Psychological Factors Associated with Poor Hypertension Control: Differences in Personality and Stress between Patients with Controlled and Uncontrolled Hypertension

Abstract

Only one-third of patients with hypertension under pharmacological treatment achieve the recommended blood pressure goals. Psychological factors could partially account for poor hypertension control through the existence of personality traits related to treatment compliance (e.g., self-discipline, deliberation, impulsiveness), and the fact that stress and some personality traits (e.g., anxiety, depression, anger expression, Type A) are involved in the etiology of some hypertension cases. This study was aimed at examining the differences in personality and stress between patients taking antihypertensive medications with controlled and uncontrolled hypertension. Results revealed that after controlling sex, age, and traditional variables associated with poor hypertension control, the uncontrolled hypertension group showed higher scores on impulsiveness, depression, anger expression-out, and stress, with differences ranging between medium and large (Hedges' g effect size = 0.77 to 1.08). These results support the hypothesized relationship between psychological factors and poor hypertension control.

Depression is linked to uncontrolled hypertension: a case–control study from Karachi, Pakistan

“…Patients with uncontrolled hypertension showed higher scores on impulsiveness, depression, anger expression-out and stress (Sanz et al, 2010). Association of hypertension control and panic attacks has also been reported but suggesting that hypertension is a risk factor for panic attacks (Davies et al, 1999).…”

“…There has been a report that has highlighted on the relationship of uncontrolled hypertension and depression. This report concluded that uncontrolled hypertension group showed higher scores on impulsiveness, depression, anger expression-out and stress (Sanz et al, 2010). In a study conducted on 31 495 adults, the risk of CVD death was highest in participants with uncontrolled hypertension and common mental disorder (Hamer et al, 2010).…”

Pathogenetic relationship between personality traits and mental derangement with coronary heart disease

“…Установлено, что пациенты с депрессией хуже придерживаются назначен-ной терапии [22]. Исследование по изучению степени контроля АД показало, что пациентам с высокими балла-ми по шкалам депрессия, гнев, импульсивность и стресс не удается должным образом контролировать артериаль-ную гипертензию (АГ) [114].…”

“Consumo De Alimentos Restringidos” en Pacientes Hipertensos Mexicanos: Un Análisis De Trayectoria

“…En efecto, si se reconoce que la HTA contribuye hasta en un 40% al desarrollo de las enfermedades isquémica del corazón y cerebro-vasculares (4), para procurar su control se requiere algo más que la atención y los cuidados médicos que se proveen en el primero de aquellos ámbitos. Es necesario, también, tener en cuenta diversos factores psicológicos e interpersonales que se ha demostrado participan decisivamente en la práctica de las conductas de adhesión a los tratamientos y las relacionadas con el cuidado de la salud: i.e., toma de los medicamentos, medición de la presión arterial, realización de ejercicio físico dosificado y adopción de hábitos alimenticios salutogénicos (5,6).…”