‘Hypertension at Work’: the Real Challenge or Much Ado About Nothing? Clinical and Psychological Study

Abstract

Introduction

Physicians discover more and more patients with Hypertension (HTN) whose blood pressure (BP) values during work appear to be higher than those values during free time. This form of HTN is called ‘HTN at work’ (Stork at al., 1992).

Objectives

To evaluate the specifics of psychophysiological mechanisms of stress reaction in patients with HTN at work, as compared with patients with essential HTN.

Methods

170 patients with EAH, stage 1-2 took part in the study. Among them 85 patients with HTN at work (mean age is 44.7±4.3years) and 85 patients with essential HTN (mean age is 47.4±4.5 years). The research was carried out with the implication of methods of psychological experiment, psychological testing, and methods of physiological data registration.

Results

Patients with HTN at work, were characterized by reliably greater increase of Systolic BP (on the average by 16 and 4 mmHg respectively) as a reaction to emotional stress. The BP increase in this group was revealed in combination with a lowering of the level of anxiety, gradual decrease of catecholamines' level in urine and renin and angiotensin-1 in blood plasma during the experiment, the fluctuant aspirations' level, and scarcity of behavioral manifestations accompanied by an abundant variety of facial expressions. This psychophysiological combination is an indicator of repression of emotions, chronic stress and psychophysiological exhaustion.

Conclusions

Repression of emotions come as a significant pathogenetic factor in genesis of psychosomatic syndrome among patients with HTN at work, as opposed to patients with essential HTN.