INTERAÇÃO ENTRE ESTRESS, RESPIRAÇÃO E CONSUMO DE SAL NA DETERMINAÇÃO DA PRESSÃO ARTERIAL.
Resumo
Este artigo faz uma revisão da evidência científica quanto à possibilidade de que o desenvolvimento da hipertensão arterial possa ser potencializado pelas interações sinergéticas entre eventos estressantes e dietas com alto nível de sódio. Uma visão popular quanto à contribuição do stress para 8 etiologia da hipertensão arterial focaliza o papel da excitação do sistema nervoso simpático (isto é, das reações de "defesa Ir). No entanto, estudos recentes com animais e com seres humanos indicam que outros mecanismos fisiológicos, que estão envolvidos no manejo do sódio, também são de importância. Por exemplo, hipertensão experimental pode ser produzida, no laboratório, em cães que tenham recebido altas doses de sódio e que mostrem inibição respiratória entre sessões experimentais de esquiva, apresentadas de modo intermitente. Não é possível evitar tal hipertensão através do bloqueio adrenérgico. É possível que ela envolva mudanças no equilíbrio ácido-base as quais poderiam aumentar o nível total de sódio no corpo. Pesquisas se tornam necessárias para definir a gama de fatores comportamentais que possam influenciara homeostase do sódio e a distribuição de sódio entre os compartimentos intra e extra celulares. Tais estudos poderiam elucidar o papel do stress no desenvolvimento da hipertensão arterial, e possibilitar intervenções não-farmacológicas mais eficazes no tratamento da hipertensão em seres humanos.
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Referências
ANDERSON, O. E., Gomez-Sanchez, C., & Oietz, J. R. (1986). Suppression of renin and aldosterone in stress salt hypertension in the dog. American Journal of Physiology, 251, R181-R186.
ANDERSON, D. E., Kearns, W. O., & Better, W. E. (1983). Progressive hypertension in dogs by avoidance conditioning and saline infusion. Hypertension, 5, 286-291.
ANDERSON, O. E., Kearns, W. O., & Worden, T. J. (1983). Potassium attenuates avoidance-saline hypertension in the dog. Hypertension, 5, 414-419.
ANDERSON, O. E., Somers, V. K., Clary, M., Sinkey, C. A., &Anderson, E.A. (in press). Muscle sympathetic nerve and hemodynamic responses during hypoventilation induced hypercapnia in humans. Neuroscience.
ANDERSON. O. E., & Tosheff, J. G. (1973). Cardiac output and total peripheral resistance changes during pre-avoidance periods in the dog. Journal of Applied Physiology, 35, 650-654. t ANDERSON, O. E., Yingling, J. E., &. Brady, J. V. (1976). Cardiovascular responses to avoidance conditioning: Effects of alpha adrenergic blockade. Pavlovian Journal of Biological Science, 11, 150-161.
ANDERSON, N. B. (1989). Racial differences in stress induced cardiovascular reactivity and hypertension: Current status and substantive issues. Psychological Bulletin, 105, 89-105.
BENSON, H. (1983). The relaxation response: Physiologic basis, history and clinical usefulness.ln T. M. Oembroski, T. H. Schmidt, & G. Blumchen (Eds.), Biobehavioral bases of coronary heart disease (pp. 539-547). Basel: Karger.
BERECEK, K.H., &Bohr, D. F. (1978). Whole bodVreactivitv during the development of deoxvcorticosterone acetate hvpertension. Circulation Research. 42,764-771.
BLAIR, M. F., Feigl, E. O., & Smith, O. A. (1976). Elevations of plasma renin activitv during avoidance performances bV baboons. American Journal 0# Phvsio1ogV. 231. 772-776. BLAUSTEIN, M. P. (1977). Sodium ions, calcium ions, blood pressure regulation and hvpertension: A reassessment of a hipothesis. American Journal of Phvsio1ogV. 323. C165-C173.
CANNON, W. B. (1915). BodilVchanges in pain. hunger. tear and rage. New York: Appleton-Centurv Crofts.
COBB, S., & Rose, R. M. (1973). Hvpertension, peptic ulcer and diabetes in air traffic controllers. Journal 0# the American Medical Association, 224, 489-492.
