Skip to main content
SpringerLink
Log in

Streß, Emotion und Hypertonie: Die integrative Rolle des Zentralnervensystems

Stress, emotion and hypertension: The integrative role of central nervous system

  • Übersichten
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

In current literature stress is assumed to be an import factor in the multifactorial pathogenesis of hypertension. The cardiovascular response might be dependent on the type and severity of stressors, the complexity of stress reaction and the ability of man to counteract stress. In this review the concept of stress, its nature and the participation of the central nervous system are elucidated. The role of emotion is also discussed, as well as a connection to stress mechanisms. The sympathetic nervous system acts as link between stress and hypertension, especially borderline-hypertension. Based on various experimental models as well as epidemiological investigations the hypothesis that stress is a causative factor in the initiation of hypertension is critically discussed. In patients with a genetic predisposition to hypertension, stress may play an important role in early manifestations of chronic blood pressure elevation, and in established hypertension, however, psychological stress contributes to temporary or longer lasting increases of blood pressure.

Zusammenfassung

In der multifaktoriellen Genese der Hypertonie wird dem Streß eine wichtige ursächliche Bedeutung zugeschrieben, die Vielfalt der Stressoren, die Komplexität der Streßreaktion sowie die vor allem dem Menschen eigene Fähigkeit der Streßreduktion modifizieren jedoch seinen Stellenwert. In dieser Übersicht werden das Konzept des Stresses, sein Erscheinungsbild und seine zentralnervösen Abläufe eingehender analysiert, die Rolle der Emotion als streßbegleitende Reaktion wird herausgestellt. Als wichtiges funktionelles Bindeglied zwischen Streßreaktion und Hypertonie kann das sympathische Nervensystem angesehen werden, da es auch bei der Borderline-Hypertonie eine übergeordnete Rolle spielt. Die naheliegende Annahme einer direkten ursächlichen Verknüpfung von Streß und Hypertonie wird vor dem Hintergrund experimenteller und epidemiologischer Daten durchleuchtet; offenbar hat Streß nur in der Initialphase der essentiellen Hypertonie einen pathogenetischen Stellenwert, bei manifester Hypertonie jedoch kann er als Auslöser intermittierender Blutdruckanstiege therapeutische Bedeutung erlangen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  1. Alexander F (1971) Psychosomatische Medizin. de Gruyter, Berlin

    Google Scholar 

  2. Arnold MB (1967) Stress and emotion. In: Appley MH, Trumbull R (eds) Psychological stress. Appleton-Century-Crofts, New York

    Google Scholar 

  3. Bard P, Macht MB (1958) The behavior of chronically decerebrated cats. In: Ciba Foundation Symposium, Neurological basis of behavior. Churchill, London, p 55

    Google Scholar 

  4. Baumann R (1974) Stress-Sensibilität und Adaptation. Ber Ges Inn Med 9:15

    Google Scholar 

  5. Bräutigam W, Christian P (1973) Psychosomatische Medizin. Thieme, Stuttgart

    Google Scholar 

  6. Brod J (1959) Circulatory changes underlying blood pressure elevation during acute emotional stress. Clin Sci 18:269

    Google Scholar 

  7. Brod J (1963) Haemodynamic basis of acute pressor reactions and hypertension. Br Heart J 25:227

    Google Scholar 

  8. Brod J (1970) Haemodynamics and emotional stress. In: Koster M, Musaph H, Visser P (eds) Psychosomatics in essential hypertension. Bibliotheca psychiatrica Nr. 144. Karger, Basel

    Google Scholar 

  9. Buchborn E (1980) Wurzeln der wissenschaftlichen Medizin. In: Pluralität in der Medizin. Umschau Verlag, Frankfurt, S 19

    Google Scholar 

  10. Cannon WB (1929) Bodily changes in pain, hunger, fear and rage, 2nd ed. Appleton, New York

    Google Scholar 

  11. Cassel J (1974) Psychosocial processes and “stress”: theoretical formulation. Int J Health Serv 4:471

    Google Scholar 

  12. Cobb S, Rose RM (1973) Hypertension, peptic ulcer, and diabetes in air traffic controllers. JAMA 224:489

    Google Scholar 

  13. Cohn JN (1966) Relationship of plasma volume changes to resistance and capacitance vessel. Effect of sympathomimetic amines and angiotensin in man. Clin Sci 30:267

