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Hypertension and Stress - A Unified Concept (Paperback)
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Hypertension and Stress - A Unified Concept (Paperback)
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Understanding and treating hypertension has progressed
significantly during the past 40 to 50 years. This progress has
made a major contribution to health care concerns such as quality
of life, prevention of disability, and mortality. In the past,
hypertension and hypertensive disease had been a "silent scourge,"
but it is presently an industry. Research on hypertension has
expanded into a variety of fields including epidemiology,
endocrinology, surgery, pharmacology, and behavioral medicine.
Therapeutic accomplishments have made hypertension a leading source
of income for the pharmaceutical industry; the field of clinical
pharmacology originated with the development of drugs to treat
hypertension. Increasingly, specific drugs to treat specific
mechanisms which raise blood pressure have moved from the
laboratory to the bedside. A constant awareness has been present
that emotional stress, both from within the individual as well as
from environmental sources, plays a role in the "three Ps" --
predisposition,precipitation, and perpetuation -- of hypertension.
Arguments range from stating that such stress may be the major
cause of at least some forms of hypertension, to allowing that
although some effect is present from stress, it is only a minor
perturbation of no significance in the overall pattern of the
disease. Advocates of stress theory may be biased by a lack of
detailed knowledge or experience with the physiology and
biochemistry involved in the establishment of this disorder. On the
other hand, those who deny the importance of stress factors may be
unaware of the large body of data that indicate the role of these
factors in any comprehensive understanding of hypertension.
Following the Mosaic Theory, this book's approach to hypertension
shows that multiple factors can be invoked in understanding the
etiology and management of hypertension, where the strength of
individual factors vary depending on genetic background, acquired
diseases, and environmental influences. Stress can be involved in
predisposition by affecting a genetically programmed person, in
precipitation by supplying the stimulus to bring the disease to a
clinical level, and in perpetuation by maintaining or exacerbating
the clinical disease. This volume attempts to integrate what is
known about the effects of stress on blood pressure with the
overall mosaic of hypertension making use of the aforementioned
"three Ps" as part of the framework for this integration.
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