Are personality traits associated with white-coat and masked hypertension?

Abstract

Objectives Anxiety and other psychological dispositions are thought to be associated with blood pressure. This study tests whether personality traits have long-term associations with masked and white coat effects. Methods A community-based sample of 2,838 adults from Sardinia (Italy) completed the Revised NEO Personality Inventory and seven years later blood pressure was assessed in the clinic and with ambulatory monitoring. Logistic regressions were used to test whether anxiety, neuroticism, extraversion, openness, agreeableness, and conscientiousness predicted the white coat and masked hypertension phenomena. Age, sex, and antihypertensive medication use were tested as moderators. Results Significant interactions were found between personality traits and antihypertensive medications in predicting masked and white coat effects. Only among those taking antihypertensive medication, higher anxiety was associated with a higher risk of pseudo-resistant hypertension due to white coat effect (OR = 1.39, 95%CI = 1.01–1.91) and higher conscientiousness was associated with a lower risk of masked uncontrolled hypertension (OR = 0.70, 95%CI = 0.49–0.99). There were no significant interactions with age or sex. Conclusions Among those on antihypertensive medications, anxious individuals were more likely to have pseudo-resistant hypertension due to white coat effect and less conscientious individuals were at increased risk of masked uncontrolled hypertension. Particularly among anxious and less conscientious individuals, ambulatory monitoring may improve the tailoring of pharmacological treatments.

Impact of depression on masked hypertension and variability in home blood pressure in treated hypertensive patients

“…Konstantopoulou et al 42 reported that MHT diagnosed by ABPM was more strongly associated with mood behavior in the hypomania-euthymia range and a lower score for type-A personality, which suggest lower depressive, compared with WHT and SHT. Terracciano et al 43 have showed that reduced conscientiousness was significantly associated with an increased risk of MHT among treated hypertensives. On the other hand, the Finn-Home study reported that MHT was associated with hypochondria and depression.…”

Dysregulated Blood Pressure: Can Regulating Emotions Help?

“…Since 2012, empirical findings have generally shown consistent associations between anxiety symptoms (clinical and sub-clinical) and higher risk of high BP or hypertension [36-39], but some null [37,40,41] and even protective [41] relationships have been observed too.…”

“…Comparably, definitions/measurements of hypertension are highly heterogeneous (e.g., self-reported diagnosis, antihypertensive medication, SBP or DBP thresholds either jointly or separately). Moreover, misclassification may occur, such as in “white-coat” hypertension where someone who only has high BP in the doctor’s office is characterized as hypertensive [40]. …”

Health-related quality of life and blood pressure 12 months after renal denervation

“…Similarly, the presence of panic disorder is more common in patients with hypertension [29]. In a recent examination based on a community sample, Terracciano et al [30] noted that pseudoresistant hypertension due to a white-coat effect was associated with higher anxiety only in those patients taking antihypertensive medications and, unlike in our cohort, patients with masked hypertension did not present with higher anxiety levels. Whether observations such as these are relevant in the present context wherein patients attended a tertiary referral centre for the management of difficult-to-treat hypertension is problematic.…”