Advertisement

Psychological Factors in Hypertension Development and Treatment

  • T. Rutledge

Abstract

This chapter begins with the ambitious aim of reviewing the evidence for psychosocial factors in the development and treatment of hypertension. The literature base is now nearly a century old, and comprises well over a thousand empirical and narrative manuscripts. The methodologies employed, psychological constructs of interest, and theoretical underpinnings in this research are many and varied, reflecting the numerous trends and cultural zeitgeists of the previous decades. At the time of this writing, the relationship between psychological factors and hypertension is a topic of growing interest, spurred by recent reviews and the continuing influx of prospective data from several large US-based cohort studies [1]–[4]. It is not the purpose of this paper to comprehensively review this extensive database. Rather, the intention is to provide a) an overview of the primary theories, methods of study and evidence for emotional factors in hypertension, with an emphasis on recent findings; b) a review of the multiple behavioral and physiological mechanisms proposed by researchers to bridge the association between psychological characteristics and blood pressure regulation, and c) a discussion of the evidence and implications for the treatment of psychological factors among patients with current or elevated risk for hypertension.

Keywords

Psychological Factor Cardiovascular Reactivity Behavioral Risk Factor Hypertension Risk Vital Exhaustion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Gerin W, Pickering TG, Glynn L et al (2000) An historical context for behavioral models of hypertension. J Psychosom Res 48:369–377CrossRefPubMedGoogle Scholar
  2. 2.
    Jorgensen R S, Johnson B T, Kolodziej ME, Scheer GE (1996) Elevated blood pressure and personality: A meta-analytic review. Psychol Bull 120:293–320CrossRefPubMedGoogle Scholar
  3. 3.
    Steptoe A (2000) Psychosocial factors in the development of hypertension. Ann Behav Med 32:371–375Google Scholar
  4. 4.
    Yan LL, Lio K, Matthews KA, Daviglus ML et al (2003) Psychosocial factors and risk of hypertension. JAMA 290:2138–2148CrossRefPubMedGoogle Scholar
  5. 5.
    Chobanian AV, Bakris GL, Black HR et al (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 report. JAMA 289:3560–3572CrossRefGoogle Scholar
  6. 6.
    Wolf-Maier K, Cooper RS, Banegas JR et al (2003) Hypertension prevalence and blood pressure levels in 6 European countries, Canada, and the United States. JAMA 289:2363–2369CrossRefPubMedGoogle Scholar
  7. 7.
    Hajjar I, Kotchen TA (2003) Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA 290:199–206CrossRefPubMedGoogle Scholar
  8. 8.
    Cote I, Gregoire JP, Moisan J (2000) Health-related quality-of-life measurement in hypertension. A review of randomised controlled drug trials. Pharmacoeconomics 18:435–450CrossRefPubMedGoogle Scholar
  9. 9.
    Irvine MJ, Garner DM, Olmstead MP, Logan AG (1989) Personality differences between hypertensive and normotensive individuals: influence on knowledge of hypertension status. Psychosom Med 51:537–549PubMedGoogle Scholar
  10. 10.
    Diamond EL (1982) The role of anger and hostility in essential hypertension. Psychol Bull 92:410–433CrossRefPubMedGoogle Scholar
  11. 11.
    Rutledge T, Hogan BE (2002) A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosomatic Medicine 64:758–766CrossRefPubMedGoogle Scholar
  12. 12.
    Davidson K, Jonas BS, Dixon KE, Markovitz JH (2000) Do depression symptoms predict early hypertension incidence in young adults in the CARDIA study? Arch Intern Med 160:1495–1500CrossRefPubMedGoogle Scholar
  13. 13.
    Everson SA, Kaplan GA, Goldberg DE, Salonen JT (2000) Hypertension incidence is predicted by high levels of hopelessness in Finnish men. Hypertension 35:561–567PubMedGoogle Scholar
  14. 14.
