Comparative assessment of the impact of physical and psychoemotional load on the cardiovascular system
Rechitsa Central District Hospital, Rechitsa, Republic of Belarus
Vestnik VGMU. 2019;18(2):81-87.
Objectives. To study the effects of physical and psychoemotional load on the functional indices (FI) of the cardiovascular system (CVS) in patients with circulatory system diseases (CSD): essential arterial hypertension, coronary heart disease (CHD), chronic heart failure (CHF) and apparently healthy subjects.
Material and methods. Altogether 53 subjects were examined. At the first stage, a series of psychoemotional tests were conducted in patients with the stimulation of such emotional excitement modalities as: anger, fear, sorrow and joy. The subjects then were divided into two groups. The main group (MG) included 12 patients with the positive test result in the form of hypertensive systolic blood pressure reaction of more than 20 mmHg in response to psychoemotional excitement, and the control group (CG) was composed of 41 persons with the negative test result. For both groups, a comparative assessment of socio-environmental, anthropometric data, the frequency of CSD diagnoses occurrence and the results of the treadmill test was conducted.
Results. The groups differed from each other according to the hypertension risk severity and the frequency of the CHF diagnosis. In the MG, patients with 3-4 risks of hypertension were more common, and CHF occurred with the frequency of 91.7%. In the CG, the diagnosis of CHF was made with the frequency of 56.1%. Hypertensive reactions were characterized by the power of psychoemotional excitement – 7 arbitrary units and an increase in the main hemodynamic parameters, as well as a shift of the Kerdo index to the parasympathetic zone. In the MG, the indices of the maximum value of the metabolic load equivalent were reduced (the result during the test was lower by 69% compared with that in the CG, the limit value was lower by 25%). In the MG, high exercise tolerance was found in 8.3% of the subjects, while in the CG – in 51.2%.
Conclusions.The mechanisms of sympathetic hyperactivation form the basis of the hypertensive reaction during psychoemotional excitement. In individuals with the reduced functional reserves of the cardiovascular system, psychoemotional excitement can provoke a hypertensive reaction due to its regulation mechanisms dysfunction.
Key words: circulatory system diseases, treadmill test, psychoemotional test, risk of arterial hypertension, chronic heart failure, metabolic load equivalent, exercise tolerance.
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Information about authors:
Lapanau P.S. – psychiatrist-narcologist, Rechitsa Central District Hospital,
ORCID: https://orcid.org/ 0000-0002-3993-4690.