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. 2013 Apr 5;30(10):631–637. [Article in Spanish] doi: 10.1016/S0212-6567(02)79125-7

Estrés ambiental y reactividad cardiovascular: la influencia de los acontecimientos vitales estresantes en pacientes hipertensos☆

Environmental stress and cardiovascular reactivity: the effect of stressful life events on hypertense patients

C Menéndez Villalva a,*, A Montes Martínez b, C Núñez Losada c, MJ Fernández Domínguez c, T Gamarra Mondelo d, S Buján Garmendia d
PMCID: PMC7679752  PMID: 12525339

Abstract

Objective

To assess the effect of stressful life events (SLE) on the monitoring of patients with essential hypertension.

Design

Observational and prospective.

Setting

Primary care.

Participants

236 hypertense patients selected by systematic randomised sampling.

Measurements

Age, sex, marital status, cultural level, kind of family, presence of SLE, social support, blood pressure, severity of hypertension, tobacco consumption, alcohol, presence of diabetes, hypercholesterolaemia, body mass index, compliance with hypertension treatment.

Results

Mean age was 63.51 (62.05; 64.96), with 66.1% being women and 33.9% men. 48.7% of the patients referred to some SLE during the follow-up. These reached a mean of 47.65 (33.16; 62.15) life change units (LCU). Patients with high-impact SLE (>150 LCU) had a significant increase of 10.91 mm Hg (0.43; 21.40) in their systolic blood pressure and of 9.48 beats per minute (3.78; 15.19) in their heart rate, after monitoring for possible factors of confusion. We observed a similar trend for diastolic pressure, but this did not reach statistical significance.

Conclusion

The presence of SLE has a negative effect on systolic blood pressure in hypertense patients.

Key words: Stressful life events, Hypertension, Primary care

Footnotes

☆

Este trabajo forma parte del proyecto de investigación financiado por el Fondo de Investigaciones Sanitarias (FIS), del Ministerio de Sanidad y Consumo, con el expediente nº 1480/96.

