CFS Affects Blood Pressure Response
By Nancy A. Melville HealthSCOUT Reporter
SUNDAY, Aug. 20 (HealthSCOUT) - A new study of chronic fatigue syndrome (CFS) in Gulf War veterans has found there may indeed be a physical basis for the condition.
CFS is baffling with no known cause but a lot of theories, ranging from chemical reactions to psychological disorders. Doctors often misdiagnose it as depression.
The latest study compared 51 Gulf War vets with CFS symptoms with 42 veterans without symptoms and found a distinctive difference in blood pressure reactions.
Those with CFS symptoms showed lower blood-pressure responses in two mental stress tests, which indicates a suppression of cardiovascular responses.
"This kind of blunted response indicates that there is something in the system, either in the brain or the blood vessels or somewhere else, that's not functioning properly," (that's a real understatement.) says lead study author Arnold Peckerman, a clinical professor at the New Jersey Medical School.
However, in a third test intended to detect differences in reflex responses to physical sensations, both groups of vets did about the same. In that test, a plastic bag filled with crushed ice and water was placed on the participants' foreheads, while their blood pressure was measured. (That is because this test does not stress the adrenal gland as the mental stress does.)
The stress of the mental efforts tests, which included math and speech tests, were expected to raise blood pressure. The increase in blood pressure, however, was much lower among the CFS sufferers, says Peckerman.
In fact, those with the least noticeable blood pressure responses were also those with the most severe CFS symptoms, suggesting a disconnect between cardiovascular stress responses and mental activities, say the researchers. (The worse the CFS, the weaker the adrenal gland system and so it cannot raise the blood pressure under stress.)
CFS sufferers also did poorly on the cognitive tests, says Peckerman. "Compared with the other veterans, those complaining of the most severe chronic fatigue symptoms, such as decline in memory and disturbances of sleep, had the most problems with the cognitive activities," he says.
"They especially had problems with arithmetic, even more than the speech skills," he says. (The lowered blood pressure cannot bring needed oxygen to the brain.)
The findings are reported in the current issue of Psychosomatic Medicine.
Peckerman says the cause of the apparent disconnect among the CFS subjects probably will be the focus of more research, but he says it could be caused by anything from brain injury to exposure to chemicals.
Studies have found that up to 45 percent of Gulf War veterans have symptoms of CFS, including 6 percent with severe cases. Overall, the risk in women is believed to be three times higher than in men.
The criteria for CFS include the following symptoms, lasting for more than six months: short-term memory loss or a severe inability to concentrate that affects work, school or other normal activities; sore throat; swollen lymph nodes in the neck or armpits; muscle pain; pain without redness or swelling in a number of the joints; intense or changing patterns of headaches; unrefreshing sleep and weariness that lasts for more than a day after any exertion. (They did a good job or defining the symptoms of the average CFS patient.)
Dr. Roberto Patarca, director of the E. A Papper Laboratory of Clinical Immunology at the University of Miami School of Medicine, says the study furthers earlier research.
"So far it seems like most of the aspects you see in CFS are documented in particular subsets. There is a whole school of people who look at the immunological changes, which seem to be evident in about a third of patients. Then about another third of patients show some kind of cardiovascular types of problems, and then the last third is sort of a mixed bag of findings," he says.
"One significant finding in setting CFS apart from depression, however, has been that one subset of CFS patients tended to have very low levels of the stress hormone cortisol, while most people with depression, in fact, tend to have very high levels of the hormone. So this latest study on Gulf War veterans would appear to go in line with that research, boosting the evidence that this is a physical and not a psychological condition," Patarca says. (Those with high levels of cortisol are CFS patients in stages one, two or three of this condition while those with low cortisol levels are in stages four, five, six or seven. See the rest of our web site or the book Chronic Fatigue Unmasked 2000)
"And at least by identifying these features in subsets of people, we can develop treatments to try to help those specific patients," he says.
(These treatment are now available for those willing to look beyond orthodoxy.)
All comments in parentheses by Dr. Poesnecker.