Alexithymia

Abstract

Abstract-Two hundred thirty-seven newly diagnosed yet untreated hypertensive men and women, 35 to 54 years of age, were compared with an age-and gender-stratified random population sample of 146 normotensive men and women to find out whether psychological distress symptoms, anger expression, and alexithymia are associated with elevated blood pressure and whether the possible associations are independent of sodium and alcohol intake, body mass index, and physical fitness. The independent attributes of mean arterial pressure were studied by multivariate regression analyses after combining the subjects in the hypertensive and control groups. Three questionnaires were used: the Brief Symptom Inventory (BSI-37), a 31-item version of the Spielberger State-Trait Anger Expression Inventory (STAXI), and the Toronto Alexithymia Scale (TAS-26).Total scores of the TAS-26 were higher (PϽ0.001) in hypertensive men and women than in their normotensive control subjects (75.6Ϯ7.8 vs 64.1Ϯ9.8 in men and 72.9Ϯ7.1 vs 57.5Ϯ11.5 in women). There were no differences between the study and control groups in psychological distress symptoms, including anxiety, depression, and hostility, or in anger expression.In multivariate regression analyses, higher age, male gender, higher sodium intake, lower physical fitness, and alexithymia were independently and highly significantly (PϽ0.01 for male gender, PϽ0.0001 for other variables) associated with increased blood pressure, explaining altogether 39.5% of the cross-sectional variation in mean arterial pressure. We conclude that alexithymia, that is, poor ability to experience and express emotions, is associated with elevated blood pressure independent of sodium and alcohol intake, body mass index, and physical fitness. (Hypertension. 1999;33:1057-1061.)Key Words: hypertension, essential Ⅲ alexithymia Ⅲ sodium Ⅲ alcohol Ⅲ body mass index Ⅲ physical fitness Ⅲ stress, psychological P sychological factors can raise blood pressure acutely, but whether they lead to development of essential hypertension, as stated by Alexander 1 in his early psychosomatic hypothesis, is not known. The hypothesis has been addressed in many crosssectional studies and in a small number of prospective studies. Suppressed feelings, anger and hostility, 2-5 alexithymia, 6 anxiety, 4 -5,7-9 depression, 9 job strain, 10 stressful work conditions, 11 and psychosocial stress 12,13 are the most common factors associated with elevated blood pressure. Some studies on suppressed hostility 3,5 and increased anxiety 14 as possible psychosomatic mechanisms in hypertension suggest that they may have a role in the development of mild high-renin essential hypertension. Prospective studies support the view that suppressed feelings 2 and especially suppressed anger 5 are of importance in predicting blood pressure rise with age, whereas others do not find any association between anger behavior and change in blood pressure over time. 4,7,8,15 Several studies suggest that high anxiety levels predict later incidence of hypertension, at least i...

Alexitimia: dificuldade de expressão ou ausência de sentimento? Uma análise teórica

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Reduced heart rate variability in hypertension: associations with lifestyle factors and plasma renin activity

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