Cardiovascular reactivity to experimental stress in psoriasis: a controlled investigation

A defective response of psoriatic skin to beta-adrenergic stimulation has been implicated in the pathophysiology of psoriasis. A psychophysiological study was planned to investigate whether the beta-adrenergic receptor hyporesponsiveness found in psoriatic skin can also be detected in other systems. Twenty-five psoriatic patients and 50 healthy controls were submitted to a standardized stressful procedure (mental arithmetic and the Stroop Colour-Word Naming Test) to trigger the activation of the sympathetic nervous system, and their haemodynamic responses were compared. While there were no differences between groups in perceived stress, a blunted increase in heart rate and a sharper increase in diastolic blood pressure was observed in psoriasis patients compared with controls. The psychophysiological reaction pattern observed in psoriatic patients might be explained by lower reactivity of heart beta1-adrenergic receptors and arteriolar walls beta2-adrenergic receptors. While this study suggests that beta-adrenergic receptor hyporesponsiveness might have a systemic expression in psoriatic patients, it needs support from future studies exploring beta-adrenergic function in psoriatic patients more directly.