Bibliografía

  • 1.Stumbo D., Good M.J., Good B. Diagnostic profile of a family practice clinic: patients with psychosocial diagnoses. J Fam Pract. 1982;14:281–282. [PubMed] [Google Scholar]
  • 2.Regier D.S., Goldberg I.D., Burms B.J. Specialist/generalist division of responsability for patients with mental disorders. Arch Gen Psychiatry. 1982;39:219–224. doi: 10.1001/archpsyc.1982.04290020071013. [DOI] [PubMed] [Google Scholar]
  • 3.Corney R.H. A survey of professional help sougt by patients for psychosocial problems. Br J Gen Pract. 1990;40:365–366. [PMC free article] [PubMed] [Google Scholar]
  • 4.De la Revilla L. Los acontecimientos vitales estresantes. In: De la Revilla L., editor. Manual de atencion familiar, bases para la práctica en la consulta. Ediciones Adhara S.L.; Granada: 1999. pp. 275–292. [Google Scholar]
  • 5.Rozanski A., Blumenthal J., Kaplan J. Impact of psychosocial factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99:2192–2217. doi: 10.1161/01.cir.99.16.2192. [DOI] [PubMed] [Google Scholar]
  • 6.Pickering T., Devereux R., James G., Gerin W., Landsbergis P., Schnall P. Environmental influences on blood pressure and the role of job strain. J Hypertens. 1996;14(Suppl 5):179–185. [PubMed] [Google Scholar]
  • 7.Harburg E., Erfurt J., Hauenstein L., Chape C., Schull W., Schork A. Socio-ecological stress, suppresed hostility, skin color and black-white male blood pressure: Detroit. Psychosom Med. 1973;35:276–296. doi: 10.1097/00006842-197307000-00003. [DOI] [PubMed] [Google Scholar]
  • 8.Dressler W. Lifestyle, stress and blood pressure in a southern black community. Psychosom Med. 1990;52:182–198. doi: 10.1097/00006842-199003000-00006. [DOI] [PubMed] [Google Scholar]
  • 9.Abel G., Chen X., Boden-Albala B., Sacco R. Social readjustment and ischemic stroke: lack of an association in a multiethnic population. Neuroepidemiology. 1999;18:22–31. doi: 10.1159/000026192. [DOI] [PubMed] [Google Scholar]
  • 10.Isaksson H., Konarski K., Theorell T. The psychosocial and social condition of hypertensives resistant to pharmacological treatment. Soc Sci Med. 1992;35:869–875. doi: 10.1016/0277-9536(92)90101-u. [DOI] [PubMed] [Google Scholar]
  • 11.Caputo J.L., Rudolph D.L., Morgan D.W. Influence of positive life events on blood pressure in adolescents. J Behav Med. 1998;21:115–129. doi: 10.1023/a:1018771706685. [DOI] [PubMed] [Google Scholar]
  • 12.Jula A., Salminen J., Saarijärvi S. Alexitimia. A facet of essential hypertension. Hypertension. 1999;33:1057–1061. doi: 10.1161/01.hyp.33.4.1057. [DOI] [PubMed] [Google Scholar]
  • 13.Ruberman W., Weinblatt E., Goldberg J., Chaudhary B. Psychosocial influences on mortality after myocardial infarction. N Engl J Med. 1985;311:552–559. doi: 10.1056/NEJM198408303110902. [DOI] [PubMed] [Google Scholar]
  • 14.O’Brien E., Mee F., Atkins N., Thomas M. Evaluation of three devices for self-measurement of blood pressure according to the revised British Hypertension Society Protocol: the Omron HEM-705CP, Philips HP5332 and Nissei DS-175. Blood Pressurer Monitoring. 1996;1:55–61. [PubMed] [Google Scholar]
  • 15.Stergiu G., Voutsa A., Achimastos A., Moustokalakis T. Home self-monitoring of blood pressure. Is fully automated oscillometric technique as good as conventional stethoscopic technique? Am J Hypertens. 1997;10:428–433. [PubMed] [Google Scholar]
  • 16.Llisterri J.L., Garrido Y., Giner G. Utilidad de la automedición de la presión arterial en atención primaria. Hipertensión. 1997;14:13–17. [Google Scholar]
  • 17.Puras A., Divison J.A. Fiabilidad de los aparatos semiautomáticos de medida de la presión arterial. Hipertensión. 1996;13:295–298. [Google Scholar]
  • 18.Artigao L.M., Llavador J.J., Puras A., López J., Rubio M.M., Torres C. Evaluación y validación de los monitores Omron Hem 705 CP y Hem 706/711 para automedidas de presión arterial. Aten Primaria. 2000;25:96–103. doi: 10.1016/S0212-6567(00)78470-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.Consenso para el control de la hipertensión arterial en España. Ministerio de Sanidad y Consumo; Madrid: 1990. [Google Scholar]
  • 20.Piñeiro F., Gil V., Orozco D., Pastor R., Merino J. Validez de 6 métodos indirectos para valorar el cumplimiento del tratamiento farmacológico en la hipertensión arterial. Aten Primaria. 1997;19:372–375. [PubMed] [Google Scholar]
  • 21.Piñeiro F., Gil V., Orozco D., Pastor R., Merino J. Factores implicados en el incumplimiento del tratamiento farmacológico en la hipertensión arterial. Aten Primaria. 1997;20:180–184. [PubMed] [Google Scholar]
  • 22.De la Revilla L. Estructura familiar. In: De la Revilla L., editor. Conceptos e instrumentos de la atención familiar. Doyma; Barcelona: 1994. pp. 27–35. [Google Scholar]
  • 23.Holmes T.S., Rahe R.H. The social readjustment rating scale. J Psychosom Res. 1976;11:213–218. doi: 10.1016/0022-3999(67)90010-4. [DOI] [PubMed] [Google Scholar]
  • 24.González J.L., Morera A. La valoración de sucesos vitales: adaptación española de la escala de Holmes y Rahe. Psiquis. 1983;4:20–25. [Google Scholar]
  • 25.De la Revilla, Aybar R., De los Ríos, Castro J.A. Un método de detección de problemas psicosociales es la consulta del médico de familia. Aten Primaria. 1997;19:133–137. [PubMed] [Google Scholar]
  • 26.Blake R., McKay D. A single-item measure of social supports as a predictor of morbidity. J Fam Practice. 1986;22:82–84. [PubMed] [Google Scholar]
  • 27.Menéndez C. Apoio social e hipertensión arterial esencial [tesis doctoral] Universidade de Santiago de Compostela; Santiago de Compostela: 2000. [Google Scholar]
  • 28.Grupo Colaborativo Peso-Hipertensión Prevalencia de sobrepeso-obesidad en la población hipertensa española mayor de 39 años atendida en centros de salud. J Hypertension (ed. esp.) 1995;2(Supl 2):17–23. [Google Scholar]
  • 29.Sociedad Española de Hipertensión, Liga Española para la lucha contra la Hipertensión Arterial . El estudio COMPAS (Control Modular de la Presión Arterial) Pharma Consult Services S.A.; Madrid: 1998. [Google Scholar]
  • 30.Joshi P.P., Salkar R.G., Heller R.F. Determinants of poor blood pressure control in urban hypertensives of central India. J Human Hypertension. 1996;10:299–303. [PubMed] [Google Scholar]
  • 31.Ahern D., Gorkin L., Anderson J., Tierney C., Hallstrom A., Ewart C. Biobehavioural variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study (CAPS) Am J Cardiol. 1990;66:59–62. doi: 10.1016/0002-9149(90)90736-k. [DOI] [PubMed] [Google Scholar]
  • 32.Soler J., Cinca J. Fisiología, epidemiología, impacto clínico. Doyma; Madrid: 1995. La frecuencia cardíaca. [Google Scholar]

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