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H Neus

Publications and source records attributed to H Neus.

At least 37 records · Page 2Linked to original sources

Hemodynamics during emotional stress in borderline and mild hypertension.

The hemodynamic response to emotional stress (mental arithmetic) was studied in ten borderline and ten mild hypertensives in comparison to ten age-matched normotensives. Due to emotional stress the blood pressure increased in all three groups; its rise was greater in borderline and mild hypertension. After stress, the blood pressure also remained elevated longer in the hypertensive groups. The increased blood pressure reaction was accompanied by a greater rise of heart rate and cardiac output. The increase of cardiac output correlated with the blood pressure elevation. Stroke volume changed in comparison to the pre-stress period only in the mild hypertension group. Total peripheral resistance decreased slightly in all three groups. No significant differences between the groups could be found in regard to stroke volume and total peripheral resistance. The cardiovascular hyperreactivity in early hypertension is attributed to a stronger sympathetic stimulation of the circulation. The hemodynamic pattern indicates an increased beta-adrenergic stimulation of the heart as the main pathological mechanism.

Adult↗

The influence of beta blockers on cardiovascular reactivity and Type A behavior pattern in hypertensives.

The influence of beta blockers on Type A behavior pattern and cardiovascular reactivity was tested. Nineteen white, male hypertensive patients were divided at random into two therapeutic groups (100 mg atenolol versus 50 mg hydrochlorothiazide + 5 mg amiloride (control group) ). For each patient, the German version of the structured interview was performed before therapy and at a minimum of 4 weeks after normalization of clinical resting casual blood pressure (BP). Prior to therapy, there were no differences in age, BP at rest, cardiovascular reactivity, and Type A between the two groups. After therapy, the patients treated with beta blockers changed Type A characteristics toward Type B, regardless where they started on the Type A scale, and beta blockers attenuated cardiovascular reactivity. In this study, Type A (hypertensive patients) was not associated with greater cardiovascular reactivity.

Amiloride↗

Cardiovascular reactivity to ergometric exercise in mild hypertension.

Cardiovascular reactivity to ergometric exercise was studied on work loads of 60, 80 and 100 W in 16 young and middle-aged males with mild hypertension and 17 normotensive subjects of the same age. The middle-aged hypertensive group showed a stronger rise in systolic blood pressure to a 100-watt work load than the matched normotensive group. Cardiovascular reactivity was not different with work loads of 60 and 80 W, and young hypertensives and normotensives had the same reactions. Thus cardiovascular reactivity to exercise is dependent on both blood pressure and age.

Adult↗

[The effect of beta receptor blockers and diuretics on blood pressure reactivity].

Previous studies showed the importance of the response of blood pressure to emotional stress in essential hypertension. However, it is unclear to what extent the response of blood pressure to emotional stress is influenced by antihypertensive treatment, and especially by beta-blockers. In the present study the influence of antihypertensive treatment with either beta-blockers (beta) or diuretics (D) was compared in two series of experiments on male hypertensives, carried out after 2 weeks (beta, n = 11; D, n = 11) and 1 year of treatment (beta, n = 11; D, n = 9). One of the two drugs was randomly allocated to each patient. In the first series of experiments an ergometric exercise test was also performed (workload depending on age and body surface area, 60-100 W). The two medications caused a similar decrease in basal blood pressure. The response of blood pressure to emotional stress was also the same in both groups, and equal to that in untreated hypertensives. However, the reaction of systolic blood pressure to dynamic exercise was lower in the patients treated with beta-blockers (30.2 +/- 9.5 mm Hg) than in those treated with diuretics (42.9 +/- 12.1 mm Hg; p = 0.013). The effect of antihypertensive treatment on the reactivity of blood pressure therefore cannot comprehensively be tested by means of a single stress test. In terms of controlling the response of blood pressure to stress, beta-blockers are not generally more effective than diuretics, but only in certain situations.

Adult↗

Effects of beta-blockers on type-A coronary-prone behaviour.

