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Theoretical model through which sodium retention during stress contributes to the development and maintenance of essential hypertension. 

Theoretical model through which sodium retention during stress contributes to the development and maintenance of essential hypertension. 

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Hypertension--an important health problem in industrialized nations--is particularly significant in blacks and obese individuals, in whom it is hypothesized to result from impaired renal sodium regulation. We reviewed studies that identified individuals with impaired sodium regulation by examining the natriuretic response to mental stress. A signif...

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... theoretical model to explain the renin-angiotensin- aldosterone system's contribution to stress-induced sodium retention and HTN development is presented in Figure 1. We hypothesized that genetic predisposition and adiposity mediate the angiotensin II response to intermit- tent periods of prolonged stress encountered throughout a normal day. This leads to angiotensin-aldosterone-medi- ated sodium retention, resulting in increased extracellular fl uid volume and BP. The volume-induced increase in BP remains elevated until sodium balance is restored. We fur- ther hypothesized that the increased BP load causes early cardiovascular and renal damage, leading to the develop- ment of oxidative stress and ...

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... In fact, an increased plasma electrolyte concentration has been reported in humans affected by kidney dysfunctions, and also in cattle [73,74]. Despite that, increased plasma concentration of electrolytes (hypernatremia) in postpartum cows has also been related to the stressful conditions driven by adrenocorticotropin hormone release and inflammatory conditions occurring around calving [75]. ...
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... There is a mount of evidence linking chronic stress with essential hypertension. Clinical and epidemiological studies indicate that chronic psychological stress can lead to essential hypertension [48,49]. Many workers in their studies have found that individuals exposed to chronic stress show persistent hypertension [40,50,51]. ...
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Stress and stress-related disorders are emerging as a major health challenge. In the classical stress concept, stress can be broadly defined as an actual or anticipated disruption of homeostasis by certain physical and psychological events that are known as 'stressors'. Prolonged exposure to stress can lead to a destructive, self-perpetuating cascade of neuroendocrine, metabolic and neuropsychological alterations that play an important role in the development and progression of cardio-vascular disease (CVD) like hypertension. Dysregulation of stress system is causally linked to pathogenesis of essential hypertension, which involves over activity of hypothalamic-pituitary-adrenal axis (HPA) and sympathoadrenal system (SAS) and resetting of baroreceptors as the underlying pathophysiological mechanisms. Evidence suggests that regular practice of yogasanas and pranayama appears to cause down-regulation of the HPA axis and the sympathetic nervous system (SNS), increases vagal activity, improves baroreceptor sensitivity, and thereby helps to reduce blood pressure. Although the exact mechanism of beneficial effects of yoga are not known, evidence suggests that yogic intervention may be acting through multiple mechanisms simultaneously influencing diverse neural structures involved in the regulation of the neuroendocrine and the cardiovascular response to stress to cause neurohumoral modulations resulting in alleviation of stress and improvement in cardiovascular indices.
... Psychosocial stress is an important factor in the pathogenesis of essential hypertension, while appropriate intensive aerobic exercise can alleviate the mental stress to decrease the sympathetic nervous system which is related to the origin of essential hypertension. [38][39][40] Besides, improving insulin sensitivity may be another potential mechanism of aerobic training on blood pressure reduction. [41] Furthermore, it was worth noting that the pooled SBP after aerobic exercise had a significant publication bias, and the DBP effect was altered after excluding 2 of included papers. ...
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... Obesity increases the sympathetic (including the renal sympathetic) nervous system activity through the high sodium intake-related mechanisms and through other mechanisms, such as hyperleptinemia. 86,87 On the contrary, clinical and epidemiological studies indicate the importance of chronic mental stress in the pathogenesis of essential hypertension. 88,89 Hypertensive subjects may decrease their blood pressure with a meditation program. ...
... Obesity increases the SNS activity through the high-sodium intake-related mechanisms and through other mechanisms, such as hyperleptinemia. 86,87 On the contrary, clinical studies indicate the importance of chronic mental stress in the pathogenesis of essential hypertension. 88,89 Hypertensive subjects may decrease their blood pressure with a meditation program. ...
... Inna, niezwykle ciekawa hipoteza dotyczy "heterogeniczności kłębków nerkowych". Zakłada ona, iż część kłębków nerkowych, na skutek niedokrwienia, ma zwiększone wydzielanie reniny, co prowadzi do wzrostu oporu nerkowego i w konsekwencji do zmniejszenia wydalania sodu przez pozostałe kłębki nerkowe [33][34][35]. ...
... Our research has found that as many as 1 in 3 individuals retain rather than excrete sodium during episodes of mental stress. Furthermore, we and others have demonstrated that this response only occurs in persons who show stress-induced increases of the RAAS system, particularly Ang II (13)(14). We postulate this response pattern possibly aids in the development of poor bone health through two pathways, see Figure 1. ...
