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Sanz J, García‐Vera MP, Magán I, Espinosa R, Fortún M. Differences in personality between sustained hypertension, isolated clinic hypertension and normotension. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.605] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of this study was to determine whether there are differences in personality between hypertension and normotension. Forty‐two male patients with essential hypertension were divided into two groups after self‐assessment of blood pressure, 18 with sustained hypertension and 24 with isolated clinic (white coat) hypertension, and were compared with 25 men with normotension on Spielberger's State‐Trait Anxiety Inventory and the Jenkins Activity Survey. In line with hypotheses, the sustained hypertensive group showed higher levels of trait anxiety, Type A behaviour pattern, and hard‐driving behaviours/competitiveness than the normotensive group, whereas isolated clinic hypertensives occupied an intermediate position between those two groups. Results provide support to the hypothesised relationship between personality and hypertension and stress the need of distinguishing sustained hypertension from isolated clinic hypertension. Copyright © 2006 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jesús Sanz
- Department of Clinical Psychology, Universidad Complutense de Madrid, Spain
| | | | - Inés Magán
- Department of Clinical Psychology, Universidad Complutense de Madrid, Spain
| | - Regina Espinosa
- Department of Clinical Psychology, Universidad Complutense de Madrid, Spain
| | - María Fortún
- Department of Clinical Psychology, Universidad Complutense de Madrid, Spain
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Coll-de-Tuero G, Saez M, Rodriguez-Poncelas A, Bayó-Llibre J, Beltran-Vilella M, Reyes-Negre C, Dalfó-Baqué A, Barceló M. What is the optimal cut-off threshold in self-home blood pressure measurement?: A cohort study according to STROBE statement. Medicine (Baltimore) 2019; 98:e14817. [PMID: 30855506 PMCID: PMC6417491 DOI: 10.1097/md.0000000000014817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Two aspects arise concerning the use of self-measured blood pressure monitoring to diagnose white-coat hypertension (WCH): the presence of target organ damage (TOD) and the normal cut-off threshold. This study aims to evaluate the cardiovascular risk of WCH according to different self-measured blood pressure normal cut-off thresholds and the influence of TOD at baseline.In all, 678 patients were followed for 6.2 years; 223 normotensive patients, 271 patients with sustained hypertension (HT), and 184 with WCH. TOD was defined as: left ventricular hypertrophy according to ECG, albuminuria, or low estimated glomerular filtration rate. The risk for different cutting points of self-measured blood pressure (<135/85 mm Hg, <130/85 mm Hg, and <130/80 mm Hg) has been determined.The patients with HT experienced an increase in cardiovascular risk and death higher than the normotensive patients (odds ratio [OR] 7.9, 95% confidence interval [CI] 3.8-16.2 for sustained HT; and OR 3.5, 95% CI 1.6-7.4 for WCH). This was observed for all the cut-off thresholds analyzed. In white-coat hypertensive patients (cut-off <135/85 mm Hg) with TOD, the risk was higher than in normotensive patients (OR 4.5; 95% CI 1.9-10.6). Using a self-monitoring blood pressure cut-off threshold of <130/80 mm Hg without TOD at baseline, the WCH cases exhibited no differences in risk to the normotensive patients (OR 2.0, 95% CI 0.5-7.7).The decisions being taken for patients with WCH based on the presence of TOD and a self-administered home monitoring blood pressure measurement cut-off point probably lower than the one that is currently recommended.
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Affiliation(s)
- Gabriel Coll-de-Tuero
- METHARISC Group, USR Girona, IdIAP Gol i Gorina
- Department of Medical Sciences, University of Girona
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | | | | | | | | | - MªAntonia Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Jurko A, Minarik M, Jurko T, Tonhajzerova I. White coat hypertension in pediatrics. Ital J Pediatr 2016; 42:4. [PMID: 26786497 PMCID: PMC4717664 DOI: 10.1186/s13052-016-0213-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/10/2016] [Indexed: 02/07/2023] Open
Abstract
The article summarizes current information on blood pressure changes in children during clinic visit. White coat as a general dressing of physicians and health care personnel has been widely accepted at the end of the 19th century. Two problems can be associated with the use of white coat: white coat phenomenon and white coat hypertension. Children often attribute pain and other unpleasant experience to the white coat and refuse afterwards cooperation with examinations. Definition of white coat hypertension in the literature is not uniform. It has been defined as elevated blood pressure in the hospital or clinic with normal blood pressure at home measured during the day by ambulatory blood pressure monitoring system. White coat effect is defined as temporary increase in blood pressure before and during visit in the clinic, regardless what the average daily ambulatory blood pressure values are. Clinical importance of white coat hypertension is mainly because of higher risk for cardiovascular accidents that are dependent on end organ damage (heart, vessels, kidney). Current data do not allow any clear recommendations for the treatment. Pharmacological therapy is usually started in the presence of hypertrophic left ventricle, changes in intimal/medial wall thickness of carotic arteries, microalbuminuria and other cardiovascular risk factors. Nonpharmacological therapy is less controversial and certainly more appropriate. Patients have to change their life style, need to eliminate as much cardiovascular risk factors as possible and sustain a regular blood pressure monitoring.
