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Could Impatience Be Raising Your Blood Pressure?

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Study Finds Hostility, Impatience Increase Hypertension Risk continued...

The study used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, which involved 3,308 black and white men and women from four metropolitan areas (Birmingham, AL, Chicago, IL, Minneapolis, MN, and Oakland, CA). The participants were aged 18-30 at the time of their enrollment in the ongoing study. 

Participants had periodic physical exams, which included blood pressure measurements and self-administered psycho-social questionnaires. Fifteen percent of all the participants had developed high blood pressure by ages 33-45.

Five psychological/social factors were assessed: time urgency/impatience, achievement striving/competitiveness, hostility, depression, and anxiety. The first three are key components of the type A behavior pattern and were assessed at the start of the study; the other two behaviors were assessed five years later. The factors were assessed by different scales based on the psychosocial instrument used but, in every case, a higher score meant the most intense degree of the behavior.

Time urgency/impatience was rated on a scale from zero to 3-4. After 15 years, participants with the highest score of 3-4 had an 84% greater risk of developing high blood pressure and those with the second highest score of 2 had a 47% greater risk, compared with those with the lowest score of zero.

Hostility was rated on a score of 0 to 50 and then categorized into quartiles. After 15 years, those in the highest quartile had an 84% higher risk of high blood pressure and those in the second highest quartile had a 38% higher risk, compared with those in the lowest quartile.

No significant relationship was found for the other factors.

Results were similar for blacks and whites and were not affected by age, gender, education, or blood pressure at the time of enrollment. They also held regardless of the presence of such established high blood pressure risk factors as overweight/obesity, alcohol consumption, and physical inactivity.

The researchers state that the rise in blood pressure due to psychological and social factors may be caused by a complex set of mechanisms and is not well understood. For instance, they note that stress could activate the sympathetic nervous system, causing a series of heart and blood vessel repercussions, including narrowing of the blood vessels and an increase in blood pressure.

"This long-term study has given us much-needed information about the effects of psychological and social factors," said Dr. Catherine Loria, CARDIA Project Officer at the NHLBI. "But more research must be done on this topic, especially considering the widespread prevalence of high blood pressure in the U.S. and the fast pace of our lives."

WebMD Medical Reference from MedicineNet

Reviewed by James Beckerman, MD, FACC on October 31, 2013
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