Taking the Tension Out of Hypertension: A Prospective Study of Psychological Well-Being and Hypertension

Authors

Claudia Trudel-Fitzgerald, Laval University
Julia K. Boehm, Chapman UniversityFollow
Mika Kivimaki, University College London
Laura D. Kubzansky, Harvard School of Public Health

Document Type

Article

Publication Date

2014

Abstract

Background—Previous studies have shown that psychological well-being is associated with reduced risk of cardiovascular disease. However, whether well-being might be specifically associated with reduced risk of hypertension has not been rigorously investigated in prospective studies.

Objective—This study examined the prospective association between two measures of psychological well-being and incident hypertension.

Methods—Participants were 6,384 healthy British civil servants age 39 to 63 from the Whitehall II cohort. Psychological well-being (emotional vitality and optimism) and cardiovascular risk factors (demographic characteristics, health status, health behaviors, psychological ill-being) were assessed during the 1991-1994 baseline. Incident hypertension was defined by clinical measures of systolic or diastolic blood pressure >140/90 mmHg, self-reported physician-diagnosed hypertension, or treatment for hypertension. Follow-up assessments of hypertension took place approximately every three years through 2002-2004. Cox proportional hazards regression models estimated hazard ratios.

Results—There were 2,304 cases of incident hypertension during the follow-up period. High versus low emotional vitality was associated with a significantly reduced risk of hypertension in an age-adjusted model (hazard ratio = 0.89; 95% confidence interval 0.80-0.98). This association was maintained after controlling for demographic characteristics and health status, but was slightly attenuated after adjusting for health behaviors and ill-being. Optimism was not significantly associated with hypertension.

Conclusions—High emotional vitality was associated with reduced hypertension risk; favorable health behaviors explained only part of the relationship. Associations did not differ by age, were similar for men and women and were maintained after accounting for ill-being.

Comments

This is a non-final version of an article published in final form in

Trudel-Fitzgerald, C., Boehm, J. K., Kivimaki, M., & Kubzansky, L. D. (2014). Taking the tension out of hypertension: A prospective study of psychological well-being and hypertension. Journal of Hypertension, 32(6), 1222–1228. http://doi.org/10.1097/HJH.0000000000000175

Recommended Citation

Trudel-Fitzgerald, C., Boehm, J. K., Kivimaki, M., & Kubzansky, L. D. (2014). Taking the tension out of hypertension: A prospective study of psychological well-being and hypertension. Journal of Hypertension, 32(6), 1222–1228. http://doi.org/10.1097/HJH.0000000000000175

Copyright

Lippincott, Williams and Wilkins