    Google Scholar 

  14. De Champlain J (1978) The contribution of the sympathetic nervous system to arterial hypertension. Can J Physiol Pharmacol 56:341

    Google Scholar 

  15. Duffy E (1972) Activation. In: Greenfield NS, Sternbach RA (eds) Handbook of psychophysiology. Holt, New York

    Google Scholar 

  16. Engel BT, Bickford AF (1961) Response specificity. Arch Gen Psychiat 5:478

    Google Scholar 

  17. Esler MD, Julius S, Zweifler A, Randallo S, Harburg E, Gardiner H, De Quattro V (1977) Mild high-renin essential hypertension. Neurogenic human hypertension? New Engl J Med 296:405

    Google Scholar 

  18. Von Euler US (1964) Quantitation of stress by catecholamine analysis. Clin Pharmacol Ther 5:398

    Google Scholar 

  19. Falkner B, Onesti G, Angelakos ET, Fernandes M, Langman C (1979) Cardiovascular response to mental stress in normal adolescents with hypertensive parents. Hypertension 1:23

    Google Scholar 

  20. Farris EJ, Yeakel EH, Medoff HS (1945) Development of hypertension in rats after blasting. Am J Physiol 144:331

    Google Scholar 

  21. Folkow B, Rubinstein EH (1966) Cardiovascular effects of acute and chronic stimulations of the hypothalamic defence area in the rat. Acta Physiol Scand 68:48

    Google Scholar 

  22. Folkow B, Neil E (1971) Circulation. Oxford University Press, New York

    Google Scholar 

  23. Folkow B (1975) The neurogenic component in spontaneously hypertensive rats (SHR) — a survey. In: Esler M, Julius S (eds) Nervous system in hypertension. Charles C Thomas, Spring-field/Ill

    Google Scholar 

  24. Folkow B (1975) Central neurohormonal mechanisms in spontaneously hypertensive rats compared with human essential hypertension. Clin Sci Mol Med 48:205s

    Google Scholar 

  25. Forsyth R (1969) Blood pressure responses to long-term avoidance schedules in the restrained rhesus monkey. Psychosom Med 31:300

    Google Scholar 

  26. Friedman R, Dahl LK (1975) The effect of chronic conflict on the blood pressure of rats with a genetic susceptibility to experimental hypertension. Psychosom Med 37:402

    Google Scholar 

  27. Graham JDP (1945) High blood pressure after battle. Lancet 1:239

    Google Scholar 

  28. Gray JA (1972) The structure of the emotions and the limbic system. In: Physiology, emotion and psychosomatic illness. Ciba Foundation Symposium 8 (new series). Elsevier Excerpta Medica, Amsterdam, p 115

    Google Scholar 

  29. Grobecker H (1977) Sympatho-neuronale and sympatho-adrenale Aktivität bei experimenteller und essentieller Hypertonie. Verh Dtsch Ges Kreislaufforsch 43:2

    Google Scholar 

  30. Groen JJ, Hansen B, Herrmann JM, Schäfer N, Schmidt TH, Selbmann KH, v Uexküll Th, Weckmann P (1977) Haemodynamic responses during experimental emotional stress and physical exercise in hypertensive and normotersive patients. In: De Jong W, Provoost AP, Shapiro AP (eds) Progress in brain research. Vol 47: Hypertension and brain mechanisms. Elsevier, Amsterdam

    Google Scholar 

  31. Gutmann MC, Benson H (1971) Interaction of environmental factors and systemic arterial blood pressure. Medicine 50:543

    Google Scholar 

  32. Haeusler G (1975) Cardiovascular regulation by central adrenergic mechanisms and its alteration by hypotensive drugs. Circ Res 36 and 37 [Suppl I]: 223

    Google Scholar 

  33. Hallbäck M, Folkow B (1974) Cardiovascular responses to acute mental “stress” in spontaneously hypertensive rats. Acta Physiol Scand 90:684

