Hipertensão e Estresse
Autor: Bioquímica da Hipertensão | Publicado: 2011-07-03T07:50:00-07:00

O estresse mental ou psicológico ocorre cotidianamente em nossas vidas e a capacidade de reagir motora e fisiologicamente é uma resposta natural e necessária. Entretanto, a reatividade exacerbada ao estresse mental identifica indivíduos sob maior risco de desenvolver hipertensão e pode provocar eventos cardiovasculares e morte súbita.
Além disso, a experiência de situações trágicas tem impacto a longo prazo, aumentando o risco de hipertensão, bem como condições sociais e de trabalho com grande demanda psicológica e baixo poder de decisão, principalmente entre homens com baixo nível socioeconômico. A identificação de indivíduos sob maior risco de hipertensão mediante os testes de reatividade cardiovascular ao estresse mental pode colaborar para a implementação de medidas preventivas e terapêuticas.

Respostas complexas que envolvem mudança comportamental e ajustes autonômicos, hemodinâmicos e endócrinos preparam o organismo para enfrentar a ameaça ou o desafio. Portanto, o estresse é um elemento natural da vida e nossa capacidade de reagir do ponto de vista motor e autonômico caracteriza um importante mecanismo homeostático e de sobrevivência. Então, não existe problema no estresse em si, mas na forma com que lidamos com ele.

Considerando que a magnitude dos efeitos fisiológicos ao estresse depende da interação entre o estímulo e o indivíduo, situações semelhantes podem produzir respostas bastante diversas em pessoas diferentes e no mesmo indivíduo em condições diferentes. Portanto, não basta a percepção subjetiva sobre o estresse para conhecer a reatividade do organismo, é necessário medi-la. Os chamados “testes de estresse mental” têm por objetivo simular situações de estresse mental ou psicológico de forma padronizada e em ambiente controlado sob monitorização hemodinâmica e eletrocardiográfica. A principal utilidade clínica desses testes está ligada ao fato de que respostas exacerbadas de pressão arterial indicam risco aumentado de desenvolvimento de hipertensão arterial.
O estresse mental é um conhecido fator capaz de desencadear eventos cardiovasculares como infarto agudo do miocárdio, arritmias malignas e morte súbita. A maior ativação do sistema nervoso simpático decorrente do estresse mental leva a aumento dos valores de pressão arterial, redução da perfusão miocárdica, aumento do consumo miocárdico de oxigênio e da instabilidade elétrica cardíaca, precipitando arritmias cardíacas e infarto agudo do miocárdio em indivíduos suscetíveis.
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 <![endif]-->  NOBREGA, Antonio C.L.CASTRO, Renata R. T. SOUZA, Alexandro C. Estresse mental e hipertensão arterial sistêmica. Rev Bras Hipertens vol.14(2): 94-97, 2007