Hypertension – Insight into the silent killer!
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A journey through mind- body interface.
The consequences of psychological stress affect the whole body but the stigma associated with psychological disturbance makes it easier for people to accept the physical disorder as an entity on its own. Human mind is incorporated in human body and its functioning is as chemically mediated as that of any other part of the body. Owing to lack of understanding of brain physiology modulating human emotions and behavior, society developed models of strengthening mind by self control and distraction resulting in a perception that all emotional disturbances can be controlled by self control itself. Novel understanding of physiology and genetics of emotional responses has thrown light on the interaction between mind and body. Any illness, weather physical or psychological happens due to an interaction between biological, psychological and environmental factors. A holistic approach to management and cure of illnesses thus requires an understanding and intervention at all these levels.
This is an attempt to explore and understand the impact of day to day stress on our physical and mental wellbeing- A journey through mind- body interface!
Physical Consequences of Stress- Why am I told that my BP is psychological?
In India, many times people use statements like ‘my BP increased’ while talking of situations when they felt anger/anxiety or stress, and with obvious reason because stress or anxiety is commonly associated with increase in blood pressure. But the problem arises when instead of evaluating and treating the psychological aspect of increase in Blood Pressure, the focus falls on lowering the blood pressure alone.
Persistent high arterial blood pressure above 120/80 mm HG is termed as pre-hypertension or hypertension, but the point to be emphasized is that this rise in blood pressure is persistent. Hypertension affects almost one billion people world- wide and is a leading cause of morbidity and mortality. The patho-physiology of increase in blood pressure is associated with either an increase in cardiac output or an increase in peripheral resistance. The cause of this increase, in patients with hypertension is not clear in 80-95% of sufferers so it is termed as essential or primary hypertension. But it is well known that the chemical released during high states of stress and anxiety constrict blood vessels and increase heart rate thereby transiently causing a rise in pressure of blood in blood vessels. Research has not directly associated essential or secondary hypertension to stress, but reduction in psychological stress has shown to result in better control even in those who are diagnosed with primary hypertension.
One of the common examples of stress induced increase in blood pressure is white coat hypertension, a condition in which an individual records high blood pressure only in front of a doctor or in a clinical setting. Stress response involves a cascade of neuro physiological responses that lead to ‘flight or flight response. Research like cardia study has shown that frequent activation of this type of response may damage the circulatory system making it vulnerable to develop vascular and cardiac complications and hypertensive disorder.
Dr. Jyoti Kapoor, DPM, DNB