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- Marcella Saccò
- Palliative Care Unit Local Health Authority Parma Italy
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- Michele Meschi
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
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- Giuseppe Regolisti
- Renal Failure Unit Department of Clinical and Experimental Medicine University of Parma Parma Italy
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- Simona Detrenis
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
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- Laura Bianchi
- Paediatric Nephrology Parma Medical School University of Parma Parma Italy
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- Marcello Bertorelli
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
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- Sarah Pioli
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
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- Andrea Magnano
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
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- Francesca Spagnoli
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
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- Pasquale Gianluca Giuri
- Internal Medicine Unit Castelnovo ne'Monti Hospital Local Health Authority Reggio Emilia Italy
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- Enrico Fiaccadori
- Renal Failure Unit Department of Clinical and Experimental Medicine University of Parma Parma Italy
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- Alberto Caiazza
- Nephro‐Cardiovascular Medicine and Hypertension Center Borgo Val di Taro Hospital Local Health Authority Parma Italy
説明
<jats:p>The relationship between pain and hypertension is potentially of great pathophysiological and clinical interest, but is poorly understood. The perception of acute pain initially plays an adaptive role, which results in the prevention of tissue damage. The consequence of ascending nociception is the recruitment of segmental spinal reflexes through the physiological neuronal connections. In proportion to the magnitude and duration of the stimulus, these spinal reflexes cause the activation of the sympathetic nervous system, which increases peripheral resistances, heart rate, and stroke volume. The response also involves the neuroendocrine system, and, in particular, the hypothalamic‐pituitary‐adrenal axis, in addition to further activation of the sympathetic system by adrenal glands. However, in proportion to an elevation in resting blood pressure, there is a contemporary and progressive reduction in sensitivity to acute pain, which could result in a tendency to restore arousal levels in the presence of painful stimuli. The pathophysiological pattern is significantly different in the setting of chronic pain, in which the adaptive relationship between blood pressure and pain sensitivity is substantially reversed. The connection between acute or chronic pain and cardiovascular changes is supported observationally, but some of this indirect evidence is confirmed by experimental models and human studies. The pain regulatory process and functional interaction between cardiovascular and pain regulatory systems are briefly reviewed. Various data obtained are described, together with their potential clinical implications.</jats:p>
収録刊行物
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- The Journal of Clinical Hypertension
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The Journal of Clinical Hypertension 15 (8), 600-605, 2013-06-10
Wiley