Alexithymia: A facet of uncontrolled hypertension

Casagrande, Maria; Mingarelli, Alessandro; Guarino, Angela; Favieri, Francesca; Boncompagni, Ilaria; Germano, Ricardo de Melo; Germanò, Giuseppe; Forte, Giuseppe

doi:10.1016/j.ijpsycho.2019.09.006

Cited by 26 publications

(26 citation statements)

References 68 publications

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“…Some psychopathological symptoms can also mediate the relationship between blood pressure and cognitive functioning. Hypertensive patients often present depression, alexithymia [110], inadequate strategies to cope with stress [111] and poorer health-related quality of life. These psychological conditions could depend on the recognition that they have "a problem" that needs treatment for all of their life [112].…”

Section: Discussionmentioning

confidence: 99%

Effects of Blood Pressure on Cognitive Performance: A Systematic Review

Forte

Pascalis

Favieri

et al. 2019

JCM

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Background: High blood pressure has been associated with an increased risk of developing cognitive impairment. However, this relationship is unclear. This study aims to systematically review the effects of blood pressure on executive functioning, language, memory, attention and processing speed. Methods: The review process was conducted according to the PRISMA-Statement, using the PubMed, PsycINFO, PsycARTICLES and MEDLINE databases. Restrictions were made by selecting studies, which included one or more cognitive measures and reported blood pressure recordings. Studies that included participants with medical conditions or people diagnosed with dementia, psychiatric disorders, stroke and head trauma were excluded. The review allows selecting fifty studies that included 107,405 participants. The results were reported considering different cognitive domains separately: global cognitive functioning, attention, processing speed, executive functions, memory and visuospatial abilities. Results: Higher blood pressure appears to influence cognitive performance in different domains in the absence of dementia and severe cardiovascular diseases, such as strokes. This relationship seems to be independent of demographic factors (gender and education), medical co-morbidity (diabetes), and psychiatric disorders (depression). Furthermore, it presents different patterns considering ageing. In the elderly, a sort of "cardiovascular paradox" is highlighted, which allows considering higher blood pressure as a protective factor for cognitive functioning. Conclusions: The results underline that higher blood pressure is associated with a higher risk of cognitive decline in people without dementia or stroke. These findings highlight the need to introduce early management of blood pressure, even in the absence of clinical hypertension, to prevent the risk of a decline of cognitive functioning typically associated with ageing. into dementia. Given the progressive ageing of the world population, the challenge of modern science is highlighted the factors associated with the evolution of cognitive impairment.Cognitive impairment appears to be amplified by several factors as the habit of smoking cigarettes [13,14], chronic use of alcohol [15], poor eating habits and obesity [16,17], inadequate exercise [18], chronic stress [19] or by some pathologies such as diabetes mellitus [20] or depression [21]. Moreover, the risk of cognitive impairment appears to increase in the presence of cardiovascular disorders, such as high blood pressure, cardiomyopathies, arteriosclerosis, cerebral infarcts and strokes [22]. Many studies have shown an association between vascular ageing indices, such as stiffness of the arteries and dysfunction of small vessels and cognitive decline [23]. The exposure to high blood pressure would damage the cerebral microcirculation, causing cognitive impairments [23].The mechanisms that can explain the relationship between high blood pressure and cognitive impairment are not wholly known. Some studies have shown associations be...

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Section: Discussionmentioning

confidence: 99%

Effects of Blood Pressure on Cognitive Performance: A Systematic Review

Forte

Pascalis

Favieri

et al. 2019

JCM

Self Cite

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“…Previous research suggested that emotional dysregulation and coping styles in individual might affect blood pressure [26,27]. Patients with hypertension were found to resort to repression of the emotions generated by a stressful situation [28].…”

Section: Discussionmentioning

confidence: 99%

Negative Affectivity Is Associated with a Higher Systolic and Diastolic Blood Pressure in Normotensive Middle-Aged and Older Adults: A Cross-Sectional Study

Lin

et al. 2020

Medicina

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Background and objectives: Type D personality, characterized by two stable traits (social inhibition and negative affectivity), is associated with adverse cardiovascular events. A possible mediating factor for this association could be hypertension. Previous research has shown that individuals with Type D personality were associated with an increased risk of hypertension. However, the association of negative affectivity and social inhibition on blood pressure in normotensive individuals has not yet been reported. Therefore, the aim of this study was to investigate whether negative affectivity and social inhibition were associated with systolic and diastolic blood pressure in normotensive middle-aged and older Taiwanese adults. Materials and Methods: A cross-sectional study design was used. Individuals attending general health examination at a regional hospital in southern Taiwan who were 40 to 75 years old were recruited. Patients with self-reported hypertension or currently receiving antihypertensive medication were excluded. Negative affectivity and social inhibition were assessed with the 14-item Type D Scale-Taiwanese version. Multiple linear regression analyses were conducted to determine the association of Z-score transformed negative affectivity and social inhibition on blood pressure. Results: A total of 92 patients with a mean age of 51.5 years were included in the study, and 15 (16.3%) were defined as having a Type D personality. The Z-score transformed negative affectivity score (p = 0.035, effect size = 0.18) and Z-score transformed social inhibition score (p = 0.054, effect size = 0.17) were significantly associated with a higher systolic blood pressure. In addition, the Z-score transformed negative affectivity score (p = 0.036, effect size = 0.28) and Z-score transformed social inhibition score (p = 0.154, effect size = 0.24) were significantly associated with a higher diastolic blood pressure. Conclusions: Negative affectivity of the Type D personality was significantly associated with higher systolic and diastolic blood pressure, with a medium effect size, in apparently healthy middle-aged and older adults. Assessment of negative affectivity may be clinically useful in identifying individuals at risk of hypertension.

