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ISSN 2522-9028 (Print)
ISSN 2522-9036 (Online)
DOI: https://doi.org/10.15407/fz

Fiziologichnyi Zhurnal

is a scientific journal issued by the

Bogomoletz Institute of Physiology
National Academy of Sciences of Ukraine

Editor-in-chief: V.F. Sagach

The journal was founded in 1955 as
1955 – 1977 "Fiziolohichnyi zhurnal" (ISSN 0015 – 3311)
1978 – 1993 "Fiziologicheskii zhurnal" (ISSN 0201 – 8489)
1994 – 2016 "Fiziolohichnyi zhurnal" (ISSN 0201 – 8489)
2017 – "Fiziolohichnyi zhurnal" (ISSN 2522-9028)

Fiziol. Zh. 2023; 69(5): 100-113


STRESS AND HYPERTENSION IN WAR AND COVID-19 CONDITIONS

L.M. Samokhina, Yu.S. Rudyk

    Government Department «L.T. Malaya named National Institute of Therapy of the National Academy of Sciences of Ukraine»
DOI: https://doi.org/10.15407/fz69.05.100


Abstract

Common mechanisms of the development of the body’s stress response under the conditions of war and the COVID-19 pandemic relate to its acute and chronic course, post-traumatic stress disorder, the role of the hypothalamus-pituitaryadrenal gland, the sympathetic nervous system, and the renin-angiotensin-aldosterone system, and deficiency of α-1- antitrypsin. The development of stress-induced hypertensive changes is characterized by the activity of enzymes independent of the angiotensin-converting enzyme pathway of the renin-angiotensin system, expression of miRNA, damage to the endothelial cells of blood vessels, changes in the content of neutrophils and lymphocytes, and the soluble receptor for glycosylation end products. The considered stress-induced hypertensive changes under the conditions of the COVID-19 pandemic relate to chronic hyperinflammation, emotional response, effects of catecholamines, chymase activity, redox imbalance, DNA damage, endoplasmic reticulum stress. The interaction between ACE/ACE2 and miRNA may increase the probability of SARS-CoV-2 infection in patients with hypertension. A factor in the severity of COVID-19 is considered to be clinical depression and low immunity, and the possibility of a negative effect of antidepressants is highlighted. A more aggressive course of COVID-19 in hypertensive patients is associated with low levels of nitric oxide (NO). Stress-induced hypertensive changes under the conditions of war are associated with adaptation disorders, increased randomness of heart rate changes, post-traumatic stress disorder, the development of hypertension partly of psychological origin against the background of changes in the central nervous system, immunity, and the polymorphism of the ACEI/D gene as an indicator of endurance.

Keywords: stress; hypertension; COVID-19; war.

