Alexithymic and nonalexithymic hypertensives were assessed for severity of hypertension using a weighting system based on diastolic blood pressure, optic fundi, ECG, chest X ray, renal studies, and patient history. Outpatient hypertensives (diastolic blood pressure > 95 mm Hg) were selected as subjects because they are largely asymptomatic; thus, focusing on somatic ills to the exclusion of thoughts about emotions is not likely to be due to their hypertensive pathology but rather reflects psychological constitution. Controlling for age differences, it was found that alexithymics manifested more severe hypertensive sequelae than did nonalexithymics; there was, however, no difference in severity of atherosclerosis. The results suggest that alexithymia is not only correlated with hypertension but may also play a role in its etiology.