Impact of stress and hypertension on the cerebrovasculature

Abstract

Objectives: Both stress and hypertension (HTN) are considered major health problems that negatively impact the cerebral vasculature. In this article we summarize the possible relationship between stress and HTN. Methods: We conducted a systematic review of the literature using a database search of MEDLINE, PubMed, Scopus, and Web of Science. Results: Psychological stress is known to be an important risk factor for essential hypertension. Acute stress can induce transient elevations of blood pressure in the context of the fight-or-flight response. With increased intensity and duration of a perceived harmful event, the normal physiological response is altered, resulting in a failure to return to the resting levels. These changes are responsible for the development of HTN. Genetic and behavioral factors are also very important for the pathogenesis of hypertension under chronic stress situation. In addition, HTN and chronic stress may lead to impaired auto-regulation, regional vascular remodeling, and breakdown of the blood brain barrier (BBB). The effects of both HTN and chronic stress on the cerebral blood vessels shows that both have common structural and functional effects including endothelial damage with subsequent increased wall thickness, vessel resistance, stiffness, arterial atherosclerosis, and altered hemodynamics. Conclusion: Most of the above mentioned vascular effects of stress were primarily reported in animal models. Further in-vivo standardization of pathological vascular indices and imaging modalities is warranted. Radiological quantification of these cerebrovascular changes is therefore essential for in depth understanding of the healthy and diseased cerebral arteries functions, identification and stratification of patients at risk of cardiovascular and neurological adverse events, enactment of preventive measures prior to the onset of systemic HTN, and the initiation of personalized medical management.

Transient Global Amnesia (TGA): Sex-Specific Differences in Blood Pressure and Cerebral Microangiopathy in Patients with TGA

“…The pathophysiology of blood pressure crises due to acute mental stress is quite different compared to blood pressure crises due to physical activity. Acute mental stress causes the activation of the sympathetic nervous system as well as the limbic system with the subsequent activation of the sympathetic nervous system and the sympathetic adrenal medullary system via the release of catecholamines and cortisol [ 30 ]. Normalisation occurs slowly via a negative feedback loop of rising catecholamine and cortisol levels via the inhibition of corticotropin releasing factor and adrenocorticotropic hormone production, causing blood pressure to return to baseline [ 31 ].…”

“…Females show more frequent association with emotional events, emotional and personality disorders [ 15 , 20 ]. In this context, acute mental stress reactions trigger hormonally induced, long-lasting hypertensive episodes over hours [ 30 , 31 , 32 ], affecting the blood–brain barrier [ 34 ] and affecting the LTP of the hippocampal CA-1 region [ 36 ]. These prolonged blood pressure episodes may further explain the observed higher extent of cerebral microangiopathy in females.…”

A Shift of the Parameters of the Cardiovascular System in Adolescents during the Period from 2004 to 2020 as a Result of Modification of Educational Environment

“…From the viewpoint of clinical medicine, most of these environmental factors have a pronounced effect on the cardiovascular system. For instance, non-compliance with hygienic requirements for the organization of the educational process contributes to psychological stress, which is an important risk factor for essential hypertension [3].Violations of daily round and poor sleep can be associated with multisystem hyperactivity, including sympathetic hyperactivity leading to the development of vascular pathology [4]. An unhealthy diet is often the cause of metabolic disorders in schoolchildren [5] that are also a risk factor for cardiovascular diseases [6].…”

Depresi, Stres, Kecemasan, dan Faktor Demografi terhadap Kejadian Hipertensi Usia 35-65 Tahun: Studi Cross-Sectional

“…obesitas, peningkatan asupan garam, stres, depresi dan kecemasan (Mucci et al, 2016). Gaya hidup modern masyarakat saat menimbulkan banyak permasalahan seperti masalah pekerjaan, permasalahan keluarga, masalah keuangan dan kekerasan menjadi faktor sangat berpotensi memicu timbulnya masalah psikologis seperti kecemasan atau stres (Elsaid et al, 2021).…”

“…Faktor resiko meningkatnya kejadian hipertensi seperti usia lansia, genetik, obesitas, kurang aktifitas, asupan garam berlebihan, alkohol dan perokok, tetapi penyebab secara pasti belum diketahui. Selain itu faktor psikologi atau stres disebutkan menjadi faktor resiko penting untuk meningkatan kejadian kasus utama hipertensi (Elsaid et al, 2021). Hipertensi merupakan penyakit kronis tidak menular, merupakan penyakit seumur hidup, dengan proses pengobatan yang dilakukan jangka Panjang dan membutuhkan manajemen diri dari pasien seumur hidup, sehingga seringkali kondisi penyakit ini dapat menimbulkan beban berat pada pasien dan juga dapat menyebabkan tekanan psikologis negatif seperti ketakutan, kecemasan dan depresi (Zhang et al, 2020).…”