None of the subjects initially had hypertension, and each study followed the subjects for at least one year. Although the 15 studies' methods, populations, and definitions of hypertension varied widely, most of them found associations between psychological factors and blood pressure levels.
Looking at all of the studies, the researchers assert that the risk of developing hypertension was about 8 percent higher among people who had high psychological distress than among people who had low psychological distress.
"Given the prevalence, clinical repercussions, and medical costs associated with hypertension, a factor disposing a risk increase of this magnitude could be considered highly important to clinical health experts," write researchers Thomas Rutledge, Ph.D., formerly of the University of Pittsburgh and now at the University of California, San Diego, and Brenda E. Hogan, M.A., of the University of British Columbia. Their study is published in the September/October issue of Psychosomatic Medicine.
The researchers also suggest that the apparent association between anger, anxiety and depression and the risk of hypertension "compares favorably with better established predictors of hypertension such as obesity and physical activity." Therefore, more research into the relationship of psychological factors and hypertension development is warranted.
The 15 research studies reviewed for the analysis included between 78 and 4,650 subjects, most of whom were white and male. However, four studies reported separate results for African Americans. Like other subjects, African Americans with high psychological distress from depression, anxiety, and anger had a higher risk of developing hypertension.
The review study is the first major quantitative look at prospective research focusing on psychological predictors of high blood pressure.
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