The relationship of hypertension and its treatment with stress and well‐being

Gill, Jaswinder; Beevers, D. G.

doi:10.1002/smi.2460010407

Cited by 2 publications

(1 citation statement)

References 52 publications

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“…As Gill and Beevers [51] have remarked: 'There is little evidence that the state of well being differs between individuals unaware of their hypertensive status and normotensives, although there does appear to be an in fluence of labelling individuals as hyperten sives, on the well-being status. The act of diagnosis and drug treatment may impair well-being and it is important that clinicians appreciate the negative effects of therapy as well as the benefits.…”

Section: Hypertensionmentioning

confidence: 99%

Use of Anti-Anxiety Drugs in the Medically Ill

Wheatley¹

1988

Psychother Psychosom

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The Stress Clinic at the Maudsley Hospital investigates anxiety due to stress and its pharmacological treatment. Nine stress areas are investigated and their relative severities estimated: social habits, social relationships, life events, psychiatric morbidity, sexual stresses, sleep, stress in old age, menstrual stresses and stress and the heart. From the results a Stress Profile can be constructed for each patient to compare the importance of these different stresses and this can also be used as a measure of change in response to treatment. The benzodiazepine (BZD) anxiolytics can be divided into two groups according to duration of action, medium (8–12 h) and long (30–100 h). Short-acting BZD drugs are particularly useful for situational anxiety, when treatment can be interrupted over night and at weekends. To overcome problems of dependence, withdrawal effects, and daytime side-effects, new non-BZD anxiolytics have been developed: buspirone, alpidem and suriclone. These may be particularly useful for long-term treatment of anxiety. Another alternative is the use of adrenergic beta-blocking drugs of which propranolol and betaxolol have been used in the Clinic, because of their relatively high concentration in the brain when taken orally. Anxiety accompanying coronary heart disease and hypertension can be controlled with anxiolytic drugs and other illnesses with an anxiety component are: sexual disorders, menstrual disorders, asthma, gastro-intestinal conditions, dermatological conditions and chronic illnesses such as malignancy and AIDS. Lack of sleep is a subtle form of stress exerting an adverse effect in almost every illness known to man. BZD hypnotics can be divided into four groups: ultra-short-acting (3–4 h), short-acting (5–6 h), medium-acting (7–8 h) and long-acting (9–12 h). Depending on the nature of the insomnia, ultra-short-acting and short-acting BZD are particularly convenient with minimal disadvantages. Nevertheless, new non-BZD hypnotics are also being developed, i.e. zolpidem and zopiclone. These drugs are relatively short-acting and of equivalent potency to the BZD without problems of dependence etc. Anxiety, as either cause or effect, accompanies many medical illnesses and the use of anti-anxiety drugs as concomitant therapy can both reduce morbidity and improve prognosis.

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Section: Hypertensionmentioning

confidence: 99%

Use of Anti-Anxiety Drugs in the Medically Ill

Wheatley¹

1988

Psychother Psychosom

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Psychiatric aspects of cardiac disorders

Wheatley

1987

Stress Med.

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A number of the aetiological factors associated with coronary heart disease (CHD) have psychogenic components, ie alcohol consumption, smoking, obesity, sex, sleep and heredity. Placebo‐controlled trials of anxiolytics in CHD and hypertension have yielded conflicting results. For the cardiac patient suffering from depression, the choice of an antidepressant drug is important in view of the potential cardiotoxicity of the tricyclic compounds. Stresses that produce anxiety in cardiac patients and others may be multiple and varied in nature. At the Stress Clinic at the Maudsley Hospital in London, stratified questionnaires are used to assess a number of different stress factors and the severities of these can then be compared by constructing a stress profile for each patient.

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The relationship of hypertension and its treatment with stress and well‐being

Cited by 2 publications

References 52 publications

Use of Anti-Anxiety Drugs in the Medically Ill

Use of Anti-Anxiety Drugs in the Medically Ill

Psychiatric aspects of cardiac disorders

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