ИСТИНА

Hypertension (HTN) is one of the most common diseases of the cardiovascular system, and it continues to be one of the basic problems of modern medicine and clinical psychology. Today researchers discover more and more patients with ”hypertension at work.” "HTN at work" is considered to be a form of "stress-induced hypertension." Many recent studies have shown that one of the causes of blood pressure (BP) regulation disorders is prolonged and excessive emotional stress. However, the psychological factors and mechanisms of emotional intensity in patients with HTN at work are almost unexplored.  Purpose of Study: In order to investigate the specifics of emotional regulation in patients with HTN, we examined 85 subjects with HTN at work, 85 patients with essential HTN, and 82 healthy individuals. Research Methods: Experimental stress simulation was performed to study aspiration level (AL). Subjective-evaluative, physiological, and behavioral characteristics were traced. Emotional experiences were processed using our modified version of Rosenzweig’s method for studying reactions to frustration. Findings: In a situation of experimental stress modeling, patients with HTN demonstrated a specific complex of physiological and behavioral responses and also features of aspiration and emotional-reaction levels that reliably differentiated them from healthy individuals. They are characterized by insufficient or excessive control over their motivations and emotions (redundant emotional repression / weakness of emotional control). Of patients with HTN at work 63% showed a significant increase in systolic BP; reduction during the experiment of the level of catecholamines, renin, and angiotensin I; reduction of reactive anxiety, inadequacy, and instability of AL; and seemingly calmer behavior, with fewer gestures and poses, but with rich facial expressions. In general, patients with HTN at work showed mostly an excess of emotional repression.      Conclusions: Both forms of response, particularly repression, are ineffective in overcoming emotional stress. They create conditions for high blood pressure and, thus, can be important links in the pathogenesis of HTN. These results contribute to an understanding of the etiology and pathogenesis of HTN, enabling the identification of strategies for psychological assistance to both patients and healthy persons who are in stressful situations.