The influence of coronary-prone behaviour on coronary heart disease is well established, but the link between behavioural and pathophysiological processes is still unknown. A beta-adrenergic hyper-reactivity of type-A subjects is assumed. In this investigation the influence of beta-blockers on the type-A behavior pattern was tested in an inter-individual comparison. Sixteen male hypertensive subjects (stage I or II) were divided at random into two therapeutic groups (beta-blockers vs diuretics). Each patient was given a type-A interview before therapy and at a minimum of 4 weeks after the onset of therapy. Subjects in both groups were similar in age and before therapy they had similar blood pressure at rest as well as similar cardiovascular reactivity and type-A behaviour pattern. After therapy, subjects in the group treated with beta-blockers exhibited less type-A behaviour than those in the group treated with diuretics. The possible influence of the attenuation of the type-A behaviour on the risk of coronary heart disease should be investigated in a prospective study.

Amiloride↗

Coronary prone behavior and cardiovascular reactions during the German version of the type A interview and during a quiz.

Type A behavior (TABP) was assessed in 212 German policemen using the structured interview (Si), whereby 10% were classified as A1 (= extreme type A), 48% as A2 (= moderate), 13% as X (= indefinite), and 29% as B (= non type A) by two independent raters. Moreover, traditional risk factors were assessed: serum cholesterol (CHOL) including high density (HDL) and low density cholesterols (LDL), cigarette smoking habits; at rest, during the Si and during a quiz systolic (SBP), and diastolic blood pressure (DBP), as well as heart rate (HR) were measured, and pressure-rate-index (PRi) was calculated. As in this group of policemen TABP and many of the investigated parameters were dependent on age, in a preliminary data analysis 18 type A1 subjects (group A) were compared to 18 age matched type B or X subjects (group B). Between group A and B no differences were found in CHOL as well as HDL and LDL, cigarette smoking, SBP, DBP, HR, and PRi at rest. During the Si group A exhibited a higher rise in SBP, HR, and PRi as well as higher maximal reactions in SBP and PRi. No differences were found during the quiz. This investigation gives some further evidence that the TABP has to be regarded as an independent risk factor; moreover, in specific situations like the Si it is associated with higher cardiovascular reactions independent of language and culture. This cardiovascular hyperreactivity might be regarded as one of the mediators between TABP and CHD.

Adult↗

Cardiovascular reactivity during mental stress testing, the type A interview, and exercise testing in healthy male subjects.

We compared the blood pressure (BP) of 61 healthy male Ss during mental arithmetic plus noise, physical exercise testing and the Type A interview. A consistent association between personality characteristics and cardiovascular reactivity was not found. There was a consistent correlation between systolic BP reactivity during mental arithmetic and the Type A interview. Mental arithmetic and exercise testing correlated significantly for middle aged men. No correlation of BP was found between the Type A interview and exercise testing.

Adult↗

[Blood pressure reactivity to emotional stress in uncomplicated forms of hypertension (author's transl)].

Blood pressure behavior under basal conditions and emotional stress was examined in 48 patients with elevated casual blood pressure values who had no hypertensive cardiovascular complications and in 48 normotensives of the same age. In order to study possible interactions with age and sex each group was divided in two age and two sex subgroups respectively. Under basal conditions the blood pressure values of the hypertensive group were within the normal range but markedly higher than the values of the normotensive group. During stress the difference between both groups increased because the hypertensive group exhibited a stronger reactivity of blood pressure. There was an interaction between sex and hypertension in that in contrast to the hypertensive group normotensive women had lower blood pressure values at rest and under emotional stress than men. There was an influence of age consisting in a stronger blood pressure reactivity of the older subjects; this effect could be found in the hypertensive as well as in the normotensive group. Patients with uncomplicated forms of hypertension exhibit a blood pressure hyperreactivity on emotional stress independently of age and sex. According to previous investigations normotensive subjects with a family history of hypertension show stronger blood pressure reactivity, too. Therefore this phenomenon must be regarded as important in the pathogenesis of essential hypertension.

Adult↗

[Problems of adaptation in hypertension research (author's transl)].

