Neurocirculatory asthenia revisited: elevated arterial pressure at presentation is a marker for subsequent hypertension

E. LEV, K. TORDJMAN, A. PINES, E. Z. FISMAN, Y. DRORY, N. STERN

Research output: Contribution to journalArticlepeer-review

Abstract

Abstract. Neurocirculatory asthenia (NCA) is a fairly common functional disorder often encountered among military recruits. Symptoms in NCA tend to appear in waves, and are believed to disappear completely with the passage of time. Elevated arterial pressure is known to occur as part of the various haemodynamic manifestations of NCA. However, the exact prevalence of hypertension, as well as its long‐term prognosis, is still unknown. The present case‐control study was designed to address these two issues. The target population consisted of 370 patients with NCA representing two separate cohorts: patients diagnosed in 1979, 10 years prior to this study, and patients diagnosed in 1983‐84, 5 years prior to the study. An overall 20% prevalence rate of mild hypertension at diagnosis was calculated for the entire study population. In total, 100 patients representing equal numbers of hypertensive and matched normotensive subjects from each cohort were re‐evaluated. At follow‐up, hypertension was present in 27% (1979 cohort) and 30% (1983‐84 cohort) of patients originally considered to be hypertensive. Hypertension was either non‐existent (1979 cohort) or limited to a single case (1983‐84 cohort) among originally normotensive individuals. In parallel, resting heart rate was higher in the hypertensive subjects of the 1979 cohort both at presentation (85.5 ± 3.2 vs. 73.7 ± 2.4 beats min‐1; P < 0.005) and at follow‐up (79.6 ± 3.2 vs. 70.0 ± 2.5 beats min‐1; P < 0.01). These results indicate that hypertension complicates the diagnosis of NCA in 20% of patients and that, contrary to common belief, it cannot be regarded as another transient manifestation of this condition. Thus hypertension in this context is, as in the younger members of the population in general, a major risk factor for lifelong hypertension, rather than an inconsequential phenomenon. 1992 Blackwell Publishing Ltd

Original languageEnglish
Pages (from-to)503-509
Number of pages7
JournalJournal of Internal Medicine
Volume231
Issue number5
DOIs
StatePublished - May 1992

Keywords

  • hypertension
  • neurocirculatory asthenia

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