Elevated blood pressure and self-reported symptom complaints, daily hassles, and defensiveness

Abstract

The association between elevated blood pressure and low rates of self-reported problems has been hypothesized to be mediated by defensiveness. In a population screening study in which 1,120 women and 903 men between 20 and 55 years of age participated, multiple resting home blood pressure measurements were performed and questionnaires were administered measuring symptom complaints, daily hassles, and defensiveness. In women, after control for potential confounders, a low number of self-reported symptoms was associated with elevated blood pressure. However, this effect was not mediated by defensiveness, although repressive defensiveness predicted independently elevated blood pressure in women. In men, no significant associations were obtained. Furthermore, no relations emerged between daily hassles and elevated blood pressure. In conclusion, although defensiveness was more prevalent among women with elevated blood pressure, it does not provide a good explanation for the low rates of self-reported symptoms found in these women.Key words: daily hassles, defensiveness, hypertension, self-reports, symptom complaints It has been hypothesized that chronic or recurrent exposure to psychosocial stressors is a significant factor in the etiology of essential hypertension (Henry, 1988).

The costs of repression: A meta-analysis on the relation between repressive coping and somatic diseases.

“…Because the applied continuity correction might have biased the results, an additional analysis was conducted that contained only the studies with a healthy control group (Ginzburg, Solomon, & Bleich, 2002; Jensen, 1987; Kraft, 1998; Kreitler, Chaitchik, & Kreitler, 1993; Perini et al, 1994; Servaes, Vingerhoets, Vreugdenhil, Keuning, & Broekhuijsen, 1999; Zachariae et al, 2004) or operationalized repressive coping as a dimensional construct (Nyklíček, Vingerhoets, van Heck, & van Limpt, 1998; Nyklíček, Vingerhoets, & van Heck, 1999). This analysis yielded an effect size of 0.53 ( OR = 1.70).…”

Clinical events in coronary patients who report low distress: Adverse effect of repressive coping.

“…They have shown elevated heart rate and blood pressure responses to laboratory stressors (Derakshan & Eysenck, 1997;Grossman et al, 1997), enhanced reductions of heart rate variability (Pauls & Stemmler, 2003), and cortisol dysregulation (Giese-Davis et al, 2004). Repressive coping is also associated with elevated ambulatory blood pressure (Nyklíček, Vingerhoets, & van Heck, 1999) and has been shown to predict the incidence of hypertension (Rutledge & Linden, 2000). Figure 2.…”

From Brain to Behavior: Hypertension's Modulation of Cognition and Affect

“…This relates to the surprising and reasonably consistent finding that negative events and symptoms are reported as lower among those with higher blood pressure, but only among those not diagnosed with hypertension [61, 84, 105]. This relationship does not seem to be necessarily related to negative affect/anxiety/defensiveness [105], but as noted above may be related to pain perception [105]. Associating possible underlying mechanisms, Wilkinson and France speculated that it is possible that changes in sensory, affective, and cognitive processing of noxious stimuli may influence hypoalgesia in hypertensives or those who are at risk for hypertension [106].…”

“…Fillingim and colleagues suggested that the effect of elevated blood pressure on pain is the result of reduced affective response rather than reduced pain sensitivity [104]. This relates to the surprising and reasonably consistent finding that negative events and symptoms are reported as lower among those with higher blood pressure, but only among those not diagnosed with hypertension [61, 84, 105]. This relationship does not seem to be necessarily related to negative affect/anxiety/defensiveness [105], but as noted above may be related to pain perception [105].…”