Psychological and Psychophysiological Mechanisms of Mental Stress Reaction in Patients with ‘Hypertension at Work’, as Compared with ‘Classical’ Version of Essential Hypertension

Introduction‘Hypertension at work’ today is found one of the most frequent forms of stress-induced hypertension.ObjectivesTo inquire into the specifics of psychological and psychophysiological mechanisms of stress reaction in patients with ‘hypertension at work’, as compared with ‘classical’ essential hypertension (EH).Materials and methodsThe study developed simulation of emotional stress with the aspiration level (AL) modeling. The level of state anxiety (SA), BP values, urine catecholamine levels and levels of renin and angiotonin I in blood plasma were taken before and after the experiment. Eighty-five patients with ‘hypertension at work’ (mean age was 45.9 ± 2.8) and 85 patients with ‘classical’ EH (mean age was 47.4 ± 4.5 years) took part in the study.ResultsRates of ‘hypertension at work’ patients, when compared with second group patients, revealed a significant increase (Р < 0.001) of systolic BP in response to stress loads (on average, for 16.1 ± 1.9 mmHg and 4.1 ± 0.7 mmHg, respectively). Initially ‘hypertension at work’ patients had significantly lower levels of catecholamines, than the second group, while the levels of renin and angiotensin I were comparable. During the experiment, the patients in the first group showed a significant decrease in all parameters. After the experiment, the patients with ‘HTN at work’ did not show increase of SA, but revealed more frequent inadequacy (69.4%) and instability (56.5%) on the AL. Patients with ‘classical’ EH more often demonstrate adequate AL and lower growth of BP after the experiment.ConclusionsPatients with ‘hypertension at work’ are more prone to repress their emotions. They reveal physiological features of chronic stress and psychophysiological exhaustion, if compared with second group patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.