Introversion associated with large differences between screening blood pressure and home blood pressure measurement: the Ohasama study

Hozawa, Atsushi; Obara, Taku; Metoki, Hirohito; Kikuya, Masahiro; Asayama, Kei; Totsune, Kazuhito; Hashimoto, Junichiro; Hoshi, Hiroyuki; Arai, Yasuhiko; Satoh, Hiroshi; Hosokawa, Toru; Imai, Yutaka

doi:10.1097/01.hjh.0000249695.81241.35

Cited by 20 publications

(11 citation statements)

References 25 publications

(33 reference statements)

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“…Anxiety and other forms of psychological distress, however, may have greater effects among those taking antihypertensive medications or who are otherwise aware of their hypertensive status [8, 9]. Apart from anxiety, studies of anger [10], depression [11–13], and other neuroticism-related constructs [14, 15] have found inconsistent evidence for associations with the white coat effect. There has been comparatively less research on the role of other personality dispositions.…”

Section: Introductionmentioning

confidence: 99%

“…There has been comparatively less research on the role of other personality dispositions. Among the few exceptions is a Japanese study that compared clinical screenings to home BP measurements in 666 individuals [15]. They found no associations with neuroticism, but introverted participants had a larger difference between the screening and the home systolic BPs.…”

Section: Introductionmentioning

confidence: 99%

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Are personality traits associated with white-coat and masked hypertension?

Terracciano

Scuteri

Strait

et al. 2014

Journal of Hypertension

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Objectives Anxiety and other psychological dispositions are thought to be associated with blood pressure. This study tests whether personality traits have long-term associations with masked and white coat effects. Methods A community-based sample of 2,838 adults from Sardinia (Italy) completed the Revised NEO Personality Inventory and seven years later blood pressure was assessed in the clinic and with ambulatory monitoring. Logistic regressions were used to test whether anxiety, neuroticism, extraversion, openness, agreeableness, and conscientiousness predicted the white coat and masked hypertension phenomena. Age, sex, and antihypertensive medication use were tested as moderators. Results Significant interactions were found between personality traits and antihypertensive medications in predicting masked and white coat effects. Only among those taking antihypertensive medication, higher anxiety was associated with a higher risk of pseudo-resistant hypertension due to white coat effect (OR = 1.39, 95%CI = 1.01–1.91) and higher conscientiousness was associated with a lower risk of masked uncontrolled hypertension (OR = 0.70, 95%CI = 0.49–0.99). There were no significant interactions with age or sex. Conclusions Among those on antihypertensive medications, anxious individuals were more likely to have pseudo-resistant hypertension due to white coat effect and less conscientious individuals were at increased risk of masked uncontrolled hypertension. Particularly among anxious and less conscientious individuals, ambulatory monitoring may improve the tailoring of pharmacological treatments.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Are personality traits associated with white-coat and masked hypertension?

Terracciano

Scuteri

Strait

et al. 2014

Journal of Hypertension

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“…Personality traits are also considered to be an important factor in functional decline risk. Several studies have reported that personality traits such as neuroticism, extraversion, anger, and hostility are significant predictors of mortality, and clinical health outcomes (Almada et al 1991;Wilson et al 2005;Hozawa et al 2006;Shipley et al 2007). Particularly in elderly populations, it has been hypothesized that these traits may affect subsequent physical health outcomes and mortality (Duberstein et al 2003;Wilson et al 2005;Krueger et al 2006;Hampson et al 2007).…”

Section: Introductionmentioning

confidence: 99%

Personality Traits as Predictors of Decline in Higher-Level Functional Capacity over a 7-Year Follow-Up in Older Adults: The Ohasama Study

Tsubota‐Utsugi¹,

Satoh

Miki

et al. 2014

Tohoku J. Exp. Med.

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Numerous factors that affect functional decline have been identified, and personality traits are considered to be an important factor in functional decline risk. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG) was developed to measure three higher-level functional capacities, instrumental activities of daily living, intellectual activity, and social roles, in Japanese elderly, which were previously not assessed adequately with existing scales of functional decline. The objective of this study was to explore the effect of personality traits as predictors of higher-level functional decline over a 7-year follow-up in a rural Japanese community. Data on 676 participants (mean 67.1 years) who were free of functional decline and had completed questionnaires at baseline and 7 years later, were analyzed. Demographic characteristics, lifestyle and personality characteristics were obtained from a self-administered questionnaire at baseline. Higher-level functional decline was examined using the subscales of the TMIG at baseline and at a 7-year follow-up examination. Over the 7-year study period, 21.7% of eligible participants reported decline in higher-level functional capacity. After adjustment for putative confounding factors, the traits that were significant predictors of decline in higher-level functional capacity at the 7-year follow-up had higher psychoticism scores [odds ratio (95% confidence interval) 2.12 (1.23-3.66)] and lower extraversion scores [1.89 (1.01-3.56)]. The personality traits of higher psychoticism and lower extraversion were significantly associated with a risk of future functional decline. A better understanding of these personality traits may help identify of at-risk individuals and could help reduce functional decline in older adults.

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“…Our clinical experience is that the white coat effect seems to be prominent in shy and rather self-conscious patients, where the uncomfortable nature of the consultation with the patient drawn towards centre stage is the trigger for the blood pressure elevation. Data from a recent Japanese study supports this observation [9]. Hozawa et al found that white coat reactors scored low on the Eysenck extroversion scale (high introversion).…”

Section: Relation Of Psychological Stress To the Development Of Hypermentioning

confidence: 70%

Psychological Stress and the Development of Heart Disease

Lambert

Dawood

Esler

et al. 2007

CPSR

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Until recently it was thought that no more than 50% of clinical coronary heart disease was explicable in terms of classical cardiac risk factors such as dyslipidemia, cigarette smoking, high blood pressure and diabetes. Recent large scale epidemiological studies have increased our understanding of the mechanisms generating cardiac risk and have provided evidence indicating that psychosocial factors, including stress at work and at home, financial stress, recent major life events and the presence of depressive illness are involved here, "triggering" clinical cardiovascular events, and possibly also contributing to hypertension and atherosclerosis development. The underlying mechanisms in play are most likely multi factorial in origin, involving the autonomic nervous system, platelet activation, thrombogenesis and endothelial dysfunction. Given that strategies for preventive therapy remain largely unformulated, future research should focus on generating a better understanding of the neurobiology of psychogenic heart disease as a basis for rational and effective therapy.

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Introversion associated with large differences between screening blood pressure and home blood pressure measurement: the Ohasama study

Abstract: Physicians may need to be aware of 'introverted' patients who have high blood pressure in clinic settings, because they have the potential for 'white-coat' hypertension.

Cited by 20 publications

References 25 publications

Are personality traits associated with white-coat and masked hypertension?

Are personality traits associated with white-coat and masked hypertension?

Personality Traits as Predictors of Decline in Higher-Level Functional Capacity over a 7-Year Follow-Up in Older Adults: The Ohasama Study

Psychological Stress and the Development of Heart Disease

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