertension and other unexplained medical conditions with a suspected mind/body link, are discussed.
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PMID:The mind/body link in essential hypertension: time for a new paradigm. 1071 Aug 2

The aim in this study was to assess the frequency and type of self-reported side-effects among hypertensives in a general population, and to estimate the relationship between drug use and side-effects and health utility using the Rating Scale (RS) method. The study is based on a postal questionnaire that was sent to a random sample of 8000 inhabitants aged 20-84 years (response rate 68%) in Uppsala County, Sweden, in 1995. The results showed that nearly 20% of the users of antihypertensive drugs reported side-effects. Men and women reported side-effects to nearly the same extent. In the linear regression analyses, those with hypertension, with or without medication, rated lower health utilities (-6.0 and -7.1 respectively) than did normotensives after controlling for age and sex. The lowest value, -8.7, was found among drug users who experienced side-effects. Side-effects causing impotence and emotional distress, i.e. insomnia, tiredness and depression had the strongest negative impact on health utility. To conclude, the study showed that side-effects among hypertensives are common. Both the disease and the drug treatment adversely affect the patient's well-being. However, drug treatment was of less importance than that found in prior studies. The findings here stress that side-effects should be taken into greater consideration when evaluating drug treatment.
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PMID:Self-reported side-effects of antihypertensive drugs: an epidemiological study on prevalence and impact on health-state utility. 1121 61

Until recently, there was little empirical data regarding the psychological impact of screening for type 2 diabetes. There is now some progress in this area, as evidenced by emerging population based studies reporting on the effects of screening for type 2 diabetes on perceived health status and well-being. Recent studies from our own and other groups show that the diagnosis type 2 diabetes has no substantial adverse or positive effect on the participants' perceived health status and well-being after notification of the test result. Importantly, screening-detected type 2 diabetes patients beforehand perceive their risk for type 2 diabetes to be low, despite the presence of risk factors, such as obesity, hypertension and a family history, and overall report low levels of diabetes-related symptom distress. Yet, screening-detected type 2 diabetes patients were bothered more by symptoms of hyperglycaemia and fatigue in the first year following diagnosis type 2 diabetes than non-diabetics. On the basis of research to date, we conclude that screening for type 2 diabetes in the general population has no serious psychological side effects. Whether lack of emotional response to screening, is because of unawareness or indifference, needs further investigation. Future studies should be aiming towards a better understanding of how to raise the awareness and understanding of type 2 diabetes and its risk factors in high-risk individuals, while avoiding or minimizing negative effects, such as emotional distress and denial. The growing number of younger people developing type 2 diabetes warrants further research into labeling effects of an early diagnosis.
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PMID:The psychological impact of screening for type 2 diabetes. 1614 14


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