Low psychological resilience massively increases the risk of high blood pressure

Swedish long-term study shows a risk factor that is difficult to influence

In 1972, Swedish draft boards began collecting data on young conscripts. The 18-year-olds were not only examined by doctors for their physical condition, but also by psychologists who were to find out how well or poorly they coped with stress. A team led by Kristina Sundquist, a physician at Lund University in Malmo, compared these stress sensitivity assessments with the medical history of those selected over the next 44 years, which was permitted by Swedish health records and data protection regulations.

The results of this comparison, published in the current ie of the journal Heart, show that among the 93.000 Swedish men who developed pathological high blood prere during this period included a significant number of persons who were found to have a low ability to cope with stress during their physical examination. Their blood prere, which rose repeatedly in situations of psychological stress, could have developed into a chronic condition over the course of time.

In older studies, habits such as alcohol abuse, lack of exercise and overeating were found to be the main risk factors for high blood prere. Some physicians (such as Werner Bartens, for example) already amed in the past that there could be deeper causes that promote such behavior. The Swedish long-term study provides further evidence: it is easy to imagine that someone who feels stressed quickly and often is more likely to become an alcoholic or to eat poorly in order to cope with psychological stress.

If such (conscious or unconscious) self-medication occurs "Self-medication", risk factors can accumulate and reinforce each other: according to Sundquist’s calculations, the risk of developing high blood prere increases three and a half times when stress sensitivity is combined with obesity. In overweight people, who are more susceptible to strictness, it is only two and a half times the average risk.

Digital blood prere monitor. Photo: Solaris2006. License: CC BY-SA 3.0.

Those at risk could face dilemmas from the study’s findings: Do they perhaps even increase their risk of disease if they forgo the after-work beer or the corporeal substances excreted during eating, because blood prere then rises more often and stays high longer? The advice not to get worked up about these dilemmas may be as useless for cholerics as the advice to live more calmly in the first place. The effectiveness of stress management techniques and therapies is controversial – it is clear that they do not help all sufferers.

If left untreated, high blood prere often leads to arteriosclerosis and cardiovascular disease, which are responsible for about 45 percent of deaths in men and 50 percent of deaths in women in Germany. The incidence of such deaths increases practically linearly with blood prere. Hypertension is therefore treated, among other things, with beta-blockers, which weaken the effect of the stress hormone adrenalin. Alternatives include calcium antagonists (which reduce vascular stress), ACE inhibitors (found in snake venoms and interfere with the blood prere-regulating renin-angiotensin-aldosterone system), and AT1 antagonists (which inhibit the angiotensin II receptor).

However, there are options for reacting to the new findings not only at the individual level, but also at the political and legal level: in future, courts will have to take greater account of the effects on physical integrity when weighing up the general freedom of action against stress-inducing noise.

According to the WHO, 20 percent of the population in Europe suffers from nocturnal noise to an extent that endangers their health. Particularly affected are financially less well-off people. Not only because they live in particularly noisy and poorly soundproofed apartments, but also because authorities in their neighborhoods are often even more reluctant to take care of rest disturbances than elsewhere (cf. Homeless arm protection and administrative court Berlin stops "Noisemaker rabe").

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