title: Low social support and poor emotional regulation are associated with increased stress hormone reactivity to mental stress in systemic hypertension.
abstract: BACKGROUND
  There is strong evidence for a physiological hyperreactivity to stress in systemic hypertension, but data on associated or potentially moderating psychological factors are scarce.
  
  
  OBJECTIVE
  The objective of the study was to identify psychological correlates of physiological stress reactivity in systemic hypertension.
  
  
  METHODS
  This was a cross-sectional, quasi-experimentally controlled study. Study participants underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience.
  
  
  METHODS
  The study was conducted in the population in the state of Zurich, Switzerland.
  
  
  METHODS
  Subjects included 22 hypertensive and 26 normotensive men (mean +/- sem 44 +/- 2 yr).
  
  
  METHODS
  We assessed the psychological measures social support, emotional regulation, and cognitive appraisal of the stressful situation. Moreover, we measured salivary cortisol and plasma epinephrine and norepinephrine before and after stress and several times up to 60 min thereafter as well as blood pressure and heart rate.
  
  
  RESULTS
  We found poorer hedonistic emotional regulation (HER) and lower perceived social support in hypertensives, compared with normotensives (P < 0.01). Compared with normotensives, hypertensives showed higher cortisol, epinephrine, and norepinephrine secretions after stress (P < 0.038) as well as higher systolic and diastolic blood pressure (P < 0.001). Cortisol reactivity and norepinephrine secretion were highest in hypertensive men with low HER (P < 0.05). In contrast, hypertensives with high HER did not significantly differ from normotensives in both cortisol and norepinephrine secretion after stress. Epinephrine secretion was highest in hypertensives with low social support but was not different between hypertensives with high social support and normotensives.
  
  
  CONCLUSIONS
  The findings suggest that both low social support and low HER are associated with elevated stress hormone reactivity in systemic hypertension.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Zurich, Zurichbergstrasse 43, CH-8044 Zurich, Switzerland. p.wirtz@psychologie.unizh.ch
authors.forename: Petra H
authors.initials: PH
authors.lastname: Wirtz
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Changiz
authors.initials: C
authors.lastname: Mohiyeddini
authors.forename: Luljeta
authors.initials: L
authors.lastname: Emini
authors.forename: Katharina
authors.initials: K
authors.lastname: Ruedisueli
authors.forename: Sara
authors.initials: S
authors.lastname: Groessbauer
authors.forename: Ulrike
authors.initials: U
authors.lastname: Ehlert
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004644:Emotions; D004837:Epinephrine / Q000097:blood*; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D006973:Hypertension / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood*; D012044:Regression Analysis; D012463:Saliva / Q000737:chemistry*; D012944:Social Support; D013315:Stress, Psychological / Q000378:metabolism*
chemical_list: D006854:Hydrocortisone; D009638:Norepinephrine; D004837:Epinephrine