CONWAY, J., & Hatton, R. (1978). Oevelopment of deoxvcorticosterone acetate hvpertension in the dog. Hvpertension, 43 (Suppl. 1), 82-86.
COSTA, E. A., Rose, G. A., Klein, C. H., Leal, M. O., Szarcwald, C. L., Bassanesi, S. L., Acxhutti, A. C., & Fischman, A. (1990). Salt and blood pressure in Rio Grande do Sul, Brazil. Bulletin ot PAHO, 24(2),159-176.
DRESSLER, W. W. (1990). Lifestvle, stress and blood pressure in a southern black communitv. Psvchosomatic Medicine, 52, 182-198.
ELY, D. L. (1985). Behavioural and neuroendocrine aspects of stress in mice and humans. Satrvck ur Stress i det kardiovasckulara perspekltvet. Hassle lakemedel, ABA, 50-70.
FOLKOW, B. (1982). Physiological aspects of primary hypertension. Physiological Reviews, 62(2), 347-504.
FRIEDMAN,R.(1990). Experimentalpsychogenic hypertension.ln D. Wheatley (Ed.), Stress and the heart (pp. 209-228). New York: Raven Press.
FRIEDMAN, S., & Mclndoe, R. A. Miyoshi T. (1990). The relation of blood sodium concentration to blood pressure in the rato Journal of Hypertension, 8, 61-66.
GUILLEMINAULT,C., Simmons, F. B., Motta,J., Cummiskey, J., Rosekind, M., Schroeder, J. S., & Dement, W. C. (1981). Obstructive sleep apnea syndrome and tracheostomy: Long-term follow-upexperience. Archives of Internal Medicine, 141,985-988.
GUYTON, A. C. (1977). Personal views on mechanisms of hypertension.ln J. Genest, E. Koiw & O. Kuchel (Eds.), Hypertension (pp. 566-575). New York: McGraw-Hill.
HADDY, F. J. (1987). Endogenous digitalis-like facto r or factors. New England Journal of Medicine, 316, 621-623.
HAMLYN, J. M., Harris, D. W., Clark, M. A., Rogowski, A. C., White, R. J., & Ludens, J. H. (1989). Isolation and characterization of a sodium pump inhibitor from human plasma. Hypertension, 13, 681-689.
HAYTHORNTHWAITE, J. A., Moore, L., & Anderson, D. E. (in press). Social and behavioral factors in inhibitory breathing. Behavioral Medicine.
HENRY,J. P., & Cassei, J. (1969). Psychosocial factors in essential hypertension. American Journal of Epidemiology, 90, 171-185.
JEONG, D., & Dimsdale, J. (in press). Sleep apnea and essential hypertension: A critica I review of the pidemiological evidence for comorbidity. Clinical Experimental Hypertension.
KOEPKE, J. P., Light, K. C., Grignolo, A., & Obrist, P. A. (1983). Neural control of renal excretory function during behavioral stress of dogs. American Journal of Physiology, 245, R251-R258.
KORNEL,L., Rafelson, M. E., Hayashi, T., Kanamarlapudi, N., & Anderson, K. M. (1988). Arterial receptors for adrenal steroids and transport of electrolytes in vascular smooth muscle. Clinical Physiology and Biochemistry, 6, 188-200.
LAWLER, J. E., & Cox, R. H. (1985), The borderline hypertensive rat (BHR):A new model for the study of environmentalfactors inthe developmentof hypertension. PavlovianJournal of Bioloqical Science, 20, 101-115.
LlPP, M. N. (1990). Aspectos psicologicos do paciente hipertenso. In B. Lamosa (Ed.), Psicologia aplicada a cardiologia (pp. 35-250). Sao Paulo: Socesp.
LlPP,M. N. (1991).Ovalor do controle do stress notratamento da hipertensão arterial. In M. Knobel (Ed.), Psicossomática (pp. 83-162). Campinas: NEP, UNICAMP.
MACCARRON,D. A. (1985).ls calcium more important than sodium in the pathogenesis of essential hypertension? Hypertension, 7, 607-627.
