Personality Characteristics of Patients with "White Coat" Hypertension.

Abstract

To clarify psychological factors related to white coat hypertension, we examined personality characteristics of patients with mild essential hypertension by psychological testing. Patients with essential hypertension were taught to measure their own blood pressure (BP) with a semi-automatic oscillometric BP measuring device and were asked to measure BP at home in the sitting position before going to sleep. The duration of the study was 8 wk. Patients were defined as "white coat" hypertensive patients (WCHT) (n = 49) if home systolic BP was 135 mmHg or less and home diastolic BP was 85 mmHg or less, and as "sustained" hypertensive patients (SHT) (n = 53) if home systolic BP was 140 mmHg or more or home diastolic BP was 90 mmHg or more. All the patients underwent the following psychometric tests: self-rating questionnaire for depression, MMPI alexithymia scale, type A behavior pattern check list, general health questionnaire (GHQ), and egogram check list. WCHT did not differ from SHT in the scores for depression, alexithymia, type A behavior pattern, or GHQ. However, WCHT showed an abnormal pattern on egograms, as compared with SHT. On egograms, SHT showed a normal hill-shaped pattern with a peak in "nurturing parent (NP)", and "free child (FC)" was higher than "adapted child (AC)" in both genders. In contrast, WCHT showed significantly lower FC and significantly higher AC than SHT, and AC was higher than FC in both genders. These findings suggested that WCHT tend to suppress their own emotions and become over-adaptive to their surroundings, as compared with SHT. (Hypertens Res 1997; 20: 99-104)

Prevalence and determinants of isolated clinic hypertension in the Finnish population: the Finn-HOME study

“…Previous studies have also concluded that individuals with ICH did not show abnormal hostility, anxiety, or depression, when compared with subjects with sustained hypertension [9][10][11][12]. The study by Muneta et al [10] suggested that subjects with ICH tend to suppress their own emotions and become over-adaptive to their surroundings. Crippa et al [9] suggested that ICH might be associated with healthcare-related fears and emotional instability.…”

“…There is early evidence that ICH might be associated with healthcare-related fears, suppression of emotions and emotional instability, but not necessarily with anxiety or depression [9][10][11][12]. The findings of these studies have been conflicting and the sample sizes often small.…”

Low Critical Parent Ego State is a Marker of Treatment-Resistant Depression in a Self-Rating Ego gram Questionnaire

“…Furthermore, Critical Parent and Adapted Child were positively correlated with scores of the Zung Self-Rating Depression Scale [16]. In addition, a study using the Egogram Checklist has demonstrated a pattern: Adapted Child is higher than Free Child in patients with "white coat" hypertension, suggesting an over-adaptive attitude among these patients [10]. Moreover, high Adapted Child is associated with dependence and avoidance [8].…”

“…Selfrating questionnaire sheets, such as the TEG (Tokyo University Egogram) [8] or Egogram Check List [9], have been widely used in clinical or occupational settings in Japan. There are clinical studies using self-rating egogram in fields of functional somatic syndromes [10,11], psycho-oncology [12], occupational health care [8], and psychiatric disorders (e.g., anorexia and bulimia nervosa) [13]. This is a result of applying a self-rating egogram, TEG to 28 patients with TRD.…”

Hipertensão de consultório

“…Harbin 33 em metanálise abrangendo 71 estudos comparativos de reatividade cardiovascular concluiu que homens com personalidade tipo A apresentam reatividade de PA sistólica, consistentemente maior, que homens com personalidade tipo B. Entretanto, testes psicológicos não revelaram diferenças entre indivíduos com HC e hipertensos estabelecidos, no que se refere à depressão, ansiedade, reatividade emocional ou hostilidade 32 , bem como reatividade pressórica a testes de estresse físicos e mentais 34 . Em contrapartida, Munetta e col 35 , utilizando testes psicométricos, concluíram que esses portadores de HC tendem a suprimir suas próprias emoções, tornando-se mais adaptativos ao ambiente, que hipertensos estabelecidos.…”