May 2019
BY ANA PENA, PHD
Systolic extinction training (SET) — which combines behavior therapy to reduce pain and physical interference with training to improve blood pressure response to stress — leads to long-term reductions in pain severity in women with fibromyalgia (FM), a clinical trial shows.
SET benefits are considered to result from a reduction in the hypertensive stress response, the natural response to stress that is dysfunctional in nearly half of fibromyalgia patients.
The study “Efficacy of Systolic Extinction Training in Fibromyalgia Patients With Elevated Blood Pressure Response to Stress: A Tailored Randomized Controlled Trial” was published in the journal Arthritis Care & Research.
Stress and pain can increase blood pressure in some fibromyalgia patients with so-called hypertensive stress response — an unbalanced response which leads to widespread pain, and increases the risk for high blood pressure (hypertension) and cardiovascular disease.
Long-term stress can lead to persistent elevated blood pressure, reduced ability to regulate blood pressure, and persistent widespread pain. In fact, nearly half of fibromyalgia patients (48%) have this kind of response to stress.
Stressor-related information from all major sensory systems is conveyed to the brain through different neuronal pathways, and generate fast responses through reflexes.
A rise in blood pressure activates pressure receptors (baroreceptors) at the carotid arteries — those carrying oxygen-rich blood from the heart to the brain — that will relay impulses to the nucleus tractus solitarius (NTS), a brainstem region bearing a cluster of sensory nerve cell bodies.
This region plays a critical role in integrating reflexes that control cardiovascular function, as well as pain, sleep, and anxiety.
