Pathogenic mechanisms of arterial hypertension in patients with chronic psychoemotional stress

Abstract

The article is based on literature review and describes the implication of psycho-emotional factors in the development of arterial hypertension (HTN). HTN and its cardiovascular complications take a leading place among the causes of high mortality and disability in the adult population. High blood pressure (BP) is known to be a major modifiable risk factor for premature death, myocardial infarction, stroke and other cardiovascular diseases. The pathogenesis of HTN is complex and multifactorial with a significant variability of the involved mechanisms in individual patients. In this regard, the determination of specific pathogenic mechanisms underlying stable BP elevation would substantially individualize therapeutic approaches, and hence increase the effectiveness of treatment. The role of psycho-emotional stress has been recently reassessed and it is widely discussed as a factor contributing to the HTN formation. Global urbanization, sedentary lifestyle, daily work-related stress, lack of physical activity and social support lead to increased anxiety, uncertainty, and finally to chronic mental and emotional stress. This review analyzes the main physiological markers of chronic stress, neuroendocrine and immunological mechanisms underlying the development of HTN. The role of endothelial dysfunction as a binding link between chronic stress and high BP is also discussed.