SUMMARY Tests made of the sensory-perceptual, cognitive, and psychomotor abilities of untreated young patients with essential hypertension have revealed a pattern suggesting a slight functional impairment of the central nervous system. Reduced performance was most marked for those tasks requiring speed arid psychomotor coordination, particularly when the behaviors observed were self-initiated. Lowered scores were more evident among female hypertensives; no differences in performance by race were noted. The deficits measured by these sensitive tests do not appear to be great enough to intrude on everyday activity nor to impair work ability. Changes that may result from blood-pressure-lowering therapies will require further study. (Hypertension 4: 355-360, 1982) KEY WORDS • mild hypertension • behavioral consequences • psychological tests

SUMMARY It was shown in a prior study that mildly hypertensive patients performed significantly less effectively on several sensory-perceptual, cognitive, and psychomotor tests than did matched normotensive controls. To determine whether these deficits are attributable to elevated blood pressure per se, hypertensive and control subjects were recalled for reexamination 15 months after the original tests. Results indicated that those hypertensives in whom blood pressure had been lowered with antihypertensive drugs showed significant restoration of performance scores toward the levels of normotensive subjects. Hypertensives who had not received active treatment remained deficient as compared with controls. These results indicated that behavioral deficits in mild hypertension may be reversible consequences of the effects of elevated blood pressure on the central nervous system. (Hypertension 6: 202-208, 1984) KEY WORDS • mild hypertension • effect of treatment • behavioral consequences psychological tests E SSENTIAL hypertension has been a disease of special interest to behavioral scientists for many years. Franz Alexander, 1 in his classic psychoanalytic study of hypertension, discussed the hostility/dependency conflicts that seemed to be involved in the etiology of high blood pressure. Over the past 40 years and persisting today, there have been many studies in both animals and humans directed at clarifying psychological factors that may eventuate in elevated blood pressure. Despite this research effort, the mechanisms by which personality and environmental variables are translated into chronic, fixed hypertensive disease remain unclear, as do their implications for prevention and treatment.2 " 5The role of psychological factors in the etiology of hypertension, while capturing most of the research endeavor, has not been the only interest of investigators. Over the years a smattering of reports has suggested that high blood pressure may produce some

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This article reviews literature concerning functional changes resulting from elevated blood pressure, from reduction of blood pressure, and as a result of the medications used to treat high blood pressure. The research reviewed includes the areas of psychomotor speed, intelligence and cognitive processing, sensory and perceptual processes, and emotional and interpersonal behaviors. The conclusions reached are that the deficits noted to date in hypertensive individuals are not extreme nor are they specific. The greatest disadvantage, however, appears in the area of response speed.