References

  1. Silva AA, Perilhão MS, Portes LA, Serra AJ, Tucci PJF, Leopoldo AS, Santos LD, Bocalini DS. Physical exercise attenuates stress-induced hypertension in rats but not the impairments on the myocardial mechanics. J Hypertens. 2022;40(3):528-35. CrossRef PubMed
  2. Limone P, Toto GA, Messina G. Impact of the COVID-19 pandemic and the Russia-Ukraine war on stress and anxiety in students: A systematic review. Front Psychiatr. 202213:1081013.
  3. Sara JDS, Toya T, Ahmad A, Clark MM, Gilliam WP, Lerman LO, Lerman A. Mental stress and its effects on vascular health. Mayo Clin Proc. 2022;97(5):951-90. CrossRef PubMed PubMedCentral
  4. Vadzyuk SN, Sas VV, Ratynska OM, Tkachuk SS. Peculiarities of the psycho-emotional state of people with different stress resistance. Fiziol Zh. 2022;68(2):92-7. [Ukrainian]. CrossRef
  5. Eshel Y, Kimhi S, Marciano H, Adini B. Morale and Perceived Threats as Predictors of Psychological Coping with Distress in Pandemic and Armed Conflict Times. Int J Environ Res Publ Health. 2021;18(16):8759. CrossRef PubMed PubMedCentral
  6. McCleave EL, Slattery KM, Duffield R, Saunders PU, Sharma AP, Crowcroft S, Coutts AJ. Impaired heat adaptation from combined heat training and "Live High, Train Low" Hypoxia. Int J Sports Physiol Perform. 2019;14(5):635-43. CrossRef PubMed
  7. Zlyvkov VL, Lukomska SO, Fedan OV. Psychodiagnostics of personality in life crisis situations. K. (Ukraine): Pedagogical opinion. 2016.
  8. Szafoni S, Piegza M. Progress in personalized psychiatric therapy with the example of using intranasal oxytocin in PTSD treatment. J Pers Med. 2022;12(7):1067. CrossRef PubMed PubMedCentral
  9. Mengin AC, Rolling J, Porche C, Durpoix A, Lalanne L. The intertwining of posttraumatic stress symptoms, alcohol, tobacco or nicotine use, and the COVID-19 pandemic: A systematic review. Int J Environ Res Publ Health. 2022;19(21):14546. CrossRef PubMed PubMedCentral
  10. Gideon A, Sauter C, Ehlert U, von Känel R, Wirtz PH. Aldosterone hyperreactivity to acute psychosocial stress induction in men with essential hypertension. Horm Behav. 2021;134:105018. CrossRef PubMed
  11. Bal NB, Han S, Kiremitci S, Uludag MO, Demirel-Yilmaz E. Reversal of deleterious effect of hypertension on the liver by inhibition of endoplasmic reticulum stress. Mol Biol Rep. 2020;47(3):2243-52. CrossRef PubMed
  12. Mahmood S, Shah KU, Khan TM, Nawaz S, Rashid H, Baqar SWA, Kamran S. Non-pharmacological management of hypertension: in the light of current research. Ir J Med Sci. 2019;188(2):437-52. CrossRef PubMed
  13. Zheng H, Han Y, Du Y, Shi X, Huang H, Yu X, Tan X, Hu C, Wang Y, Zhou S. Regulation of hypertension for secondary prevention of stroke: The possible 'bridging function' of acupuncture. Complement Med Res. 2018;25(1):45-51. CrossRef PubMed
  14. Franco C, Sciatti E, Favero G, Bonomini F, Vizzardi E, Rezzani R. Essential hypertension and oxidative stress: Novel future perspectives. Int J Mol Sci. 2022;23(22):14489. CrossRef PubMed PubMedCentral
  15. Guzmán-Tordecilla DN, Vecino-Ortiz AI, Lucumí D, Mentz G. Chronic stress as a mediator of the relationship between socioeconomic status and pharmacological adherence in hypertensive patients. Biomedica. 2020; 40(2):243-56. CrossRef PubMed PubMedCentral
  16. Naiel S, Carlisle RE, Lu C, Tat V, Dickhout JG. Endoplasmic reticulum stress inhibition blunts the development of essential hypertension in the spontaneously hypertensive rat. Am J Physiol Heart Circ Physiol. 2019;316(5): H1214-23. CrossRef PubMed
  17. Stasenko T. Effective treatment of hypertension in stress conditions. The PharmaMedia. (Ukraine). 2022. [Russian].
  18. Gubbi S, Nazari MA, Taieb D, Klubo-Gwiezdzinska J, Pacak K. Catecholamine physiology and its implications in patients with COVID-19. Lancet Diabet Endocrinol. 2020;8(12):978-86. CrossRef PubMed
