Document Detail

Psychophysiological theories on sympathetic nervous system reactivity in the development of essential hypertension.
MedLine Citation:
PMID:  1759143     Owner:  NLM     Status:  MEDLINE    
Psychophysiological theories on the development of essential hypertension are reviewed and evaluated. Two interconnected theories that relate behavior to essential hypertension and account for individual differences in susceptibility to disease are the "hyperreactivity" theory and "the symptom specificity" theory. The "hyperreactivity" theory identifies individual differences in autonomic nervous system reactivity as the pathophysiological mechanism and the "symptom specificity" theory suggests that inflexible, stereotypical responding increases the risk to develop hypertension. Based on a literature review, these theories are examined. There exist both case/control and prospective studies on autonomic nervous system reactivity and the development of hypertension. It is concluded that a neurogenically mediated hyperreactivity to stress is a precursor and not an effect of hypertension. Tasks that call for active but not passive coping efforts are more efficient elicitors of reactivity differences between those at high and low risk to develop hypertension in case/control studies. In prospective studies, active tasks may also have a predictive advantage over passive with respect to blood pressure development. In the early phase of hypertension, an increased cardiovascular reactivity is accompanied by increased neuroendocrine activation. In the later phase, heightened reactivity is confined to the cardiovascular system. This does not prove but is consistent with the notion that transient episodes of increased cardiac output translate into essential hypertension by causing vascular hypertrophy. Case/control studies suggest that an increased "symptom specificity", with stereotypical responding across multiple stressors, is independent of cardiovascular reactivity and a precursor of hypertension. The literature lacks prospective studies on the clinical relevance of stereotypical responding. It is suggested that the presence of both hyperreactivity and symptom specificity in a single individual increases the risk to develop essential hypertension.
M Fredrikson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Scandinavian journal of psychology     Volume:  32     ISSN:  0036-5564     ISO Abbreviation:  Scand J Psychol     Publication Date:  1991  
Date Detail:
Created Date:  1992-02-05     Completed Date:  1992-02-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0404510     Medline TA:  Scand J Psychol     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  254-74     Citation Subset:  IM    
Department of Psychiatry and Psychology, Karolinska Institute, Stockholm, Sweden.
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MeSH Terms
Arousal / physiology*
Hypertension / physiopathology*,  psychology*
Sympathetic Nervous System / physiopathology*

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