Abstract
BackgroundAffective temperaments (anxious, depressive, cyclothymic, irritable and hyperthymic) measure subclinical manifestations of major mood disorders. Furthermore, cumulating evidence suggests their involvement in somatic disorders as well. We aimed to assess associations between affective temperament scores and blood pressure and arterial stiffness parameters in hypertensive patients.MethodsIn this cross-sectional study, 173 patients with well-controlled or grade 1 chronic hypertension, with no history of depression, completed the TEMPS-A, Beck Depression Inventory (BDI) and Hamilton Anxiety Scale (HAM-A) questionnaires in three GP practices. Arterial stiffness was measured with tonometry (PulsePen).ResultsAccording to multiple linear regression analysis, cyclothymic temperament score was positively associated with brachial systolic blood pressure independently of age, sex, total cholesterol, brachial diastolic blood pressure, BDI, HAM-A and the use of alprazolam (β = 0.529, p = 0.042), while hyperthymic temperament score was negatively related to augmentation index independent of age, sex, smoking, heart rate, BDI, HAM-A and the use of alprazolam (β = -0.612, p = 0.013). A significant interaction was found between cyclothymic temperament score and sex in predicting brachial systolic blood pressure (p = 0.025), between irritable and anxious temperament scores and sex in predicting pulse wave velocity (p = 0.021, p = 0.023, respectively) and an interaction with borderline significance between hyperthymic temperament score and sex in predicting augmentation index (p = 0.052).ConclusionsThe present findings highlight elevated blood pressure among subjects with high cyclothymic temperament as well as an increased level of arterial stiffening in subjects with low hyperthymic scores suggesting that affective temperaments may play a role in the development of hypertension and arterial stiffening and may thus represent markers of cardiovascular risk. Sex differences were also present in these associations.
Highlights
Affective temperaments measure subclinical manifestations of major mood disorders
CV diseases cardiovascular diseases, BMI body mass index, GFR-EPI glomerular filtration rate assessed by the chronic kidney disease epidemiology collaboration glomerular filtration rate equation, ACE Angiotensin converting enzyme, ARB angiotensin II receptor blocker, TEMPS-A Temperament Evaluation of Memphis Pisa, Paris and San Diego questionnaire, BDI Beck Depression Inventory, HAM-A Hamilton Anxiety Scale, SBPbrach brachial systolic pressure, DBPbrach brachial diastolic pressure, PPbrach brachial pulse pressure, SBPcentr central systolic pressure, PPcentr central pulse pressure, PPAmp pulse pressure amplification, PWV carotidfemoral pulse wave velocity, Augmentation index (Aix) augmentation index upon further correction for age and sex, certain temperaments failed to be independent covariables of these parameters, notably irritable temperament score of brachial systolic blood pressure (p = 0.056) and depressive temperament score of Aix (p = 0.595)
To the best of our knowledge, this is the first study to demonstrate that, in chronic hypertensive patients, cyclothymic temperament score is associated with brachial systolic blood pressure while hyperthymic temperament score is independently related to the augmentation index after adjustment for potential confounders including severity of depression and anxiety and the use of alprazolam
Summary
Affective temperaments (anxious, depressive, cyclothymic, irritable and hyperthymic) measure subclinical manifestations of major mood disorders. We aimed to assess associations between affective temperament scores and blood pressure and arterial stiffness parameters in hypertensive patients. In addition to elevated blood pressure, arterial stiffening – integrating the damage of risk factors on the aortic wall over a long period [6] – is increasingly recognized as a marker and mediator of cardiovascular diseases. Carotid-femoral pulse wave velocity (PWV), an accepted non-invasive measure of arterial stiffness, is recommended for cardiovascular risk prediction among hypertensive patients in European Guidelines [7]. Anger, hostility and anxiety – the negative impact of adverse individual psychological traits and characteristics – are well-documented risk factors of coronary heart diseases [10, 11], while antagonism-related traits appear to predict a variety of cardiovascular outcomes [12, 13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
