Essential Hypertension: Abnormal Renal Vascular and Endocrine Responses to a Mild Psychological Stimulus

SUMMARY We have assessed the influence of a mild emotional stimulus on arterial blood pressure, heart rate, renal blood flow, plasma resin activity (PRA), and plasma aldosterone concentration in 24 normal subjects, eight of whom had a parent with hypertension, and in IS patients with essential hyper...

Full description

Saved in:
Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 1981-01, Vol.3 (1), p.11-17
Main Authors: HOLLENBERG, NORMAN K, WILLIAMS, GORDON H, ADAMS, DOUGLASS F
Format: Article
Language:English
Subjects:
Adult
Aged
Aldosterone - blood
Angiotensin II - blood
Blood Pressure
Emotions - physiology
Heart Rate
Humans
Hydrocortisone - blood
Hypertension - physiopathology
Hypertension - psychology
Kidney - blood supply
Middle Aged
Renin - blood
Space life sciences
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:SUMMARY We have assessed the influence of a mild emotional stimulus on arterial blood pressure, heart rate, renal blood flow, plasma resin activity (PRA), and plasma aldosterone concentration in 24 normal subjects, eight of whom had a parent with hypertension, and in IS patients with essential hypertension. A nonverbal IQ test, Ravenʼs Progressive Matrices, was employed as the stimulus. In 11 of the 15 hypertensives, arterial blood pressure rose transiently by 7 mm Hg or more, but in only three of 16 normal subjects (x = 7.23, p < 0.01). Transient moderate increases in heart rate were also more common in the hypertensives (p < 0.01). Renal blood flow rose in 11 of 16 normal subjects and fell in each of the 15 patients with essential hypertension (x* − 15.1;/> < 0.005). As opposed to the transient changes in arterial pressure and heart rate, the fall in renal perfusion was sustained. The PRA fell in 10 of the 16 normal subjects with a negative family history and rose In 14 of 15 patients with essential hypertension (p < 0.005). Changes in plasma angiotensin II concentration and in plasma aldosterone were in accord with the changes in PRA, but plasma cortisol did not change. Both the renal vascular response and the change in PRA were intermediate in normal subjects in whom family history was positive for hypertension. For the entire group of 39 subjects there was statistically significant agreement between the direction of the renal vascular response and the directional change in PRArenal blood flow rose when PRA fell and fell when PRA rose (p < 0.005). We conclude that there is an abnormality in the control of both the renal circulation and of renin release in patients with essential hypertension in response to psychological provocation, and that a similar process is present in some normotensive subjects whose parents have hypertension.
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.3.1.11