Alexithymia and Hypertension: Does Personality Matter? A Systematic Review and Meta-analysis

Abstract

Purpose of review Personality characteristics, such as alexithymia, may lead to alterations in the autonomic nervous system functionality, predisposing individuals to an increased risk of hypertension (HTN). The present meta-analysis aimed to quantify the presence of alexithymia in people with HTN and to assess for potential sources of heterogeneity between studies. PubMed, PsycINFO and Scopus databases were systematically searched, using the following strings: (“alexithymia” OR “alexithymic”) AND (“hypertension” OR “hypertensive”). Data were meta-analyzed with random-effects models. Recent findings A total of 13 studies met the inclusion criteria. The prevalence of alexithymia in people with and without HTN were obtained from 5 studies (26.3% vs 15.0%; pooling of odd ratios, 3.15 [95% CI, 1.14;8.74]), whereas the mean level of alexithymia between people with and without HTN was obtained from 7 studies Hedges g, 1.39 [95% CI, -0.39;3.16]). There was a significant association between alexithymia prevalence and year of article publication (ĝ = -0.04; 95% CI, -0.07;-0.01), whereas no significant relationship was detected between the former and both sex and age. Summary Findings revealed a greater prevalence of alexithymia in people with HTN than in participants without HTN. These findings suggest that alexithymia may contribute to both the onset and persistence of HTN symptomatology. However, future research is needed to clarify this association.

Hypertension with hidden causes: the cognitive and behavioral profile of an adult female with chronic stress and 16p11.2 microdeletion

“…Exposure to psychosocial chronic stress and nonadaptive affective response to stress may cause hypertension [ 16 ]. Also, alexithymia has been found more often in people with hypertension as compared to people without hypertension, possibly suggesting an association between alexithymia and hypertension [ 17 ]. Furthermore, the cognitive and behavioral profile of this patient was in accordance with findings of previous studies of patients with a 16p11.2 microdeletion on a group level.…”

Age-related changes of interoceptive brain networks: Implications for interoception and alexithymia.

“…These data coexist with the result of experiments showing that older adults demonstrate reduced recognition of negative emotions in nonverbal expressions such as faces (Ruffman et al, 2008) and tend to pay more attention to and remember more positive versus negative information (Carstensen & DeLiema, 2018), a phenomenon known as the positivity effect. While the nonprocessing of negative stimuli may represent an adaptive mechanism and contribute to the maintenance of well-being despite the changes in internal and external resources (Ruffman et al, 2008; Urry & Gross, 2010), alexithymia is associated with an increased risk of affective (Hemming et al, 2019) and cardiovascular disorders (Di Tella et al, 2023; Grabe et al, 2010; Tolmunen et al, 2010) and even all-cause mortality (Terock et al, 2021). One explanation of this paradox may lie in the decoupling phenomena: in alexithymic individuals, lower awareness of stress-induced emotions is accompanied by a similar or higher physiological arousal in comparison with nonalexithymic controls (Eastabrook et al, 2013; Lumley et al, 2007; Papciak et al, 1985).…”

Enabling brief assessments of alexithymia: psychometric properties of the Russian version of the Perth Alexithymia Questionnaire-Short Form (PAQ-S) and its correlates with ill-being and well-being

“…Alexithymia was first coined in the 1970's by Nemiah and Sifneos [3] based on their observations of these features in many of their psychiatric patients. Alexithymia appears to impair emotion regulation [4,5] and is an important transdiagnostic risk factor for a range of psychopathologies, including anxiety disorders, depression, substance use disorders, personality disorders, eating disorders, and psychosomatic disorders (e.g., [5][6][7][8][9][10]). Thus, alexithymia assessments are of high importance in a wide range of clinical and research settings.…”