Pressure responses of hypertensive patients treated with thiazides, beta blockers and clonidine during a psychological experimental stress situation.

A total of 61 hypertensive patients treated during more than six months with antihypertensive drugs and showing a satisfactory evolution and normal basal arterial pressure values were studied. Patients were subjected to a psychological stress test in order to evaluate the effectiveness of the pharmacological treatment during and after an emotional situation. Systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) were measured in three instances: before (I), during (II) and after the test (III). Patients were divided in two groups: a) moderate hypertensive subjects (N = 38) treated with thiazides and beta-blockers and b) severe hypertensive subjects (N = 23) treated with the same drugs plus clonidine. A group of 26 normotensive subjects was used as control. Reactivity was determined comparing SAP and DAP values in instances I and II, whereas the recovery phase was evaluated by comparing instances I and III. SAP and DAP reactivity were highest in severe hypertensive patients and lowest in normal subjects. SAP and DAP recovery was partial in severe hypertensive subjects and complete in the other two groups. All reactivity and recovery differences were statistically significant. These results suggest that antihypertensives treatment that normalized basal arterial pressure values in these patients was not sufficiently effective to protect them during a psychological stress situation.