Blood Pressure and Pulse Changes in Normal Individuals Under Emotional Stress; Their Relationship to Emotional Instability

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Abstract
Sixty-two student nurses at the University Hospital and seventeen student pilots in training under the Civil Aeronautics Authority were interviewed for approximately one half-hour each in order to determine the presence of emotional instability. Follow-up studies on the first group covered a period of 12–18 months, on the second group 4–6 months. The nurses were under some emotional stress at the time of the physical examination required for admission to the school, and blood pressure and pulse readings were available from these examinations. The student pilots were studied more intensively in several situations of emotional stress including the qualifying physical examination, the first flight, the first “solo” flight, the first “spin” or “spiral,” the first experience in the Link trainer, and the injection of normal saline solution at a time when the subject expected some physiological effect from a drug. At these times blood pressure and pulse rate were each recorded several times, a subjective report was obtained, and the individual was observed for the presence of pallor, tremor, flushing, excessive sweating, restlessness, and apprehensive facial expression. In the situations studied in this manner systolic blood pressure elevations of 10–30 per cent were extremely common. The reaction of the pulse rate was more variable; there were decelerations of 20 per cent and accelerations of 40 per cent or more. With both the nurses and the pilots there was no correlation between such changes in pulse rate and blood pressure and instability as determined by the interview or difficulty in adjustment as determined by the follow-up study. In fact, when several situations of emotional stress were studied in the same individual, vascular reactions of the type outlined were so common as to constitute the normal physiological response.

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