Абстрактный

Blood pressure in women presenting fibromyalgia as a function of pain and avoidance disparities.

Kerstin Wentz, Trevor Archer

Objective: To investigate the relationships between dimensions of PTSD and clinical everyday pain, physiological adaptation to a sub maximal test, i.e. moderate intensity exercise in terms of systolic blood pressure (SBPR) in women with fibromyalgia (FM), and to compare the result to a gender- and age-matched healthy control group.

Materials and method: Twenty-two women presenting FM and twenty-six healthy women were education- and age-matched. All the women completed questionnaires regarding background, Impact of Event Scale-Revised (IES-R) and the short form health related quality of life instrument SF 36. All the women performed a stepwise load increment submaximal exercise test on a cycle ergometer to the severe perceived exertion level. Systolic blood pressure (SBPR) pressure was recorded before, during and after the test.

Results: In comparison to healthy women, the women presenting FM showed higher IES-R values of intrusion, avoidance and hypertension and a tripled impact from clinical pain over 4 weeks. During recovery from the test, the successive decrease in SBPR was smaller in women presenting FM. In both groups the SBPR domain and IES-R domain presented intra correlation. In FM, a correlative link concerned avoidance and SBPR from baseline and through the test. In parallel, hypertension was correlatively linked to SBPR during recovery from the test. Clinical pain correlated with blunted SBPR responses through the test and also during recovery from the test.

Conclusion: Both FM and PTSD are known to mirror suboptimal resources in dimensions such as avoidance, hyper-arousal and different ANS regulatory resources. This situation may be manifested by an interplay avoidance and hypertension and SBPR where in turn, both a vigorous a SBPR response and vigorous SBPR recovery after the test relates to less clinical pain. Further examinations regarding this blunted dynamic and clinical pain together may unfold the role of various agents on resting values and response versus recovery, respectively.