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Biomedical subjects

M Rostrup

Publications and source records attributed to M Rostrup.

51 records · Page 3Linked to original sources

Awareness of high blood pressure influences on psychological and sympathetic responses.

The aim of the present study was to examine the effects of awareness of hypertension on psychological factors and whether there was an association between psychological and sympathetic responses. To avoid self-selection bias 32 19-yr old white men, all with mean blood pressure of 116 mm Hg were randomized into two groups. One group was informed that the blood pressure was elevated and asked to come to a second examination while the other was invited to take part in a coronary heart disease prevention program. A cold pressor test was undertaken and the subjects completed the Karolinska Scale of Personality (KSP). Assessed by the KSP, the informed group showed lower verbal aggression (p less than 0.01), irritability (p less than 0.05), monotony avoidance (p less than 0.05) and impulsiveness (p less than 0.05), higher detachment (p less than 0.05) but no significant differences in the other subscales like anxiety, psychasthenia or factors of hostility. Information significantly increased resting blood pressure and increments in heart rate and plasma adrenaline responses to cold pressor test. Thus, both psychological and sympathetic responses were influenced by awareness of high blood pressure. There were significant correlations between less assertive behaviour and increased plasma catecholamines.

Adaptation, Psychological↗

The sympathetic nervous system may modulate the metabolic cardiovascular syndrome in essential hypertension.

The association between blood pressure and coronary artery disease may be caused by a concurrence of atherogenic biochemical abnormalities in hypertensive patients, i.e., the metabolic cardiovascular syndrome (increased total cholesterol, triglycerides, and insulin; decreased high-density lipoprotein (HDL) cholesterol; and insulin resistance, glucose intolerance, and blood platelet dysfunction). There are numerous reports of sympathetic nervous system overactivity in hypertensive subjects that could be of importance for the pathophysiology of the high blood pressure. Plasma catecholamines have metabolic hormonal effects at concentrations slightly above low normal resting levels. Even transiently and certainly chronically raised plasma catecholamine levels may cause biochemical abnormalities. Catecholamines may raise total cholesterol, triglycerides, and insulin, decrease HDL cholesterol, and cause insulin resistance and glucose intolerance, and recent evidence supports an in vivo influence of epinephrine on blood platelets, causing dysfunction in hypertensive subjects. Thus, the sympathetic nervous system may modulate the metabolic cardiovascular syndrome in essential hypertension. Hypertensive subjects may respond to environmental stimuli with larger sympathoadrenal responses than normal subjects. Furthermore, emotional stress has been associated with coronary artery disease. Thus, the metabolic hormonal effects of catecholamines, by causing the metabolic cardiovascular syndrome, may be the crucial link between "stress" and cardiovascular disease.

Blood Platelets↗

[Medical experiences from the Norwegian Nanga Parbat Expedition 1990].

The author reports five cases of severe acute mountain sickness on a climbing expedition to Nanga Parbat (8,125 m) in Himalaya, Pakistan. One porter developed high altitude pulmonary edema, Grade IV, at an altitude of 4,200 m, and was successfully treated with oxygen, nifedipine and descent. One of the climbers developed a moderate pulmonary edema, and two moderate cerebral edema. All of these incidents occurred above 7,000 m, and responded to descent. A case of moderate high altitude sickness is also reported. Certain pathophysiological and symptomatic features of high altitude sickness are discussed.

Adult↗

The epinephrine-blood platelet connection with special reference to essential hypertension.

About three decades ago it was shown by an aggregometer that epinephrine activated blood platelets, and it was proposed that platelets could be the link between stress and cardiovascular disease. During the past 10 years this hypothesis has been tested in clinical studies. It has been found that subjects with hypertension consistently have raised plasma catecholamine levels and in particular elevated epinephrine levels. Arterial but not venous epinephrine concentrations correlated with plasma concentrations of the platelet-release reaction marker beta-thromboglobulin (BTG). Plasma BTG is elevated in hypertensive patients, and psychological stress (i.e., hypertension labeling) stimulates plasma epinephrine and BTG. When a physiologic dose of epinephrine is infused into essential hypertensive patients, platelet counts, platelet size, and plasma BTG concentrations increase more than in normotensive subjects. Data suggest that there is a connection between psychological stress, plasma epinephrine levels, and platelet function, especially in patients with essential hypertension.

Adult↗

Awareness of high blood pressure increases arterial plasma catecholamines, platelet noradrenaline and adrenergic responses to mental stress.

Thirty-six, 19-year-old men within the 95th percentile of mean blood pressure (110 mmHg) at a routine medical screening were randomized into two groups and requested to return for a follow-up visit in 2 weeks. One group was sent a neutral letter, while the other was sent a letter conveying the information that their blood pressures were elevated. After 15 min sitting in the laboratory, there was a significantly higher heart rate (P less than 0.05) in the informed group. Thirteen informed and 13 uninformed subjects were examined further by intra-arterial blood pressure recording and serial sampling of arterial catecholamines during cold pressor and mental stress tests. The study was undertaken examiner-blind. Informing the subjects of high blood pressure increased both baseline plasma noradrenaline (P less than 0.01) and adrenaline (P less than 0.05) and intraplatelet noradrenaline (P less than 0.05). Blood pressure (P less than 0.05) and heart rate (P less than 0.05) increased significantly more in the informed group when the subjects were told of the cold pressor test. In addition, there were exaggerated adrenaline (P less than 0.05) and diastolic blood pressure (P less than 0.05) responses to mental stress in the informed group. Thus, awareness of high blood pressure in young men may increase sympathetic tone and responses as measured in the laboratory. Conclusions from studies on early pathogenesis of essential hypertension should therefore be drawn with more caution when patients are aware of their high blood pressure.