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Gender differences in the epidemiology, pathophysiology, clinical manifestations and outcomes of cardiovascular disease are well established but there is still a lack of awareness of this both in the general population and among healthcare providers. In addition to the traditionally recognized cardiovascular risk factors, more recently psychosocial risk factors such as stress, mood disorders, low socioeconomic status and sleep disorders have been linked to cardiovascular diseases and hypertension. Psychosocial factors may have different cardiovascular consequences in men and women; thus further efforts are required to explore pathophysiological mechanisms, to obtain gender-specific data from clinical trials and to translate this knowledge into everyday clinical practice.
... • We have shown that mental stress leads to hypertension via its impact on renal sodium handling. 3 • Approximately 1 in 3 African Americans and 1 in 5 Caucasians retain rather than excrete sodium during episodes of mental stress. 3 • Pharmacologic interventions have shown that this sodium response only occurs in those who show a stress-induced increase in RAS activity, particularly Ang II. ...
... 3 • Approximately 1 in 3 African Americans and 1 in 5 Caucasians retain rather than excrete sodium during episodes of mental stress. 3 • Pharmacologic interventions have shown that this sodium response only occurs in those who show a stress-induced increase in RAS activity, particularly Ang II. [4][5][6][7] We postulate that this same response pattern may impair bone metabolism, particularly in salt-sensitive individuals. ...
... It is reasonable to hypothesize that the increased blood pressure load will lead to the early development of structural and functional changes that precede the development of target organ changes. Consistent with this hypothesis, we reported the cross-sectional data described in our previous studies which suggest that impaired stress-induced pressure natriuresis in youth is associated with dysfunctional cardiac structure and function [46,47] as well as decreased vascular and renal function [48]. ...
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As the development of hypertension and target organ damage becomes more prevalent, it becomes exceedingly important to determine the underlying mechanisms through which this detrimental development occurs. Specifically, our studies and others have explored mechanisms through which stress elicits a salt-sensitive response in approximately 20-30 % of the population, resulting in the early development of hypertension and target organ damage. Data associated with this stress-induced cardiovascular response pattern have recently demonstrated additional effects across the body systems including factors contributing to the development of osteoporosis, obesity, autoimmune disease, and chronic inflammation. As each of these diseases become more prevalent in conjunction with hypertension, further research may discover stress and salt sensitivity to be at the "heart" of the matter for the development of many of today's most deadly conditions.
... 4 Psychological stress can be elicited by AF episodes and might also predispose to AF initiation. The Framingham Offspring Study demonstrated that tension was an independent predictor of coronary heart disease, AF and mortality in men. 5 Several studies have demonstrated an improvement in QoL after catheter ablation of paroxysmal AF. [6][7][8][9] Limited data exist regarding the role of AF ablation on psychological stress, [10][11] which can be linked with AF triggering and maintenance through a number of interactions: psychological stress is associated with sympathetic overactivation and catecholamine release, 12 sodium retention and increased blood pressure, [12][13][14] as well as with impaired hormonal homeostasis and endothelial function. 15 All these factors have direct or indirect effects on AF pathogenesis and, as a result, it would be clinically relevant to investigate how psychological parameters could affect AF ablation results. ...
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Background Atrial fibrillation (AF) is associated with significant impairment of quality of life (QoL). Anxiety and depression are common in AF patients and might predispose to AF. We sought to investigate associations of preablative QoL and stress parameters with AF ablation outcomes, as well as possible changes in QoL, anxiety, and depression parameters after ablation.MethodsA total of 57 consecutive patients with paroxysmal AF underwent pulmonary vein (PV) antral isolation. The Short-Form Life Survey-36 items (SF-36), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI) were assessed before and at 6 months after ablation.ResultsAfter a mean follow-up of 8.0 ± 2.5 months, 41 patients (71.9%) remained free from arrhythmia. Baseline mental health summary QoL SF-36 score was significantly lower in patients with AF recurrence (53.2 ± 10.3 vs 69.7 ± 17.9; P = 0.001), while the physical health summary score did not differ significantly between patients with and without recurrence. Patients with recurrence had higher baseline STAI-trait (41.9 ± 1.5 vs 34.7 ± 4.9) and BDI (17.3 ± 9.7 vs 5.4 ± 3.0) scores (P < 0.001 for both). In multivariable analysis, SF-36 mental health summary, STAI-trait, and BDI scores remained significant predictors of recurrence after adjustment for age, gender, body mass index, diabetes, and hypertension. Mental and physical domain SF-36 summary scores were significantly improved 6 months after ablation (P = 0.001) and a significant reduction in symptoms of depression (P = 0.001) and anxiety (P = 0.001) was observed.Conclusions Baseline QoL, anxiety, and depression metrics were associated with AF recurrence following PV antral isolation. Furthermore, there was a significant improvement in QoL, anxiety, and depression after left atrial ablation.