Psychologic Differences Between High-, Normal-, and Low-Ren in Hypertensives

Thailer, Sheryl A.; Friedman, Richard A.; Harshfield, Gregory A.; Pickering, Thomas G.

doi:10.1097/00006842-198505000-00007

Cited by 24 publications

(7 citation statements)

References 4 publications

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“…These results may be due to conceptualizing hypertension as a homogeneous condition. According to Thailer et al (1985), essential hypertension may be a heterogeneous condition. Possible differences among the borderline hypertension group therefore may have been obscured by clustering all these men into a single group.…”

Section: Discussionmentioning

confidence: 99%

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Self‐disclosure and coping styles in men with cardiovascular reactivity

Hahn

Brooks

Hartsough

1993

Research in Nursing & Health

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The purpose of this study was to investigate self-disclosure, emotion-focused, and problem-focused coping styles among men with borderline hypertension and two groups of normotensive men differentiated by parental hypertension. Because blood pressure reactivity may discriminate between hypertensive and normotensive men, subjects in these three groups were categorized as high or low cardiovascular reactors based on their blood pressure response to a mental arithmetic task. Self-disclosure and coping styles were investigated in relation to status effects within the doctor-patient relationship. Men with exaggerated blood pressure reactivity were less self-disclosive and used fewer emotion-focused coping strategies than men with no blood pressure reactivity. Normotensives with a history of parental hypertension were less self-disclosive than normotensives without a history of parental hypertension.

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Section: Discussionmentioning

confidence: 99%

“…Evidence from the psychophysiological literature suggests another explanation. Essential hypertension may be a heterogeneous condition (Thailer, Friedman, Harshfield, & Pickering, 1985), and the inconsistencies in the selfdisclosure studies may be due to failure to differentiate among different types of hypertension.…”

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confidence: 99%

Self‐disclosure and coping styles in men with cardiovascular reactivity

Hahn

Brooks

Hartsough

1993

Research in Nursing & Health

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“…This could be explained if FR subjects tended to have "inhibitory personalities," that is, if an attitude of cautious vigilance characterized their approach to interpersonal encounters (including, perhaps, basal BP assessment!). Symptoms of submissiveness, sensitivity, anxiety, and paranoia documented in hypertensive adults suggest that this is possible (37,38). Assessment of interpersonal behavior, personality and possibly dietary sodium sensitivity (39) might provide a model for the chronic persistence of inhibition-like effects.…”

Section: Discussionmentioning

confidence: 99%

Diminished pulse pressure under mental stress characterizes normotensive adolescents with parental high blood pressure.

Ewart¹,

Harris²,

Zeger³

et al. 1986

Psychosomatic Medicine

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An exaggerated blood pressure response to mental stress is believed to characterize young adults with genetic risk of essential hypertension, suggesting that stress-induced changes might provide a useful index of pathogenetic processes. We explored this by studying pressor responsivity to competitive tasks in adolescents drawn from a large urban population. Individuals with systolic or diastolic pressures persistently between the 85th and 95th percentiles were evaluated on basal blood pressure, parental history of hypertension, and pressor and heart rate response to a challenging video game. Basal pressure was measured again at 6, 10, and 14 months. A persistently diminished pulse pressure was the cardiovascular characteristic that most reliably typified normotensive subjects with familial hypertension. Response to the video game was the best indicator of risk status. Contrary to expectations derived from research with convenience samples, epidemiologic investigation points to an increased peripheral resistance and lower cardiac output as the cardiovascular pattern more prominently associated with genetic risk in the normotensive adolescent.

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“…Suppressed feelings, anger and hostility, 2-5 alexithymia, 6 anxiety, 4 -5,7-9 depression, 9 job strain, 10 stressful work conditions, 11 and psychosocial stress 12,13 are the most common factors associated with elevated blood pressure. Some studies on suppressed hostility 3,5 and increased anxiety 14 as possible psychosomatic mechanisms in hypertension suggest that they may have a role in the development of mild high-renin essential hypertension. Prospective studies support the view that suppressed feelings 2 and especially suppressed anger 5 are of importance in predicting blood pressure rise with age, whereas others do not find any association between anger behavior and change in blood pressure over time.…”

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confidence: 99%

Alexithymia

Jula

Salminen²,

Saarijärvi³

1999

Hypertension

127

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Abstract-Two hundred thirty-seven newly diagnosed yet untreated hypertensive men and women, 35 to 54 years of age, were compared with an age-and gender-stratified random population sample of 146 normotensive men and women to find out whether psychological distress symptoms, anger expression, and alexithymia are associated with elevated blood pressure and whether the possible associations are independent of sodium and alcohol intake, body mass index, and physical fitness. The independent attributes of mean arterial pressure were studied by multivariate regression analyses after combining the subjects in the hypertensive and control groups. Three questionnaires were used: the Brief Symptom Inventory (BSI-37), a 31-item version of the Spielberger State-Trait Anger Expression Inventory (STAXI), and the Toronto Alexithymia Scale (TAS-26).Total scores of the TAS-26 were higher (PϽ0.001) in hypertensive men and women than in their normotensive control subjects (75.6Ϯ7.8 vs 64.1Ϯ9.8 in men and 72.9Ϯ7.1 vs 57.5Ϯ11.5 in women). There were no differences between the study and control groups in psychological distress symptoms, including anxiety, depression, and hostility, or in anger expression.In multivariate regression analyses, higher age, male gender, higher sodium intake, lower physical fitness, and alexithymia were independently and highly significantly (PϽ0.01 for male gender, PϽ0.0001 for other variables) associated with increased blood pressure, explaining altogether 39.5% of the cross-sectional variation in mean arterial pressure. We conclude that alexithymia, that is, poor ability to experience and express emotions, is associated with elevated blood pressure independent of sodium and alcohol intake, body mass index, and physical fitness. (Hypertension. 1999;33:1057-1061.)Key Words: hypertension, essential Ⅲ alexithymia Ⅲ sodium Ⅲ alcohol Ⅲ body mass index Ⅲ physical fitness Ⅲ stress, psychological P sychological factors can raise blood pressure acutely, but whether they lead to development of essential hypertension, as stated by Alexander 1 in his early psychosomatic hypothesis, is not known. The hypothesis has been addressed in many crosssectional studies and in a small number of prospective studies. Suppressed feelings, anger and hostility, 2-5 alexithymia, 6 anxiety, 4 -5,7-9 depression, 9 job strain, 10 stressful work conditions, 11 and psychosocial stress 12,13 are the most common factors associated with elevated blood pressure. Some studies on suppressed hostility 3,5 and increased anxiety 14 as possible psychosomatic mechanisms in hypertension suggest that they may have a role in the development of mild high-renin essential hypertension. Prospective studies support the view that suppressed feelings 2 and especially suppressed anger 5 are of importance in predicting blood pressure rise with age, whereas others do not find any association between anger behavior and change in blood pressure over time. 4,7,8,15 Several studies suggest that high anxiety levels predict later incidence of hypertension, at least i...

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Psychologic Differences Between High-, Normal-, and Low-Ren in Hypertensives

Cited by 24 publications

References 4 publications

Self‐disclosure and coping styles in men with cardiovascular reactivity

Self‐disclosure and coping styles in men with cardiovascular reactivity

Diminished pulse pressure under mental stress characterizes normotensive adolescents with parental high blood pressure.

Alexithymia

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