    Google Scholar 

  34. Harburg E (1973) Sociological stressor areas and black-white blood pressure. Detroit. J Chronic Dis 26:595

    Google Scholar 

  35. Haymaker W, Anderson E, Nauta WJH (eds) (1969) The hypothalamus, chapter 4. Thomas, Springfield/Ill, p 136–209

    Google Scholar 

  36. Henry JP, Stephens PM, Santisteban GA (1973) A model of psychosocial hypertension showing reversibility and progression of cardiovasculär complications. Circ Res 36:156

    Google Scholar 

  37. Henry JP (1976) Understanding the early pathophysiology of essential hypertension. Geriatrics 30:59

    Google Scholar 

  38. Hess WR (1949) Das Zwischenhirn. Schwabe, Basel

    Google Scholar 

  39. Hess WR (1954) Die funktionelle Organisation des vegetativen Nervensystems, 2. Aufl. Schwabe, Basel

    Google Scholar 

  40. Hess WR (1968) Psychologie in biologischer Sicht. 2. Aufl. Thieme, Stuttgart

    Google Scholar 

  41. Hilton SM, Spyer KM (1971) Participation of the anterior hypothalamus in the baroceptor reflexe. J Physiol 218:271

    Google Scholar 

  42. Holmes TH, Rahe RH (1967) The social readjustment rating scale. J Psychosom Res 11:213

    Google Scholar 

  43. Isaacson RL (1974) The limbic system. Plenum, New York

    Google Scholar 

  44. Jonsson A, Hansson L (1977) Prolonged exposure to a stressful stimulus (noise) as a cause of raised blood pressure in man. Lancet 1:86

    Google Scholar 

  45. Julius S, Pascual AJ, London R (1971) Role of parasympathic inhibition in the hyperkinetic type of borderline hypertension. Circulation 44:413

    Google Scholar 

  46. Kahn RL (1970) Some propositions toward a researchable conceptualization of stress. In: McGrath (ed) Social and physiological factors in stress. Holt, Rinehart & Winston, New York London, p 97

    Google Scholar 

  47. Korner PI (1971) Integrative neural cardiovascular control. Physiol Rev 51:312

    Google Scholar 

  48. Kvetnansky R, Kopin IJ, Saavedra JM (1978) Changes in epinephrine nephrine in individual hypothalamic nuclei after immobilisation stress. Brain Res 155:387

    Google Scholar 

  49. Kvetnansky R, Mitro A, Palkovits M, Brownstein M, Torda T, Vigas M, Mikulaj L (1976) Catecholamines in individual hypothalamic nuclei in stressed rats. In: Usdin E, Kvetnansky R, Kopin IJ (eds) Catecholamines and stress. Pergamon Press, Oxford, p 39

    Google Scholar 

  50. Labarthe D et al. (1973) Health effects of modernization in Paulau. Am J Epidemiol 98:161

    Google Scholar 

  51. Lacey JI (1967) Somatic response patterning and stress: Some revisions of activation theory. In: Appley MH, Trumbull R (eds) Psychological stress: Issues in research. Appleton-Century-Crofts, New York

    Google Scholar 

  52. Lapin BA, Cherkovich GM (1971) Environmental change causing the development of neuroses and corticovisceral pathology in monkeys. In: Levi L (ed) Society, stress and disease, Vol 1. Oxford University Press, London New York, p 266

    Google Scholar 

  53. Lazarus HS (1966) Psychological stress and the coping process. Mc Graw Hill, New York

    Google Scholar 

  54. Lazarus RS (1967) Cognitive and personality factors underlying threat and coping. In: Trumbull R, Appley MH (eds) Psychological stress. Appleton, New York

    Google Scholar 

  55. Lazarus RS (1971) The concept of stress and disease. In: Levi L (ed) Society, stress and disease. Oxford University Press, London

    Google Scholar 

  56. Levi L (1974) Psychological stress and disease: A conceptual model. In: Gunderson EKE, Rathe RH (eds) Life stress and illness. Thomas, Springfield/Ill, p 8

