Elevated blood pressure and self-reported symptom complaints, daily hassles, and defensiveness

The impact of emotion-related autonomic nervous system responsiveness on pain sensitivity in female patients with fibromyalgia

OBJECTIVE

Patients with fibromyalgia have shown hyporeactive autonomic nervous system (ANS) responses to physical stressors, augmented pain to ANS changes, and heightened negative emotions, which can increase pain. This study examined ANS reactivity to negative emotions and its association with pain in fibromyalgia and control participants.

METHODS

Sixty-two women with fibromyalgia and 59 women in a control group recalled neutral, and anger- and sadness-eliciting experiences while ANS activity was monitored. Clinical and experimental pain were assessed in response to each emotion.

RESULTS

Compared with neutral recall, heart rate (p = .050), mean arterial pressure (p < .001), and high-frequency heart rate variability (p = .012) increased in response to sadness, whereas heart rate decreased (p = .002) and mean arterial pressure increased (p < .001) in response to anger; however, ANS responses did not differ between patients and control participants (all p > .29). Among patients only, decreased preejection period (anger-pain threshold: r = 0.31, p = .018) and total peripheral resistance in response to negative emotions (anger-pain tolerance: r = 0.35, p = .025; sadness-pain threshold: r = 0.51, p < .001; sadness-pain tolerance: r = 0.61, p < .001) correlated with more pain.

CONCLUSIONS

These data suggest that the ANS is not hyporesponsive to elicited emotions in fibromyalgia; however, patients with a larger pain response showed an ANS response pattern reflecting heightened β-adrenergic and reduced α-adrenergic reactivity. Future research should test whether a specific ANS response pattern to emotions is a consequence of increased pain or whether it amplifies pain.

From Brain to Behavior: Hypertension's Modulation of Cognition and Affect

Accumulating evidence from animal models and human studies of essential hypertension suggest that brain regulation of the vasculature is impacted by the disease. Human neuroimaging findings suggest that the brain may be an early target of the disease. This observation reinforces earlier research suggesting that psychological factors may be one of the many contributory factors to the initiation of the disease. Alternatively or in addition, initial blood pressure increases may impact cognitive and/or affective function. Evidence for an impact of blood pressure on the perception and experience of affect is reviewed vis-a-vis brain imaging findings suggesting that such involvement in hypertensive individuals is likely.

Elevated resting blood pressure and dampened emotional response

OBJECTIVE

Increased blood pressure is associated with decreased reports of aversiveness for both physical pain and psychosocial stressors. Based on these findings, higher blood pressure could be associated with altered emotional responses to a broader range of stimuli. There are at least 3 ways this could happen: a) less dire response to negative stimuli with no change in response to positive stimuli; b) more positive responses to both negative and positive stimuli; or c) dampened emotional responses to both positive and negative stimuli.

METHODS

Sixty-five normotensive volunteers had their resting blood pressure measured, then rated their emotional responses to a series of positive and negative photographs.

RESULTS

Resting systolic blood pressure was significantly and negatively correlated with subjective emotional ratings of both positive (r = -.26) and negative (r = -.35) photographs.

CONCLUSION

Results were consistent with emotion dampening for elevated resting blood pressure and may reflect homeostatic integration of neurocirculatory control and affect regulation.

Hypertension and appraisal of physical and psychological stressors

OBJECTIVE

In the operant conditioning of hypertension hypothesis, it is assumed that the frequently found diminished sensitivity to painful stimuli in hypertensives can be generalized to sensitivity to other stressors, including psychological stressors. The validity of this assumption is examined in the present study.

METHODS

Unmedicated hypertensives (42) and normotensive controls (21) of both sexes were exposed to a physical stressor (electric current) and psychological active coping (mental arithmetic, free speech) and passive coping (unpleasant films) tasks, while indices of prestressor anxiety and task appraisal were measured.

RESULTS

Hypertensive women, but not men, showed diminished pain sensitivity, together with lower prestressor anxiety and a tendency to lower negative appraisal of the tasks, compared to their normotensive counterparts. In addition, positive correlations were obtained between pain sensitivity and negative appraisal of psychological stressors involving interpersonal threat (speech) and passive coping (films).

CONCLUSION

Preliminary support has been obtained for extrapolation of diminished pain appraisal to appraisal of some psychological stressors (although for a part only in women); an important assumption in the operant conditioning hypothesis of hypertension.