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Affiliation(s)
- Alexander Jurko
- Pediatric Cardiology Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 03601, Martin, Slovak Republic.
| | - Milan Minarik
- Faculty of Health Care, Catholic University in Ruzomberok, Ruzomberok, Slovak Republic.
| | - Tomas Jurko
- Department of Neonatology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
| | - Ingrid Tonhajzerova
- Department of Physiology and Martin Centre for Biomedicine (BioMed), Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
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Abstract
In the USA, hypertension affects one in three adults, and anxiety disorders are the most commonly diagnosed mental health disorders. Both hypertension and anxiety have been studied extensively. Yet, a full understanding of anxiety's relationship to hypertension has been elusive. In this review, we discuss the spectrum of anxiety disorders. In addition, we consider the evidence for acute and long-term effects of anxiety on blood pressure. We review the effect on blood pressure of several "real-world" stressors, such as natural disasters. In addition, we review the effect of anxiety treatments on blood pressure. We explain the American Heart Association's recent recommendations regarding meditation and other relaxation methods in the management of hypertension. We conclude that novel research methods are needed in order to better elucidate many aspects of how anxiety relates to hypertension.
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Affiliation(s)
- James Brian Byrd
- Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, 20-209 W, 2800 Plymouth Road, Ann Arbor, MI, 48109-2800, USA,
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Differences in emotional personality traits and stress between sustained hypertension and normotension. Hypertens Res 2010; 33:203-8. [PMID: 20057490 DOI: 10.1038/hr.2009.210] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study was aimed at determining whether there are differences in emotional personality traits and psychosocial stress between hypertension and normotension. From a large community sample of adults, 14 individuals having hypertension and showing clinic blood pressures (BP) >or=140/90 mm Hg and self-measured BPs >or=135/85 mm Hg (sustained hypertensives) were selected and compared with a sex- and age-matched group of 14 individuals with normotension (clinic BPs <140/90 mm Hg and self-measured BPs <135/85 mm Hg) on measures of trait anxiety, trait depression, trait anger and stress derived from standardized questionnaires. There were no significant differences between hypertensives and normotensives on trait anger, but, in line with hypotheses, the sustained hypertensive group showed higher levels of trait anxiety, trait depression and stress than did the normotensive group. A discriminant analysis revealed that trait depression was the most important psychological variable to discriminate between sustained hypertension and normotension. Results provide support to the hypothesized relationship of emotional personality traits and stress with hypertension, and underscore the need to define hypertension on the basis of both clinic and home/ambulatory BP measurements and to simultaneously evaluate all relevant negative emotional constructs, when conducting research on psychological factors in hypertension.
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Pronóstico y recomendaciones para el manejo de la hipertensión clínica aislada. HIPERTENSION Y RIESGO VASCULAR 2010. [DOI: 10.1016/s1889-1837(10)70004-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Boreu QF, de Tuero GC, Rodríguez-Poncelas A, Albertos MS, Zafra MS, Radó MAB. Proportion of isolated clinical hypertension in primary care settings. Comparison of target organ damage in patients with isolated clinical hypertension and patients with sustained arterial hypertension. Blood Press 2007; 16:354-61. [PMID: 17852096 DOI: 10.1080/08037050701538089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to determine the proportion of isolated clinical hypertension (ICH) in newly diagnosed hypertensive patients, and to compare the incidence of target organ damage (TOD) in ICH and sustained hypertension patients. Participants. In a multi-centre study involving 14 primary care centres in Girona, Spain, 140 researchers recruited 214 newly diagnosed hypertensive patients 15-75 years of age, without history of cardiovascular events. Period of study. 2004-6. Method. Self-blood pressure monitoring (SBPM) and ambulatory blood pressure monitoring (ABPM). Evaluation. Anamnesis including blood pressure, physical examination and analysis (creatinine, albumin/creatinine index), electrocardiogram (left ventricular hypertrophy) and retinography (fundus damage). Results. In 129 (60.3%) subjects with sustained hypertension and 85 (39.7%) with ICH, no significant differences were found relative to gender, age, body mass index or blood pressure (155/90 vs 154/90 mmHg, respectively). Cholesterol levels were significant differences between both groups (5.97 mmol/l in sustained hypertension vs 5.64 mmol/l in ICH, p = 0.029). The proportion of ICH was approximately 40%. TOD incidence in sustained hypertensives was similar to that of ICH patients.
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Wimmer NJ, Sathi K, Chen TL, Townsend RR, Cohen DL. Comparison of Pulse Wave Analysis Between Persons With White Coat Hypertension and Normotensive Persons. J Clin Hypertens (Greenwich) 2007; 9:513-7. [PMID: 17617760 PMCID: PMC8109852 DOI: 10.1111/j.1524-6175.2007.06553.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
White coat hypertension (WCH) is considered by some but not all investigators to be a benign condition without increased cardiovascular risk. Pulse wave analysis is a noninvasive method to measure how the reflected pressure wave interacts with central aortic blood pressure (BP) and to assess how it is related to vascular stiffness. The purpose of the study was to compare central aortic BP in normotensive and WCH participants. WCH participants were identified after ambulatory BP monitoring. Normotensive participants served as controls. Using radial artery applanation tonometry, aortic pulse wave analysis was performed. Augmentation index (AI), AI75, and differences in systolic BP between central aortic and peripheral vasculatures were calculated. Results show a difference in AI, AI75, (AI standardized to a heart rate of 75 beats per minute), and central aortic systolic pressures between WCH and normotensive participants. The WCH group had significantly higher systolic BP and pulse pressure; however, these were still within the normal range. In summary, WCH participants had increased central aortic pressures compared with normotensives, supporting the potential for increased cardiovascular risk in WCH.
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Affiliation(s)
- Neil J. Wimmer
- From the Renal‐Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Kinji Sathi
- From the Renal‐Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Tiffany L. Chen
- From the Renal‐Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Raymond R. Townsend
- From the Renal‐Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Debbie L. Cohen
- From the Renal‐Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA
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