Emotional stress testing was performed twice in 12 normotensive and 12 hypertensive patients. When compared with normotensive persons, hypertensive patients had a clearly greater adaptation of blood pressure response in second stress test. This effect was so pronounced that differences between normotensive and hypertensive persons observed in the first test disappeared. Because of this pronounced adaptation effect, demonstrated until now only for emotional stress, intraindividual comparison does not seem a method of choice in the evaluation of antihypertensive effects by stress situations. Specific influence of antihypertensive drugs on emotional blood pressure reactions can only be demonstrated in the inter-individual comparison with another antihypertensive drug. First comparison between both groups should only be done after establishing a therapeutic effect on resting blood pressure.

Adaptation, Physiological↗

[Traffic noise and hypertension risk. Hypothalamus theory of essential hypertension. Second communication (author's transl)].

In connection with the Bonn Study on Traffic Noise, 56 males with healthy cardiovascular systems were selected at random from two areas with different traffic noise conditions. The blood pressure was measured under the influence of a 5 minute standardized stressor and a 30 minute exposure to traffic noise. The 17 subjects with hereditary tendency to hypertension reacted significantly under the influence of both stressors with more marked rises in systolic and diastolic blood pressures than the 35 subjects who denied a hereditary tendency. On the other hand, the different residential areas did not affect the blood pressures obtained experimentally. The results support the hypothalamus theory of essential hypertension through the decisive etiological factors. At the same time they form the basis of a working hypothesis for a prospective study. According to this it is expected that males with a hereditary tendency to hypertension who have been exposed to traffic noise for several years will be more likely to develop hypertension.

Adult↗

Relationship between blood pressure reactions on an ergometric and an emotional stress test.

The relationship between blood pressure reactions on an ergometric and an emotional stress test was studied in a population of 62 normotensive subjects. Significant correlations for systolic (r = 0.34, p = 0.004) and diastolic ( r = 0.03, p = 0.01) blood pressure were found. It is concluded that 1) there is a individual-specific blood pressure reactivity, 2) Hypertension is closely related to the individual-specific systolic blood pressure reactivity for it is known that hypertensives exhibit stronger systolic blood pressure reactions on both stressors.

Adult↗

[Traffic noise and the risk of hypertension. 1].

Traffice Noise and Hypertension. First communication: the question whether traffic noise could be a risk factor of essential hypertension was studied by means of interviews. In Bonn 931 inhabitants between 20 and 59 years of age, who lived either in streets with high (minimum: 9062 cars/day) or low (maximum: 1182 cars/day) traffic volumes were interviewed. While no differences were found in the frequencies of treatment of diabetes mellitus, gout, asthma and peptic ulcer, there was a difference in response to treatment of hypertension (p = 0.002); in the noisy area 22.8% and in the quiet area 14.6% of respondents stated that they were treated. Also in both male and females aged 29-39 years, there was a connection between hypertensive treatment and the duration of stay in the noisy area (p less than 0.05).

Adult↗

[On the reaction of finger pulse amplitude to noise (author's transl)].

1. Forty-three (30 male and 13 female) subjects were exposed to traffic noise of ca. 72dB. Their reactions concerning blood pressure, pulse pressure, finger pulse amplitude and radialis pulse amplitude, heart rate, breathing rate, and integrated EMG were analyzed. 2. Each of the circulatory parameters exhibited significant reactions in either direction in more than 40% of the subjects. The vasoconstrictive reaction in finger pulse amplitude was most outstanding. Moreover, pulse pressure, radioalis pulse amplitude and, heart rate also tended to decrease whereas diastolic blood pressure tended to increase. Breathing rate and EMG remained mainly unchanged. 3. Owing to the different direction of reactions the mean values of a sample can yield possible misleading information. Furthermore, it is suggested that the reaction of finger pulse amplitude should be related to the standard deviation of the prestimulus resting period instead of to the mean value of this period. 4. Male subjects react with a stronger decrease of heart rate than female subjects. Male subjects with higher diastolic casual blood pressure and heart rate values exhibit stronger decreases in finger pulse amplitude and heart rate. Older male subjects tend to react with an increase of heart rate. 5. Within the male subjects, the reaction of finger pulse amplitude correlated positively with the reactions of pulse pressure and heart rate, but not with the reaction of radialis pulse amplitude. The attempt to distinguish between vasoactive and pressure-dependent components in finger pulse amplitude means of radialis pulse amplitude failed, which is probably a consequence of artifacts in radialis pulse amplitude.

Adult↗