  19. Tsampasian V, Corballis N, Vassiliou VS. Renin-angiotensin-aldosterone inhibitors and COVID-19 infection. Curr Hypertens Rep. 2022;24(10):425-33. CrossRef PubMed PubMedCentral
  20. Kobayashi K, Chin K, Umezawa S, Ito S, Yamamoto H, Nakano S, Takada N, Hatori N, Tamura K. Influence of stress induced by the first announced state of emergency due to Coronavirus disease 2019 on outpatient blood pressure management in Japan. Hypertens Res. 2022; 45(4):675-85. CrossRef PubMed PubMedCentral
  21. Adedoyin O, Brijmohan S, Lavine R, Lisung FG. Undetectable SARS-CoV-2 active adaptive immunitypost-vaccination or post-COVID-19 severe diseaseafter immunosuppressants use. BMJ Case Rep. 2021; 14(11):e246308. CrossRef PubMed PubMedCentral
  22. Gramaglia C, Gattoni E, Gambaro E, Bellan M, Balbo PE, Baricich A, Sainaghi PP, et al. Anxiety, stress and depression in COVID-19 survivors from an Italian Cohort of Hospitalized patients: Results From a 1-Year FollowUp. Front Psychiatr. 2022;13:862651. CrossRef PubMed PubMedCentral
  23. Hay M, Barnes C, Huentelman M, Brinton R, Ryan L. Hypertension and Age-related cognitive impairment: common risk factors and a role for precision aging. Curr Hypertens Rep. 2020;22(10):80. CrossRef PubMed PubMedCentral
  24. Srinivasagopalane B, Rajarathinam AS, Balasubramaiyan T. Clinical pertinence of neutrophil-to-lymphocyte ratio among hypertensives with different grades and duration of hypertension - an insight. Clin Exp Hypertens. 2019;41(4):394-9. CrossRef PubMed
  25. Korinek K, Young Y, Teerawichitchainan B, Kim Chuc NT, Kovnick M, Zimmer Z. Is war hard on the heart? Gender, wartime stress and late life cardiovascular conditions in a population of Vietnamese older adults. Soc Sci Med. 2020;265:113380. CrossRef PubMed PubMedCentral
  26. Yang C, Zhao H, Tebbutt SJ. Leave no one behind: inclusion of alpha-1 antitrypsin deficiency patients in COVID-19 vaccine trials. Eur J Hum Genet. 2022;30(8):872-4. CrossRef PubMed PubMedCentral
  27. 27. Finotti P, Pagetta A. A heat shock protein70 fusion protein with alpha1-antitrypsin in plasma of type 1 diabetic subjects. Biochem Biophys Res Commun. 2004;315(2):297-305. CrossRef PubMed
  28. Nava R, Zuhl MN. Heat acclimation-induced intracellular HSP70 in humans: a meta-analysis. Cell Stress Chaperones. 2020;25(1):35-45. CrossRef PubMed PubMedCentral
  29. Khode V, Patil S, Babu G, Ruikar K, Patel S. Detection of cognitive impairment by choice auditory reaction time (ART) and visual reaction time (VRT)s during acute mental stress in young hypertensives: A case control study. Curr Hypertens Rev. 2022;18(1):64-9. CrossRef PubMed
  30. Samokhina LM. Stress, hypertension and adaptation. Enzymes of vasoconstriction and destruction under conditions of stress, hypo- and hypertension. Rhythmic cold effects. Publisher: LAP LAMBERT Academic Publishing, Saarbrucken, Deutschland, Germany. 2015. [Russian].
  31. Samokhina LM, Lomako VV. The effectiveness of rhythmic cold effects on the activity of proteinases and their inhibitors in rats with alcohol-dependent hypertension. Fiziol Zh. 2022;68(1):34-4. [Ukrainian]. CrossRef
  32. Sansone R, Baaken M, Horn P, Schuler D, Westenfeld R, Amabile N, Kelm M, Heiss C. Release of endothelial microparticles in patients with arterial hypertension, hypertensive emergencies and catheter-related injury. Atherosclerosis. 2018;273:67-74. CrossRef PubMed
  33. Zarbafian M, Dayan S, Fabi SG. Teachings from COVID-19 and aging-An oxidative process. J Cosmet Dermatol. 2020;19(12):3171-6. CrossRef PubMed PubMedCentral
  34. Maresca AM, Guasti L, Bozzini S, Mongiardi C, Tandurella N, Corso R, et al. sRAGE and early signs of cardiac target organ damage in mild hypertensives. Cardiovascul Diabetol. 2019;18(1):17. CrossRef PubMed PubMedCentral
  35. Xue B, Yu Y, Wei SG, Beltz TG, Guo F, Felder RB, Johnson AK. Stress-induced sensitization of angiotensin II hypertension is reversed by blockade of angiotensinconverting enzyme or tumor necrosis factor-α. Am J Hypertens. 2019;32(9):909-17. CrossRef PubMed PubMedCentral