Adult↗

Awareness of high blood pressure stimulates platelet release reaction.

The present study aimed at testing the hypothesis of a link between mental stress and blood platelet function. Twenty-nine 19-year-old men were recruited from the 98th percentile of mean blood pressure (116 mmHg) at a routine medical screening. They were not informed about their elevated blood pressures at the time of the screening. One year later they were randomized into two groups. Group 1 (n = 16) was exposed to mental stress by a letter informing them about their high blood pressure, while group 2 (n = 13) was sent a neutral letter. At an examination 2 weeks later, heart rate (p less than 0.05) and plasma adrenaline (p less than 0.05) responses to a cold pressor test were exaggerated in the informed group. The plasma beta-thromboglobulin (beta TG) concentration was elevated in the informed group (p less than 0.05) as was mean blood pressure (p less than 0.05). beta TG correlated positively with hematocrit (r = 0.59, p less than 0.005) and mean blood pressure (r = 0.43, p less than 0.05), and negatively with plasma HDL (r = -0.61, p = 0.001). The study shows that awareness of hypertension induces a hyperadrenergic state which is associated with the platelet release reaction. Under these circumstances platelet release seems to be correlated to established coronary heart disease risk factors.

Adult↗

Awareness of hypertension increases blood pressure and sympathetic responses to cold pressor test.

The present study was aimed at examining the effects of awareness of hypertension on blood pressure and sympathetic responses to the cold pressor test. Nineteen-year-old men with similarly elevated mean blood pressure at a medical screening, but without knowledge of this, were randomized into two groups. The first group (n = 16) was sent a letter saying that their pressure was too high, and the second (n = 13) was sent a neutral letter. Information increased mean blood pressure both after 15 min sitting, by an average of 11.5 mm Hg (P less than .01), and after 30 min supine rest, by an average of 4.5 mm Hg (P less than .05). Changes in heart rate (8.4 +/- 2.4 v 1.9 +/- 1.7 beats/min) and plasma epinephrine (0.11 +/- 0.04 v 0.01 +/- 0.03 nmol/L) during execution of a cold pressor test were significantly greater in the informed group (P less than .05). Plasma dopamine was lower in the informed group (P less than .05). Thus, psychological stress caused by the awareness of hypertension may increase blood pressure and sympathetic responses to a provocative maneuver. Ideally, studies on sympathetic function in essential hypertension should be undertaken on subjects unaware of their blood pressure status.

Adult↗

[A snow avalanche in Vassdalen. Medical experiences].

Of 31 soldiers caught by an avalanche in Northern Norway, one was not buried, 13 were partly buried and 17 were completely buried by the mass of snow. Only one of the completely buried soldiers survived. On admission to hospital after being buried by snow for three hours he had moderate hypothermia. The cause of death in the other 16 was most probably general compression of the body with acute respiratory and circulatory failure. Five of the 13 partly buried had physical traumas. None of the nine attempts at resuscitation succeeded. Self-rescue and rescue by friends were most important to the soldiers who survived. We discuss aspects of the organized rescue operation.

Accidents↗

[Self-poisoning in Northwest Norway in 1975-1984].

During the ten-year period 1975-84, 251 patients were hospitalized because of self poisoning in Nordmøre, the northern part of Møre and Romsdal county. During the five last years, there was a large increase in hospital admittances because of self poisoning, especially of persons below the age of thirty. Men dominated in the age group 20-30 years, and women in the age group 15-20 years. There was a significant correlation between the number of unemployed and the number of self poisonings through out the ten-year period.

Adolescent↗

[Self-poisoning in Northwest Norway in 1984. A follow-up after 6 months. A prospective study].

During the one-year period of study, 37 patients were admitted to the medical department, Kristiansund hospital, because of self poisoning. Mixed intoxications dominated, especially combinations of benzodiazepines and alcohol. One patient died. Interpersonal conflicts were stated as the main reason for the self poisoning. Five patients were considered suicidal. 27 patients were followed up six months later. A majority considered both their social and mental situation to be better than at the time of the self poisoning episode, and had reduced consumption of alcohol and drugs.

Adolescent↗

Mechanism of death in avalanche victims.

The autopsies of 12 victims from two snow avalanches in North-Norway are reported. Supportive evidence from non-autopsied and surviving victims is included. Consistent autopsy findings were prominent lung oedema, moderate cerebral oedema, extreme contraction of the left ventricle, petechiae in the superior vena cava drainage area, and acute congestion in lungs and kidneys. In four cases in whom no resuscitation was attempted, aortic oxygen pressure was in the range expected in pure asphyxial-type deaths in one and in pure cardiac-type deaths in three. No air pocket was seen in front of the mouth and nose in any of the fatal cases. Three fatal cases had fractures. It is concluded that the immediate cause of death in most cases was general body compression with acute respiratory and circulatory failure.

Adolescent↗