Blood Pressure in Nuns in a Secluded Order: A 30-Year Follow-Up

Abstract

The powerful effect of psychosocial and acculturating influences on population blood pressure trends seems to be confirmed, through longitudinal observations, in the nuns in a secluded order. After initial observations had been made on culture, body form, blood pressure, diet, and other variables in 144 nuns and 138 lay women, included as a control group, a 30-year follow-up study was undertaken. Most striking were opposite trends noted between the two groups in blood pressure trend. During the follow-up period, blood pressure remained remarkably stable among the nuns. None showed an increase in diastolic blood pressure over 90 mm Hg. By contrast, the control women showed the expected increase in blood pressure with age. This resulted in a gradually greater difference (δ>30/15 mm Hg) in systolic and diastolic blood pressure between the two groups, which was statistically significant. In addition, cardiovascular morbidity and mortality, expressed as the outcome of fatal and nonfatal events, were different in the two groups. They were significantly more common in the lay women than in the nuns. Comparisons between survivalcurves were statistically significant (p = 0.0043 for fatal events; p = 0.0056 for nonfatal events) between the two groups. In conclusion, it seems reasonable to attribute much of the difference in blood pressure and cardiovascular events, to the different burden in psychosocial factor and to the preserved peaceful lifestyle of the nuns.

Sympathetic Nerve Activity in Monozygotic Twins

“…This and other findings are also consistent with the idea of neural and behavioral mechanisms (Lawler et al, 1984;Li et al, 1997). The study by Timio also strongly suggests a neural genesis to hypertension in humans (Timio et al, 1988;Timio et al, 1999;Timio et al, 1999) and perhaps it is not the strength of the stimulus but rather its recurring nature that may be most important (Folkow, 1991), as is common in a modern urban environment.…”

“…It has been shown in a highly controlled study that moving from a rural area into an urban environment leads to increased BP levels, strongly indicating that increased stress is a major factor (Hollenberg et al, 1997). Furthermore, a 30 year follow up compared nuns living in a secluded order in northern Italy to a group of lay women from the neighboring area (Timio et al, 1988;Timio et al, 1997;Timio et al, 1999). Significant blood pressure differences were observed, again suggesting that the environment and the stress it brings is important.…”

Sympathetic Nerve Activity in Monozygotic Twins

“…This and other findings are also consistent with the idea of neural and behavioral mechanisms (Lawler et al, 1984;Li et al, 1997). The study by Timio also strongly suggests a neural genesis to hypertension in humans (Timio et al, 1988;Timio et al, 1999;Timio et al, 1999) and perhaps it is not the strength of the stimulus but rather its recurring nature that may be most important (Folkow, 1991), as is common in a modern urban environment.…”

“…It has been shown in a highly controlled study that moving from a rural area into an urban environment leads to increased BP levels, strongly indicating that increased stress is a major factor (Hollenberg et al, 1997). Furthermore, a 30 year follow up compared nuns living in a secluded order in northern Italy to a group of lay women from the neighboring area (Timio et al, 1988;Timio et al, 1997;Timio et al, 1999). Significant blood pressure differences were observed, again suggesting that the environment and the stress it brings is important.…”

No Socioeconomic Inequalities in Mortality among Catholic Monks: A Quasi-Experiment Providing Evidence for the Fundamental Cause Theory

“…Although we cannot rule out these processes of self-selection, at the same time, we find no good argument or empirical evidence that the low-SES monks should be more selective than the higher educated ones. By contrast, a study on female members of religious orders from a study by Timio et al (1999), which looked at medical conditions and health behaviors that could introduce bias when comparing the monastic and the general populations, found that nuns and the worldly women were similar in most of these conditions. More recent analyses of survey data on nuns and monks from Austria and Germany also found no evidence of strong selection effects in psychosocial characteristics, family background, and living conditions during childhood and adolescence that might bias our study (Bowen 2021; Krivanek and Wiedemann 2021).…”

Anxiety, Anger, Personality, and Heart Disease

“…Interestingly, the role of psychosocial stress on the pathogenesis of hypertension has been demonstrated by a 30-year follow-up study, finding that blood pressure remained remarkably stable in a group of nuns in Italy; conversely, the control group of laywomen showed the expected increase in blood pressure with age. Comparisons between survival curves were statistically significant between the two groups [68].…”