  36. Abo-Al-Ela HG, Faggio C. MicroRNA-mediated stress response in bivalve species. Ecotoxicol Environ Saf. 2021;208:111442. CrossRef PubMed
  37. Samokhina LM. Functional significance of miRNA in the development of diseases of internal organs. Ukr Therapeut J. 2016;4:103-15. [Russian].
  38. Matshazi DM, Weale CJ, Erasmus RT, Kengne AP, Davids SFG, Raghubeer S, Davison GM, Matsha TE. Circulating levels of MicroRNAs associated with hypertension: A cross-sectional study in male and female South African Participants. Front Genet Sec Human Med Genom. 2021;12. CrossRef PubMed PubMedCentral
  39. Zacher M, Wang J, Short SE. The contributions of hypertension diagnosis and blood pressure control to subjective life expectancy in a representative sample of older US adults. J Gerontol B Psychol Sci Soc Sci. 2022;77(2):378-88. CrossRef PubMed PubMedCentral
  40. Santa-Rosa FA, Shimojo GL, Dias DS, Viana A, Lanza FC, Irigoyen MC, De Angelis K. Impact of an active lifestyle on heart rate variability and oxidative stress markers in offspring of hypertensives. Sci Rep. 2020;10(1):12439. CrossRef PubMed PubMedCentral
  41. Feinsilver T, Tandeter H. False positive ambulatory blood pressure monitoring: challenges in accurate Diagnosis of masked uncontrolled hypertension. Harefuah. 2021;160(5):297-300. [Article in Hebrew]
  42. Lamontagne SJ, Pizzagalli DA, Olmstead MC. Does inflammation link stress to poor COVID-19 outcome? Stress Health. 2021;37(3):401-14. CrossRef PubMed
  43. Li G, Hu R, Gu X. A close-up on COVID-19 and cardiovascular diseases. Nutr Metab Cardiovascul Dis. 2020;30(7):1057-60. CrossRef PubMed PubMedCentral
  44. Nakhaee H, Zangiabadian M, Bayati R, Rahmanian M, Jolfayi AG, Rakhshanderou S. The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis. PLoS One. 2022; 17(10): e0267423. CrossRef PubMed PubMedCentral
  45. Achiron A, Mandel M, Gurevich M, Dreyer-Alster S, Magalashvili D, Sonis P, Dolev M, Menascu S, Harari G, Flechter S, Falb R. Immune response to the third COVID-19 vaccine dose is related to lymphocyte count in multiple sclerosis patients treated with fingolimod. J Neurol. 2022;269(5):2286-92. CrossRef PubMed PubMedCentral
  46. Singh S, Desai R, Gandhi Z, Fong HK, Doreswamy S, Desai V, Chockalingam A, Mehta PK, Sachdeva R, Kumar G. Takotsubo syndrome in patients with COVID-19: a systematic review of published cases. SN Compr Clin Med. 2020;2(11):2102-8. CrossRef PubMed PubMedCentral
  47. Majumder N, Deepak V, Hadique S, Aesoph D, Velayutham M, Ye Q, et al. Redox imbalance in COVID-19 pathophysiology. Redox Biol. 2022;56:102465. CrossRef PubMed PubMedCentral
  48. Muhammad Y, Kani YA, Iliya S, Muhammad JB, Binji A, El-Fulaty Ahmad A, Kabir MB, Bindawa KU, Ahmed A. Deficiency of antioxidants and increased oxidative stress in COVID-19 patients: A cross-sectional comparative study in Jigawa, Northwestern Nigeria. SAGE Open Med. 2021;9:2050312121991246. CrossRef PubMed PubMedCentral
  49. Griendling KK, Camargo LL, Rios FJ, Alves-Lopes R, Montezano AC, Touyz RM. Oxidative stress and hypertension. Circ Res. 2021;128:993-1020. CrossRef PubMed PubMedCentral
  50. Oren O, Gersh BJ, Blumenthal RS. Anticipating and curtailing the cardiometabolic toxicity of social isolation and emotionalstressin the time of COVID-19. Am Heart J. 2020;226:1-3. CrossRef PubMed PubMedCentral
  51. Senkal N, Serin I, Pehlivan S, Pehlivan M, Medetalibeyoglu A, Cebeci T, et al. The effect of DNA repair gene variants on COVID-19 disease: susceptibility, severity, and clinical course. Nucleosid Nucleotid Nucl Acids. 2023:1-15. CrossRef PubMed
  52. Emanuelli G, Nassehzadeh-Tabriz N, Morrell NW, Marciniak SJ. The integrated stress response in pulmonary disease. Eur Respirat Rev. 2020;29(157):200184. CrossRef PubMed PubMedCentral