    Jonas BS, Franks P, Ingram DD (1997) Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I epidemiologic follow-up study. Arch Fam Med 6:43–49CrossRefPubMedGoogle Scholar
  15. 15.
    Kopp MS, Falger PR, Appels A, Szedmak S (1998) Depressive symptomatology and vital exhaustion are differentially related to behavioral risk factors for coronary artery disease. Psychosom Med 60:752–758PubMedGoogle Scholar
  16. 16.
    Brownley KA, Hurwitz BE, Schneiderman N (1999) Ethnic variations in the pharmacological and nonpharmacological treatment of hypertension: biopsychosocial perspective. Hum Biol 71:607–639PubMedGoogle Scholar
  17. 17.
    Rosenthal R, Rubin DB (1979) A note on percent variance explained as a measure of the importance of effects. J App Soc Psychol 9:395–396CrossRefGoogle Scholar
  18. 18.
    Schmidt FL (1996) Statistical significance testing and cumulative knowledge in psychology: implications for training of researchers. Psychol Method 2:115–129CrossRefGoogle Scholar
  19. 19.
    Rosenthal R, Rosnow RL, Rubin DB (2000) Contrasts and effect sizes in behavioral research: A correlational approach. New York, NY: Cambridge University PressGoogle Scholar
  20. 20.
    Willenheimer R (2001) Statistical significance versus clinical relevance in cardiovascular medicine. Prog Cardiovasc Dis 44:155–167CrossRefPubMedGoogle Scholar
  21. 21.
    Abelson RP (1985) A variance explanation paradox: When a little is a lot. Psychol Bull 97:129–133CrossRefGoogle Scholar
  22. 22.
    Greenland S, Schlesselman JJ, Criqui MH (1986) The fallacy of employing standardized regression coefficient and correlations as measures of effect. Am J Epidemiol 123:203–208PubMedGoogle Scholar
  23. 23.
    Baron R M, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51:1173–1182CrossRefPubMedGoogle Scholar
  24. 24.
    Holmbeck GN (1997) Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. J Consult Clin Psychol 65:599–610CrossRefPubMedGoogle Scholar
  25. 25.
    Everson S, Kauhanen J, Kaplan G et al (1997) Hostility and risk of mortality and acute myocardial infarction: the mediating role of behavioral risk factors. Am J Epidemiol 146:142–152PubMedGoogle Scholar
  26. 26.
    Rutledge T, Reis SE, Olson M et al (2001) Psychosocial variables are associated with atherosclerosis risk factors among women with chest pain: the WISE study. Psychosom Med 63:282–288PubMedGoogle Scholar
  27. 27.
    Sielger IC, Peterson BL, Barefoot JC, Williams RB (1992) Hostility during late adolescence predicts coronary risk factors at mid-life. Am J Epidemiol 136:146–154Google Scholar
  28. 28.
    McDermott MM, Schmitt B, Wallner E (1997) Impact of medication nonadherence on coronary heart disease outcomes. Arch Intern Med 157:1921–1929CrossRefPubMedGoogle Scholar
  29. 29.
    Glassman AH, Covey LS, Stetner F, Rivelli S (2001) Smoking cessation and the course of major depression: a follow-up study. Lancet 16:1929–1932CrossRefGoogle Scholar
  30. 30.
    Wang PS, Bohn RL, Knight E et al (2002) Noncompliance with antihypertensive medications: the impact of depressive symptoms and psychosocial factors. J Gen Intern Med 17:504–511CrossRefPubMedGoogle Scholar
  31. 31.
    Zigelstein RC, Bush DE, Fauerbach J (1998) Depression, adherence behavior, and coronary disease outcomes. Arch Intern Med 158:808–809CrossRefGoogle Scholar
  32. 32.
    Frasure-Smith N, Lesperance F, Talajic M (1995) The impact of negative emotions on prognosis following myocardial infarction: is it more than depression? Health Psychol 14:388–398CrossRefPubMedGoogle Scholar
  33. 33.
    Kamarck T, Jennings JR (1991) Biobehavioral factors in sudden cardiac death. Psychol Bull 109:42–75CrossRefPubMedGoogle Scholar
  34. 34.
    Rozanski A, Blumenthal JA, Kaplan J (1999) Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 99:2192–2217PubMedGoogle Scholar
  35. 35.
    Williams JE, Nieto FJ, Sanford CP et al (2002) The association between trait anger and incident stroke risk: the Atherosclerosis Risk in Communities (ARIC) Study. Stroke 33:13–19CrossRefPubMedGoogle Scholar