Sympathetic Nerve Activity in Monozygotic Twins

“…This and other findings are also consistent with the idea of neural and behavioral mechanisms (Lawler et al, 1984;Li et al, 1997). The study by Timio also strongly suggests a neural genesis to hypertension in humans (Timio et al, 1988;Timio et al, 1999;Timio et al, 1999) and perhaps it is not the strength of the stimulus but rather its recurring nature that may be most important (Folkow, 1991), as is common in a modern urban environment.…”

“…It has been shown in a highly controlled study that moving from a rural area into an urban environment leads to increased BP levels, strongly indicating that increased stress is a major factor (Hollenberg et al, 1997). Furthermore, a 30 year follow up compared nuns living in a secluded order in northern Italy to a group of lay women from the neighboring area (Timio et al, 1988;Timio et al, 1997;Timio et al, 1999). Significant blood pressure differences were observed, again suggesting that the environment and the stress it brings is important.…”

No Socioeconomic Inequalities in Mortality among Catholic Monks: A Quasi-Experiment Providing Evidence for the Fundamental Cause Theory

“…Although we cannot rule out these processes of self-selection, at the same time, we find no good argument or empirical evidence that the low-SES monks should be more selective than the higher educated ones. By contrast, a study on female members of religious orders from a study by Timio et al (1999), which looked at medical conditions and health behaviors that could introduce bias when comparing the monastic and the general populations, found that nuns and the worldly women were similar in most of these conditions. More recent analyses of survey data on nuns and monks from Austria and Germany also found no evidence of strong selection effects in psychosocial characteristics, family background, and living conditions during childhood and adolescence that might bias our study (Bowen 2021; Krivanek and Wiedemann 2021).…”

Anxiety, Anger, Personality, and Heart Disease

“…Interestingly, the role of psychosocial stress on the pathogenesis of hypertension has been demonstrated by a 30-year follow-up study, finding that blood pressure remained remarkably stable in a group of nuns in Italy; conversely, the control group of laywomen showed the expected increase in blood pressure with age. Comparisons between survival curves were statistically significant between the two groups [68].…”

Sympathetic Nerve Activity in Monozygotic Twins

“…This and other findings are also consistent with the idea of neural and behavioral mechanisms (Lawler et al, 1984;Li et al, 1997). The study by Timio also strongly suggests a neural genesis to hypertension in humans (Timio et al, 1988;Timio et al, 1999;Timio et al, 1999) and perhaps it is not the strength of the stimulus but rather its recurring nature that may be most important (Folkow, 1991), as is common in a modern urban environment.…”

“…It has been shown in a highly controlled study that moving from a rural area into an urban environment leads to increased BP levels, strongly indicating that increased stress is a major factor (Hollenberg et al, 1997). Furthermore, a 30 year follow up compared nuns living in a secluded order in northern Italy to a group of lay women from the neighboring area (Timio et al, 1988;Timio et al, 1997;Timio et al, 1999). Significant blood pressure differences were observed, again suggesting that the environment and the stress it brings is important.…”

No Socioeconomic Inequalities in Mortality among Catholic Monks: A Quasi-Experiment Providing Evidence for the Fundamental Cause Theory

“…Although we cannot rule out these processes of self-selection, at the same time, we find no good argument or empirical evidence that the low-SES monks should be more selective than the higher educated ones. By contrast, a study on female members of religious orders from a study by Timio et al (1999), which looked at medical conditions and health behaviors that could introduce bias when comparing the monastic and the general populations, found that nuns and the worldly women were similar in most of these conditions. More recent analyses of survey data on nuns and monks from Austria and Germany also found no evidence of strong selection effects in psychosocial characteristics, family background, and living conditions during childhood and adolescence that might bias our study (Bowen 2021; Krivanek and Wiedemann 2021).…”

Anxiety, Anger, Personality, and Heart Disease

“…Interestingly, the role of psychosocial stress on the pathogenesis of hypertension has been demonstrated by a 30-year follow-up study, finding that blood pressure remained remarkably stable in a group of nuns in Italy; conversely, the control group of laywomen showed the expected increase in blood pressure with age. Comparisons between survival curves were statistically significant between the two groups [68].…”