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Hostility and differences between clinic, self-determined, and ambulatory blood pressure
L D Jamner1, D Shapiro, K K Hui
1Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine.
Insights
Personality traits, specifically hostility, influence blood pressure readings across different measurement methods. High hostility correlates with consistently high readings, while low hostility shows lower self and ambulatory blood pressure compared to clinic measurements.
Area of Science:
- Cardiology
- Psychology
- Behavioral Medicine
Background:
- Blood pressure measurement methods (clinic, self, ambulatory) can yield different results.
- Individual personality factors may contribute to these discrepancies.
- Understanding these differences is crucial for accurate hypertension diagnosis and management.
Purpose of the Study:
- To investigate the association between personality factors and blood pressure measurement differences.
- To explore the role of hostility, anxiety, and depression in blood pressure assessment variations.
- To examine the implications for "white coat hypertension".
Main Methods:
- Studied 45 patients with mild hypertension withdrawn from medication.
- Assessed blood pressure using clinic, self-recorded, and ambulatory methods.
- Administered the Buss-Durkee Hostility Inventory and measures of anxiety and depression.
Main Results:
- Significant differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed across assessment methods.
- Hostility scores (total and subscales like Assault, Resentment, Guilt) correlated with blood pressure variations.
- High hostility was linked to consistently high readings; low hostility showed lower self/ambulatory readings versus clinic values.
Conclusions:
- Hostility is a significant personality factor influencing blood pressure measurement discrepancies.
- Low hostility may be associated with lower blood pressure readings outside the clinic setting.
- Findings offer insights into "white coat hypertension" and the impact of psychological traits on cardiovascular assessment.
Abstract:
This study examined the role of personality factors in differences between three methods of assessing blood pressure (clinic, self, ambulatory) in 45 patients with mild hypertension. The data were obtained after the patients were withdrawn from antihypertensive medications and had achieved stable clinic diastolic blood pressure levels of 95 to 110 mm Hg, averaged over three visits in 2 to 4 weeks. Significant differences were obtained in systolic blood pressure (SBP) and diastolic blood pressure (DBP) as a function of method of assessment. These differences in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were associated with individual differences in the total score and several subscales of the Buss-Durkee Hostility Inventory (Assault, Resentment, Guilt), but not in anxiety, depression, or other characteristics. High hostile subjects had consistently high blood pressure values in both clinic, self, and ambulatory recordings. Low hostile subjects were significantly lower in self-recorded blood pressure readings taken at home and in ambulatory recordings, compared with clinic values. Implications of these findings for "white coat hypertension" are discussed.