    Google Scholar 

  57. Levi L (1974) Stress, distress and psychosocial stimuli. In: Mac Lean A (ed) Occupational stress. Thomas, Springfield/Ill, p 31

    Google Scholar 

  58. Lindsley DB (1970) The role of nonspecific reticulo-thalamocortical systems in emotion. In: Black P (ed) Physiological correlates in emotion. Academic Press, New York

    Google Scholar 

  59. Lipman RL, Shapiro AP (1967) Effects of behavioral stimulus on blood pressure of rats with experimental pyelonephritis. Psychosom Med 29:6

    Google Scholar 

  60. Lorimer AR, MacFarlane PW, Provan G, Duffy T, Lawrie TDV (1971) Blood pressure and catecholamine responses to “stress” in normotensive subjects. Cardiovasc Res 5:169

    Google Scholar 

  61. Malmo RB (1959) Activation: A neurophysiological dimension. Psychol Rev 66:367

    Google Scholar 

  62. Mason JW (1975) Emotion as reflected in patterns of endocrine integration. In: Levi L (ed) Emotions — Their parameters and measurement. Raven Press, New York

    Google Scholar 

  63. Miasnikov AL (1961) The significance of higher nervous activity in the pathogenesis of hypertensive disease. In: Cort JH, Fencl V, Hejl Z, Jirka J (eds) The pathogenesis of essential hypertension. State Medical Publishing House, Prague, S 152

    Google Scholar 

  64. Miller JG (1964) A theoretical review of individual and group psychological reactions to stress. In: Grosser, Wechsler, Greenblatt (eds) The threat of impending disaster. Cambridge (Mass), p 11

  65. Miller NE (1976) The role of learning in physiological response to stress. In: Serban G (ed) Psychopathology of human adaption. Plenum Press, New York, p 25

    Google Scholar 

  66. Moulton R, Spencer AG, Willaughby DA (1958) Noradrenaline sensitivity in hypertension measured with radioactive noradrenaline technique. Br Heart J 20:224

    Google Scholar 

  67. Moruzzi G, Magoun HW (1949) Brain stem reticular formation and activation of the EEG, Electroencephalogr Clin Neurol 1:455

    Google Scholar 

  68. Nauta WJH (1971) The problem of the frontal lobe: A reinterpretation. J Psychiatr Res 8:167

    Google Scholar 

  69. Nosaka S, Wang SC (1972) Carotis sinus baroceptor functions in the spontaneously hypertensive rat. Am J Physiol 222:1079

    Google Scholar 

  70. Ostfeld AM, Shekelle RB (1967) Psychological variables and blood pressure. In: Stamler J, Stamler R, Pullman TN (eds) The epidemiology of hypertension. Grune & Stratton, New York, p 321

    Google Scholar 

  71. Ostfeld AM, D'Atri DA (1977) Rapid sociocultural change and high blood pressure. Adv Psychosom Med 9:20

    Google Scholar 

  72. Palkovits M (1979) Changes in brain amines during stress. In: Jones MT, Gilham B, Dallman MF, Chattopadhyay S (eds) Interaction within the brain-pituitiary-adrenocortical system. Academic Press, London, p 87

    Google Scholar 

  73. Pfeffer MA, Frohlich ED (1973) Hemodynamic and myocardial function in young and old normotensive and spontaneously hypertensive rats. Circ Res 32–33 [Suppl 1] 1:28

    Google Scholar 

  74. Pfeffer MA, Pfeffer JM, Frohlich ED (1976) Autonomic inhibition in spontaneous hypertensive rats. In: Julius S, Esler MD (eds) The nervous system in arterial hypertension. Charles C Thomas, Springfield, p 60

    Google Scholar 

  75. Pflanz M (1969) Psychosomatische Aspekte der essentiellen Hypertonie. In: Heintz R, Losse H (Hrsg) Arterielle Hypertonie. Thieme, Stuttgart, S 185

    Google Scholar 

  76. Pflanz M (1974) Psychische und soziale Faktoren bei der Entstehung des Hochdrucks. Internist 15:124

    Google Scholar 

  77. Rand MJ, McCulloch MW, Story DF (1975) Prejunctional modulation of noradrenergic modulation of noradrenergic transmission by noradrenaline, dopamine, and acetylcholine. In: Davies DS, Reid JL (eds) Central action of drugs in blood pressure regulation. Pitman Medical Publishing Co, London, p 94

