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.
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