  53. Yiang GT, Wu CC, Lu CL, Hu WC, Tsai YJ, Huang YM, Su WL, Lu KC. Endoplasmic reticulum stress in elderly patients with COVID-19: Potential of melatonin treatment. Viruses 2023, 15(156):1-22. CrossRef PubMed PubMedCentral
  54. Dal Moro F, Vendramin I, Livi U. The war against the SARS-CoV2 infection: Is it better to fight or mitigate it? Med Hypothes. 2020;143:110129. CrossRef PubMed PubMedCentral
  55. Tiezzi M, Morra S, Seminerio J, Van Muylem A, Godefroid A, Law-Weng-Sam N, et al. SP-D and CC16 pneumoproteins' kinetics and their predictive role during SARS-CoV-2 infection. Front Med (Lausanne). 2022;8:761299. CrossRef PubMed PubMedCentral
  56. Kurbel S. The renin-angiotensin system in COVID-19: Why ACE2 targeting by coronaviruses produces higher mortality in elderly hypertensive patients? Bioessays. 2021;43(3):e2000112. CrossRef PubMed PubMedCentral
  57. Safdar M, Ozaslan M, Mustafa RM, Smail SW, Khan SS, Khan MS, et al. The severity of COVID-19 in hypertensive patients is associated with mirSNPs in the 3′ UTR of ACE2 that associate with miR-3658: In silico and in vitro studies. J Taibah Univ Med Sci. 2023; 18(5): 1030-47. CrossRef PubMed PubMedCentral
  58. Liu S, Suzuki Y, Takemasa E, Watanabe R, Mogi M. Mast cells promote viral entry of SARS-CoV-2 via formation of chymase/spike protein complex. Eur J Pharmacol. 2022;930:175169. CrossRef PubMed PubMedCentral
  59. Koval SM, Snigurska IO, Mysnychenko OV, Penkova MU. Arterial hypertension in servicemen and veterans of various wars. Ukr Therapeut J. 2023;1:57-63. [Ukrainian]. CrossRef
  60. Dursa EK, Barth SK, Porter BW, Schneiderman AI. Health status of female and male gulf war and Gulf Era Veterans: A population-based study. Womens Health Iss. 2019;29 Suppl 1:S39-S46. CrossRef PubMed
  61. Blanchard M, Molina-Vicenty HD, Stein PK, Li X, Karlinsky J, Alpern R, Reda DJ, Toomey R. Medical Correlates of Chronic Multisymptom Illness in Gulf War Veterans. Am J Med. 2019;132(4):510-8. CrossRef PubMed
  62. Coller JK, Tuke J, Wain TJ, Quinn E, Steele L, Abreu M, Aenlle K, Klimas N, Sullivan K. Associations of Immune Genetic Variability with Gulf War Illness in 1990-1991 Gulf War Veterans from the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study Brain. 2021;11(11):1410. CrossRef PubMed PubMedCentral
  63. Santić Z, Lukić A, Sesar D, Milicević S, Ilakovac V. Longterm follow-up of blood pressure in family members of soldiers killed during the war in Bosnia and Herzegovina. Croat Med J. 2006;47(3):416-23.
  64. Bapolisi A, Maurage P, Pappaccogli M, Georges CMG, Petit G, Balola M, et al. Association between posttraumatic stress disorder and hypertension in Congolese exposed to violence: a case-control study. J Hypertens. 2022;40(4):685-91. CrossRef PubMed
  65. Gammoh O, Bjørk MH, Al Rob OA, AlQudah AR, Hani AB, Al-Smadi A. The association between antihypertensive medications and mental health outcomes among Syrian war refugees with stress and hypertension. J Psychosom Res. 2023;168:111200. CrossRef PubMed
  66. Howard JT, Stewart IJ, Kolaja CA, Sosnov JA, Rull RP, Torres I, et al. Hypertension in military veterans is associated with combat exposure and combat injury. J Hypertens. 2020;38(7):1293-301. CrossRef PubMed
  67. Yoo JH. Deletion polymorphism in the gene for angiotensin-converting enzyme is associated with essential hypertension in men born during the PacificWar. Mech Ageing Dev. 2005;126(8):899-905. CrossRef PubMed
  68. Brown MC, Sims KJ, Gifford EJ, Goldstein KM, Johnson MR, Williams CD, Provenzale D. Genderbased Differences among 1990-1991 Gulf War Era Veterans: Demographics, Lifestyle Behaviors, and Health Conditions. Womens Health Issues. 2019;29 Suppl 1:S47-55. CrossRef PubMed PubMedCentral
  69. Kasović M, Kalčik Z, Štefan L, Štefan A, Knjaz D, Braš M. Normative Data for Blood Pressure in Croatian War Veterans: A Population-based study. Int J Environ Res Public Health. 2021;18(8):4175. CrossRef PubMed PubMedCentral

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