    Google Scholar 

  78. Reis DJ (1972) The relationship between brain norepinephrine and aggressive behavior. Res Publ Assoc Res Nerv Ment Dis 50:266

    Google Scholar 

  79. Rodan E, Alvarez-Pelaez R, Fernandez de Molina A (1974) Electrographic study of the amygdaloid defense response. Physiol Behav 13:779

    Google Scholar 

  80. Ruskin A, Beard OW, Schaffer RL (1948) Blast hypertension: Elevated arterial pressure in victims of the Texas City Disaster. Am J Med 4:228

    Google Scholar 

  81. Saavedra JM, Palkovits M, Brownstein MJ, Axelrod J (1974) Localisation of phenylethanolamine N-methyl transferase in the rat brain nuclei. Nature 248:695

    Google Scholar 

  82. Satin DG (1972) Life stresses and psychosocial problems in the hospital emergency unit. Soc Psychiatry 7:119

    Google Scholar 

  83. Schmid G, Palkovits M, Bahner U, Heidland A (1980) Altered cyclic AMP levels in specific cardiovascular brain centers of spontaneously hypertensive rats (SHR). Klin Wochenschr 58:1091

    Google Scholar 

  84. Schwartz GE (1977) Biofeedback and patterning of autonomic and central processes: CNS-cardiovascular interactions. In: Schwartz GE, Beatty J (eds) Theory and research. Academic Press, New York, p 183

    Google Scholar 

  85. Scotch NA, Geiger HJ (1963) The epidemiology of essential hypertension: a review with cultural factors: II. Psychologic and sociocultural factors in etiology. J Chronic Dis 16:1183

    Google Scholar 

  86. Selye H (1956) The stress of life. McGraw-Hill, New York

    Google Scholar 

  87. Shapiro AP, Schwartz GE, Ferguson DCE, Redmond DP, Weiss SM (1979) Behavioral methods in the treatment of hypertension. In: Stoyva J, Kamiyay J, Barber TX, Miller NE, Shapiro D (eds) Biofeedback and self-control 1977/78. Aldine Publ Comp, New York

    Google Scholar 

  88. Shekelle RB, Schoenberger JA, Stamler J (1976) Correlates of the JAS type. A behavior pattern score. J Chronic Dis 29:381

    Google Scholar 

  89. Sokolov YN (1963) Perception and the conditioned reflex. Macmillan, New York

    Google Scholar 

  90. Uexküll Th v, Wick E (1962) Die Situationshypertonie. Arch Kreisl Forsch 39:236

    Google Scholar 

  91. Weiss JM (1972) Influence of psychological variables on stress-induced pathology. Physiol emotion & Psychosom illness, Ciba Found Symp No 8, p 253

  92. Welch BL, Welch AS (1968) Differential activation by restraint stress of a mechanism to conserve brain catecholamines and serotonin in mice differing excitability. Nature 218:575

    Google Scholar 

  93. Welch BL, Welch AS (1971) Isolation, reactivity and aggression: evidence for an involvement of brain catecholamines and serotonin. In: Eleftheriou BE, Scott JP (eds) The physiology of aggression and defeat. Plenum Press, New York

    Google Scholar 

  94. Zanchetti A, Baccelli G, Mancia G (1970) Cardiovascular effects of emotional behavior. In: Bartorelli C, Zanchetti A (eds) Cardiovascular regulation in health and disease. Instituto die recherche cardiovasculari, Milano, p 17

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Luitpoldkrankenhaus, Medizinische Universitätsklinik Würzburg, Germany

    E. Heidbreder & A. Heidland

Authors
  1. E. Heidbreder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Heidland
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heidbreder, E., Heidland, A. Streß, Emotion und Hypertonie: Die integrative Rolle des Zentralnervensystems. Klin Wochenschr 59, 715–726 (1981). https://doi.org/10.1007/BF01721259

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01721259

Key words

Schlüsselwörter

Search

Navigation