INCREASED STRESS-REACTIVITY OF MALES WITH HIGH NORMAL BLOOD PRESSURE AND HYPERTENSION: INFLUENCE ON THE VESSELS

Aim. To assess stress-reactivity of males younger than 55 y. o. with high normal blood pressure (HNBP) and arterial hypertension (AH) and possible influence on asymptomatic atherosclerosis and arterial stiffness.

Material and methods. Into the study, males were included of age 40-55 y. o. According to blood pressure level (BP), they were selected to groups: 1st group included 91 men with HNBP, 2nd — 89 men with the diagnosed AH and reached target BP. The cardiovascular risk factors were assessed, as intima-media thickness of brachiocephalic vessels (BCV), velocity of carotid-femoral pulse wave. Stress-test was done with the “mathematic count”, and the increased reactivity was defined as increase of systolic blood pressure (SBP) and/or heart rate (HR) by >7% and >10%, respectively, during the test. Statistics was done with Statistica 6.0 (StatSoft Inc.).

Results. An increased stress-reactivity was found in 34,7% of patients with HNBP and 22,5% with AH. Abdominal obesity patients had higher increase of SBP and HR by 4,1% (p=0,01) and 5,8% (p=0,01), respectively. Higher SBP had smokers, by 4,3% (p=0,001), dyslipidemic males, 6,0% (p<0,001) and those with early cardiovascular anamnesis, by 35,0% (p=0,001) comparing to those with no studied risk factors. Signs of atherosclerosis of BCA had 46,8% and 70,0% males in 1st and 2nd groups with excessive BP reaction to stress-test, and those studied, with normal reactivity had it rarer by 35,7% (p=0,02) and 33,2% (p>0,05). Arterial stiffness was found in 53,1% and 75,0% of men from 1st and 2nd groups with increased stress reactivity, that is more prevalent 6,1 times (p<0,001) and 2,8 times (p=0,001) comparing to normal reactivity in HNBP and AH, respectively.

Conclusion. The negative influence was found of the increased stress-reactivity of BP to vessel wall in men with HNBP and AH, and such influence does result not only to early atheroscleoris, but to arterial rigidity

1. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Journal of Hypertension: July 2013; Volume 31, Issue 7: 1281–1357.

2. Yuli Huang, Sheng Wang, Xiaoyan Cai et al. Prehypertension and incidence of cardiovascular disease: a meta-analysis. Huang et al. BMC Medicine 2013, 11:177.

3. Kobalava G. D., Kotovskay U. V., Achmetov R. E. Arterial stiffness and central pressure, new pathophysiological and therapeutic concept. Hypertension. 2013, 2: 126-133 (Кобалава Ж.Д., Котовская Ю.В., Ахметов Р.Е. Артериальная ригидность и центральное давление: новые патофизиологические и лечебные концепции.Артериальная гипертония 2013, т.16,№2: 126-133.

4. Aftanas L.I. Pavlov S.V., Brak I.V. et al. Individual predisposition to the unconscious perception of facial threat of incentives and positive reinforcement and cardiovascular stress reactivity. / Bulletin RAMN 2013. 111:3-6. (Афтанас Л.И., Павлов С.В., Брак И.В., Коренек В.В. Индивидуальные предиспозиции к неосознаваемому восприятию лицевых стимулов угрозы и положительного подкрепления и кардиоваскулярная стресс-реактивность. Вестник РАМН 2013. 111: 3-6.

5. Mestanik M., Mestanikova A., Visnovsova Z. et al. Cardiovascular Sympathetic Arousal in Response to Different Mental Stressors. /Physiol. Res. – 2015- 64 (Suppl. 5): S585-S594.

6. A method of predicting hypertension in the workplace in individual operator professions: Patent 2371083.2009. Russian Federation: A61B5/02 / Osipova I.V., Antropova O.N., Vorobeva E.N. et al. 2008115809/14; 27.10.2009. (Способ прогнозирования артериальной гипертензии на рабочем месте у лиц операторских профессий: патент 2371083.2009. Российская Федерация: A61B5/02 / Осипова И.В., Антропова О.Н., Воробьева Е.Н. и др. 2008115809/14; 27.10.2009).

7. Garafova A., Penesova A., Cizmarova E. et al. Cardiovascular and Sympathetic Responses to a Mental Stress Task in Young Patients With Hypertension and/or Obesity. / Physiol. Res.- 2014 - 63 (Suppl. 4): S459-S467.

8. Smith M.M., Minson CT: Obesity and adipokines: effects on sympathetic overactivity. /J Physiol. 2012. - 590: 1787-1801.

9. Lambert, G. Stress reactivity and its association with increased cardiovascular risk: a role for the sympathetic nervous system? / G. Lambert, M. Schlaich, E. Lambert et al. // Hypertension. –2010. –Vol. 55(6). –P. e20-e21.