  36. 36.
    Lovallo WR, Gerin W (2003) Psychophysiological reactivity: Mechanisms and pathways to cardiovascular disease. Psychosom Med 65:36–45CrossRefPubMedGoogle Scholar
  37. 37.
    Schwartz AR, Gerin W, Davidson KW et al (2003) Toward a casual model of cardiovascular responses to stress and the development of cardiovascular disease. Psychosom Med 65:22–35CrossRefPubMedGoogle Scholar
  38. 38.
    Kamarck T, Lovallo WR (2003) Cardiovascular reactivity to psychological challenge: Conceptual and measurement considerations. Psychosom Med 65:9–21CrossRefPubMedGoogle Scholar
  39. 39.
    Knox SS, Hausdorff J, Markovitz JH (2002) Coronary Artery Risk Development in Young Adults Study. Reactivity as a predictor of subsequent blood pressure: racial differences in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Hypertension 40:914–919CrossRefPubMedGoogle Scholar
  40. 40.
    Matthews KA, Salomon K, Brady SS, Allen MT (2003) Cardiovascular reactivity to stress predicts future blood pressure in adolescence. Psychosom Med 65: 410–415CrossRefPubMedGoogle Scholar
  41. 41.
    Kaplan JR, Manuck SS, Clarkson TB et al (1983) Social stress and atherosclerosis in normocholesterolemic monkeys. Science 220:733–735CrossRefPubMedGoogle Scholar
  42. 42.
    Kaplan JR, Manuck SB, Adams MR et al (1987) Inhibition of coronary atherosclerosis by propranolol in behaviorally predisposed monkeys fed an atherogenic diet. Circulation 76:1365–1372Google Scholar
  43. 43.
    Rutledge T, Linden W (2003) Defensiveness and prospective blood pressure increases: the mediating effect of cardiovascular reactivity. Ann Behav Med 25:34–40CrossRefPubMedGoogle Scholar
  44. 44.
    Allen K, Blascovich J, Mendes WB (2002) Cardiovascular reactivity and the presence of pets, friends, and spouses: the truth about cats and dogs. Psychosom Med 64:727–739CrossRefPubMedGoogle Scholar
  45. 45.
    Karlin WA, Brondolo E, Schwartz J (2003) Workplace social support and ambulatory cardiovascular activity in New York city traffic agents. Psychosom Med 65:167–176CrossRefPubMedGoogle Scholar
  46. 46.
    Kamarck TW, Janicki DL, Shiffman S et al (2002) Psychosocial demands and ambulatory blood pressure: a field assessment approach. Physiol Behav 77:699–704CrossRefPubMedGoogle Scholar
  47. 47.
    Fauvel JP, M’Pio I, Quelin P et al (2003) Neither perceived job stress nor individual cardiovascular reactivity predict high blood pressure. Hypertension (in press)Google Scholar
  48. 48.
    Appel LJ, Champagne CM, Harsha DW et al (2003) Writing Group of the PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on blood pressure control: main results of the PREMIER clinical trial. JAMA 289:2083–2093CrossRefPubMedGoogle Scholar
  49. 49.
    Jacob RG, Chesney MA, Williams DM et al (1991) Relaxation therapy for hypertension: design effects and treatment effects. Ann Behav Med 13:5–17Google Scholar
  50. 50.
    Linden W (1988) Biopsychological barriers to the behavioral treatment of essential hypertension. In: Linden W (Ed) Biological Barriers in Behavioral Medicine. New York, NY: Plenum Press 163–192Google Scholar
  51. 51.
    Linden W, Chambers LA (1994) Clinical effectiveness of non-drug therapies for hypertension: a meta-analysis. Ann Behav Med 16:35–45Google Scholar
  52. 52.
    Batey DM, Kaufmann PG, Raczynski JM et al (2000) Stress management intervention for primary prevention of hypertension: detailed results from Phase I of Trials of Hypertension Prevention (TOHP-I). Ann Epidemiol 10:45–58CrossRefPubMedGoogle Scholar
  53. 53.
    Linden W, Lenz JW, Con AH (2001) Individualized stress management for primary hypertension. Arch Intern Med 161:1071–1080CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2006

Authors and Affiliations

  • T. Rutledge
    • 1
  1. 1.Department of PsychiatryUniversity of California - San DiegoSan DiegoUSA

Personalised recommendations