PSYCHOPHYSIOLOGIC MECHANISMS IN HYPERTENSIVE VASCULAR DISEASE*
- ALVIN P. SHAPIRO, M.D. Pittsburgh, Pennsylvania
- Requests for reprints should be addressed to Alvin P. Shapiro, M.D., Assistant Professor, Department of Clinical Science, University of Pittsburgh School of Medicine, Pittsburgh 13, Pennsylvania.
Excerpt
In few somatic disorders is the potent impact of emotional stimuli more generally appreciated than in hypertensive vascular disease. Terms such as psychogenic hypertension, neurogenic hypertension, hypertensive personality, vascular stress, repressed hostility and autonomic nervous system lability have developed and are employed commonly. Yet precisely what these terms mean, what the qualitative and quantitative relationships of the emotions to blood pressure are, and what significant contributions to understanding the basic mechanisms of hypertension are made by the study of psychological forces, comprise questions which have not been answered in any systematic fashion. It is little wonder, therefore, that most investigators
This 100-word excerpt has been provided in the absence of an abstract.
Acknowledgment
The author wishes to acknowledge his indebtedness to the late Eugene B. Ferris, M.D., who supplied the impetus to the development of many of the ideas expressed in this essay.
Summario in Interlingua
Es revistate le stato de nostre cognoscentias con respecto al aspectos psychophysiologic de hypertensive morbo cardiovascular. Il ha multe indicationes que circuitos physiologic existe per que emotiones pote esser traducite in elevationes del tension de sanguine e que iste circuitos functiona per medio de mechanismos tanto neurogene como etiam humoral. Tal effectos es indubitabilemente responsabile pro multe occurrentias de acute e mesmo de chronic elevationes del tension de sanguine que es observate in subjectos hypertensive, e illos es probabilemente inter le factores que causa un aggravation del morbo. Tamen, le factos e observationes etiam suggere que multe variabiles—incluse etate, sexo, e le intensitate e le signification del evenimento psychologic—exerce un influentia super le natura qualitative e etiam quantitative del responsa pressori al stimulos nocive. Multe recerca—utilisante technicas psychologic si ben como physiologic—es ancora necessari pro clarificar le relative contributiones de iste variabiles. Il es pauco probabile que pertubationes psychogene es unquam exclusivemente responsabile pro le disveloppamento original de un hypertensive morbo vascular, sed il non pare possibile dubitar que iste influentias ha le rolo de causa contributori, como—per exemplo—quando illos interage con un genetic o acquirite predisposition vascular.
Le si-appellate "personalitate hypertensive" probabilemente non existe como distincte entitate clinic, sed il es certo ver que studios de patientes con hypertension ha demonstrate un modo particular del comportamento de illes in lor relationes interpersonal. Iste modo es characterisate per le timor de esser rejicite per personas in positiones cardinal e resulta particularmente in le incapacitate del patiente de gestionar impulsos aggressive. Le casos in que un intense psychotherapia es applicabile al hypertension per se es rar, sed si le medico presta attention a ille conflictos cardinal, ille pote utilisar le psychotherapia como tractamento supportative que contribue significativemente al melioration del regime medical in general. Il pare ben establite que tanto le melioration del symptomas como etiam le stabilisation del tension de sanguine—e forsan mesmo un retardo del progresso del condition—pote resultar in parte ab un tal therapia supportative.
Es signalate in conclusion que mechanismos psychophysiologic ha un rolo importante in omne phases de morbo hypertensive e que le investigatores—sin reguardo a si lor interesse es primarimente therapeutic o hemodynamic o etiologic—debe prender iste paramentro in consideration.
Article and Author Information
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↵* Received for publication December 4, 1959.
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From the Department of Clinical Science, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
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