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“…Also, the absence of an analysis of drug treatments is a limitation, because we do not know how antihypertensive therapy affected BP circadian variations. It would be useful to analyze this aspect, because it could mediate the relationship between psychological and physiological aspects [25].…”

Section: Limitsmentioning

confidence: 99%

“…An increase in sympathetic nervous system activity appears to be associated with some psychological states [20,21] and cognitive dysfunctions [22,23]. It is well known that some psychological factors, such as hostility, depression, anxiety, dysfunctional coping strategies, and emotional dysregulation, appear to have a role in both cardiovascular events and the development and maintenance of hypertension [24][25][26][27][28][29]. A growing body of evidence suggests that also the variations in nocturnal BP dipping are influenced by some psychosocial factors, such as anger and hostility [30,31], perceived racism/discrimination [32], job strain [33], depression [34], and social support [35].Many studies focused their attention on the relationship between BP dipping status and hostility and anger [30,31,36].…”

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confidence: 99%

The Night Effect of Anger: Relationship with Nocturnal Blood Pressure Dipping

Casagrande

Favieri

Guarino

et al. 2020

IJERPH

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Introduction: The circadian pattern of blood pressure is characterized by a physiological drop occurring after sleep onset. The alteration of this phenomenon (non-dipping, extreme dipping, or reverse dipping) is associated with an increased cardiovascular risk. Besides altered autonomic and endocrine circadian rhythms, psychological aspects seem to play a role in this modification. However, the few studies that have analyzed the influence of psychological dimensions on the dipping phenomenon have reported inconsistent results. This study aimed to examine the relationship between anger expression and blood pressure (BP) dipping. Methods: We obtained 24 h ambulatory BP measurements from 151 participants and used them to define three groups according to their dipping status: Dippers (N = 65), Non-Dippers (N = 42), and Extreme Dippers (N = 44). Sociodemographic and anamnestic information was collected, and the State-Trait Anger Expression Inventory was used to assess anger. Results: Analysis of variance evidenced significant higher scores for Trait Anger Temperament and Anger Expression in Extreme Dippers than in both Dippers and Non-Dippers. However, after controlling for confounding variables, there was no significant relationship with trait anger, and only the result concerning the suppression of anger was confirmed. Conclusions: These findings suggest that the analysis of some psychological factors, such as anger, could be necessary to better understand differences in nocturnal BP alterations. Trait anger and suppression of anger may contribute to the description and classification of patients who exhibit a maladaptive dipping phenomenon. However, modifiable (i.e., cigarette consumption) and unmodifiable (i.e., age) risk factors appear to mediate this relationship. Although further studies are necessary to explore this association, these results highlight that some aspects of anger can represent risk factors or markers of maladaptive modulation of the dipping phenomenon. different declinations of BP dipping may occur. In some individuals, an excessive reduction of BP (Extreme Dipping), or an increase of the BP trend after sleep onset (Reverse Dipping) may be reported. Earlier studies mainly focused on the absence of dipping, highlighting that a non-dipping pattern is a significant predictor of a range of organ damage and cardiovascular events [3,7,8]. The increase of cardiovascular risk associated with Non-Dipping seems to be due to the difficulty in physiological recovering from the typical demand-driven elevations of blood pressure during the waking hours of the day [9] and it is characterized by a disruption of the circadian rhythm of the autonomic balance [10]. Accordingly, some studies suggested that Non-Dippers have a high sympathetic nervous system activity during wake time [11][12][13] and a lower parasympathetic nervous system activity throughout the sleep period [13,14].However, the exact causes of Non-Dipping are not fully clarified [15][16][17], and genetic, biological, environmental, and sociodemogra...

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Alexithymia: A facet of uncontrolled hypertension

Cited by 26 publications

References 68 publications

Effects of Blood Pressure on Cognitive Performance: A Systematic Review

Effects of Blood Pressure on Cognitive Performance: A Systematic Review

Negative Affectivity Is Associated with a Higher Systolic and Diastolic Blood Pressure in Normotensive Middle-Aged and Older Adults: A Cross-Sectional Study

The Night Effect of Anger: Relationship with Nocturnal Blood Pressure Dipping

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