Psychosocial Factors and Personality Traits and the Prevalence of Arterial Hypertension Among 35- and 55-Year-Old Men and Women in Sweden and Estonia: a SWESTONIA Longitudinal Study

Perceived Control and Blood Pressure: A Systematic Review

BACKGROUND

Perceived control, defined as an individual's belief in their ability to influence life events and circumstances, has been implicated in reducing the risk of cardiovascular disease (CVD). Some research has demonstrated a link between perceived control and blood pressure, a major CVD risk factor. However, methodological differences across studies, including variability in definitions and measures of perceived control, preclude a clear understanding of this relationship.

PURPOSE

This systematic review describes the evidence regarding the association between perceived control and blood pressure, with a specific focus on integrating the literatures across multiple control-related constructs to provide a comprehensive understanding of their relationship with blood pressure.

METHODS

A systematic search was conducted across five databases. Data were extracted from 24 studies that quantitatively examined the relationship between perceived control and blood pressure and met inclusion criteria. Results across studies were narratively synthesized.

RESULTS

Limited evidence emerged across studies showing a negative relationship between perceived control and both resting blood pressure and ambulatory blood pressure, but no studies reviewed found that perceived control was associated with lower blood pressure reactivity to a lab stressor.

CONCLUSIONS

The findings here provide preliminary evidence that perceived control may serve as an important protective factor against high blood pressure. The findings highlight the need for additional quality research to examine this link more thoroughly. Recommendations for future research are provided.

The Association Between Life Events and Incidence of Hypertension Among Government Employees in China: A Prospective Cohort Study

Background

Hypertension (HTN) is a global public health concern. However, the association between life events (LEs) and HTN is complex. Thus, we conducted a prospective cohort study to explore this complex association.

Methods

A total of 8,077 government employees without HTN were recruited through cluster sampling between 2018 and 2019 in Hunan Province, China. At baseline, information regarding sociodemographic characteristics, LEs, and behavioral factors was collected. After the 1-year follow-up, the participants were revisited to obtain the HTN diagnosis. Crude and adjusted Poisson regression models were constructed to calculate the incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Cubic regression spline models were used to visualize the trends between LEs and HTN IRRs. Interactive and subgroup analyses were also performed.

Results

The 1-year HTN incidence rate among government employees in Hunan province was 4.30% (95% CI: 3.86-4.74%). LEs were associated with a higher HTN risk (IRR, 1.02; 95% CI, 1.00-1.04). When calculating positive and negative LEs scores separately, only the latter was a risk factor for HTN incidence (IRR, 1.04; 95% CI, 1.03-1.06); conversely, positive LEs reduced the risk (IRR, 0.90; 95% CI, 0.85-0.96). Compared with patients in the lowest quartile of LEs score, those in quartiles two (IRR, 1.28; 95% CI, 0.96-1.71), three (IRR, 1.43; 95% CI, 1.04-1.96), and four (IRR, 1.73; 95% CI, 1.26-2.37) were at progressively higher risk. In restricted spline curves, a non-linear association was noted between LEs and HTN risk. Regarding the subcategories of LEs, work-related LEs, personal LEs, and all subcategories of negative LEs were associated with an increased risk of HTN. However, among positive LEs, only the family-related cases were associated with a lower risk of HTN.

Conclusion

LEs had a non-linear association with an increased risk of HTN. Negative LEs were risk factors for HTN incidence, whereas positive LEs reduced the risk of HTN. Thus, the importance of LEs should be highlighted in the development of HTN prevention strategies and initiatives.