HEMODYNAMIC AND ENDOCRINE RESPONSIVENESS TO MENTAL ARITHMETIC TASK AND MIRROR DRAWING TEST IN PATIENTS WITH ESSENTIAL-HYPERTENSION

To evaluate the reactivity to psychological stress in patients with es sential hypertension we investigated hemodynamic and endocrinologic ch anges during a mental arithmetic task (MAT) and a mirror drawing test (MDT) in 10 hypertensive subjects. Hemodynamic changes were assessed c ontinuously using an ambulatory radionuclide cardiac detector. There w ere significant increases in systolic blood pressure (Delta SBP: +37.8 +/- 11.1 and +41.0 +/- 9.4 mm Hg during MAT and MDT, respectively, P < .01) and diastolic blood pressure (Delta DBP: +17.5 +/- 3.1 and +21. 2 +/- 3.9 mm Hg, P < .01) and in heart rate (Delta HR: +17.1 +/- 5.3 a nd +12.5 +/- 2.9 beats/min, P < .01) during both tasks in association with an increase in cardiac output (GO). The plasma levels of norepine phrine and epinephrine increased during both the MAT (Delta NE: +0.074 +/- 0.022 ng/mL, P < .01; Delta EP: +0.068 +/- 0.025 ng/mL, P < .01) and the MDT (Delta NE: +0.067 +/- 0.034 ng/mL, P < .01; Delta EP: +0.0 30 +/- 0.011 ng/mL, .05 < P < .1). Although the Delta NE was similar i n response to the MAT and MDT, the Delta EP during the MDT tended to b e less than half the Delta EP during the MAT (.05 < P < .10). The Delt a EP was positively correlated with the Delta DBP and the Delta CO dur ing both tasks and with the Delta SBP and the Delta HR during the MAT. These findings suggest that MAT- and MDT-induced increases in BP were attributable mainly to an increase in CO, possibly as the result of s timulation of the sympathoadrenomedullary system. However, the sympath oadrenomedullary system appeared to be more closely associated with th e hemodynamic responses during the MAT than during the MDT. (C) 1997 A merican Journal of Hypertension, Ltd.