MacGregor, G. A. (1985). Sodium is more important than calcium in essential hypertension. Hypertension, 7, 628-637.
MARK, A., Lawton, W., Abbound, F., Fitz, A., Connor, W., & Heistad, D. (1975). Effects of high and low sodium intakeon arterialpressureandforearmvascularresistance in borderline hypertension. Circulation Research, 36, 1-194.
MASON,J. W. (1968). A review ot psychoendocrine research on the pituitary-adrenal cortical system. Psychosomatic Medicine, 30, 576-607.
MASON, J. W., & Brady, J. V. (1956). Plasma 17-hydroxycorticosteroid changes related to reserpine effects on emotional behavior. Science, 124, 983-984.
MASON, J. W., Jones, J. A., Ricketts, P. T., Brady, J. V., & Tolliver, G. A. (1968). Urinary aldosterone and urine volume responses to 72-hr. avoidance sessions in the monkey. Psychosomatic Medicine, 30, 733- 746.
MITHOEFER,J. C. (1965). Breath Holding. In W. O. Fenn & H. Rahn (Eds.), Handbook of physiology: Respiration 1/, (pp. 1011-1025). Washington, DC: American Physiological Society.
MORRISON, S. l., & Morris, J. N. (1959). Epidemiological observations on high blood pressure without apparent cause. Lancet. 2, 864-870.
NICE,D. S., &Trent, L. K. (1979). Prevalence 01 hypertension among active duty Navy personnel (NHRC Technical Report N° 90-5). San Diego, CA: Naval Health Research Center.
ONOYAMA, K., Bravo, E. L. &Tarazi, R. C. (1979). Sodium, extracellular fluid volume and cardiac output changes in the genesis of mineralocorticoid hypertension in the intact dog. Hypertension. 1, 333-336.
OTIS, A. B. (1964). The work of breathing. In W. O. Fenn & H. Rahn (Eds.), Handbook 01 Physiology: Respiration I (pp. 463-476). Washington, DC: American Physiological Society
PARFREY, P. S., Condon, K., Wright, P., Vandenburg, M. J., Holly, J. M. P., Goodwin, F. J., Evans, S. J. W., & Ledingham, J. M. (1981). Blood pressure and hormonal changes following alterations in sodium and potassium in young men with and without a familial predisposition to hypertension. Lancet. 113-11 7.
PERINI, C., Muller, F.B.& Buhler, F. R. (1991). Suppressed aggression accelerates early development of essential hypertension. Journal of Hypertension. 9. 499-503.
RICHTER-HEINRICH, E., Enderlein, J., Knust, U., Schmidt, K. H., & Wiedemann, R. (1989). Effects of a breath relaxation training.ln K.V. Sudakov (Ed.), Perspectives on research in emotional stress (pp. 239-250). New York: Gordon & Breach.
STRADLlNG, J. R., Chadwick, G. A., & Frew, A. J. (1985). Changes in ventilation and its components during sleep. Thorax, 40, 364-370.
SULLlVAN, J. M., & Ratts, T. E. (1983). Hemodynamic mechanisms of adaptation to chronic high sodium intake in normal humans. Hypertension, 5. 814-820.
THOMAS, C. B., & Greenstreet, R.L. (1973). Psychobiological characteristics in youth as predictors of 5 disease states: Suicide, mental iIIness, hypertension, coronary artery disease and tumor. Johns Hopkins Medical Journal, 132, 16-43.
TIMIO, M., Verdecchia, P., Venanzi, S., Gentili, S., Ronconi, B., Francucci, B., Montanari, M., & Bichisao, E. (1988). Age and blood pressure changes: A 20-year follow-up study in nuns in a secluded order. Hypertension, 12, 457-461
WILLlAMS,G. H., &Dluhy, R. G. (1983). Control of aldosterone secretion. In J. Genest, O. Kuchel, P. Hamet, & M. Cantin (Eds.), Hypertension: Physiopatholoqy and treatment (2ndEd.)(pp.320-337). New York: McGraw-H i11.
WINKLEBY,M. A., Ragland, D. R., & Syme, L.(1988). 5elf reported stressors and hypertension: Evidence of an inverse association. American Journal of Epidemiology, 127, 124-134.
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