Life events and elevated blood pressure in young men

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.

Stressful life events, neighbourhood characteristics, and systolic blood pressure in South Africa

The relationship between negative events, neighbourhood characteristics, and systolic blood pressure in developing countries is not well-documented, particularly using longitudinal data. To explore this relationship, we analysed panel data from the first three waves of the South African National Income Dynamics Study using a correlated random effects model adjusted for confounding risk factors. Our sample comprised of 15,631 respondents in 2008, 14,443 respondents in 2010/2011, and 14,418 respondents in 2012, all aged above 15 years. The prevalence of at least one negative household event across the three waves was approximately 30%. In any of the three waves, the adjusted prevalence of hypertension was 23.84%. This share was 21.75% in 2008 (95% CI 18.06-25.44), 23.16% in 2010/11 (95% CI 19.18-27.14), and 18.39% in 2012 (95% CI 16.03-20.75). In our adjusted correlated random effects model, we found that systolic blood pressure was significantly higher among respondents from households that reported death of a household member (0.85 mmHg; p =  0.02) and a reduction in grant income and remittances (2.14 mm Hg; p = 0.01). We also found no significant association between systolic blood pressure and neighbourhood income level. In a country with social and economic challenges, our results indicate that grief and negative financial events are adversely associated with blood pressure, which may explain in part the significant burden of hypertension in low- and middle-income countries.

Assessing emotional processing difficulties in normotensive individuals with high and isolated blood pressure elevations

This study examined the effect of sense modality (auditory/visual) on emotional dampening (reduced responsiveness to emotions with elevation in blood pressure). Fifty-six normotensive participants were assessed on tasks requiring labelling and matching of emotions in faces and voices. Based on median split of systolic and diastolic blood pressures (SBP and DBP, respectively), participants were divided into low BP, high BP and isolated BP groups. On emotion-labelling tasks, analysis revealed reduced emotion recognition in the high BP than the low BP group. On emotion-matching tasks, reduced emotion recognition was noted in high and also isolated BP group as compared to low BP group for the task that required matching a visual target with one of the four auditory distractors. Our findings show for the first time that even isolated elevations in either SBP or DBP may result in emotional dampening. Furthermore, the study highlights that the emotional dampening effect generalises to explicit processing (labelling) of emotional information in both faces and voices-and that these effects tentatively occur during more pragmatic and covert (matching) emotion recognition processes too. These findings require replication in clinical hypertensives.

Effects of naltrexone on repressive coping and disclosure of emotional material: a test of the opioid-peptide hypothesis of repression and hypertension

OBJECTIVE

The present study was designed to assess the role of endogenous opioids in the relationship of hypertension to repressive coping.

METHODS

Ten hypertensive and 8 normotensive males were given either the opioid antagonist naltrexone or placebo in a randomized, double-blind fashion over the course of four laboratory sessions. Measures of repression and disclosure were completed and blood pressure was assessed during a laboratory stressor protocol.

RESULTS

Opioid antagonism reduced repression and increased disclosure only in the hypertensive group. Also, opioid antagonism increased stress-related systolic blood pressure only in the hypertensive group.

CONCLUSION

The results support the hypothesis that endogenous opioid dysregulation underlies both hypertension and repressive phenomena.

Defensive coping in relation to casual blood pressure and self-reported daily hassles and life events

Our aim was to investigate the relationships between defensiveness and repression, on the one hand, and self-reported stressor exposure and resting blood pressure, on the other hand. In addition, different operationalizations of defensiveness and repression were compared. Participants were 310 male and 90 female employees representing a wide range of occupations. Before a medical examination, all subjects completed questionnaires measuring defensiveness, anxiety, repression, daily hassles, and life events. After controlling for potentially confounding variables, multiple regression analyses revealed an inverse association between defensiveness and self-reported number of daily hassles and a positive link between defensiveness and resting systolic blood pressure. In general, the interaction between defensiveness and anxiety (representing repression) did not add to the predictive power of defensiveness and anxiety alone. The results support the notion that defensive individuals tend to underreport problems, while exhibiting elevated resting blood pressures.

Influence of positive life events on blood pressure in adolescents

It has been reported that adults suffering from refractory essential hypertension experience significantly fewer positive life events than healthy peers. However, the influence of positive life events on blood pressure (BP) in adolescents has been largely ignored. Therefore, we examined the relationship between self-reported positive life events and BP in 69 sixth graders with a mean age of 11.7 years. Positive life events were assessed with the Adolescent Perceived Events Scale and resting blood pressure was measured with a mercurial sphygmomanometer. Correlational analyses showed an inverse relationship between positive life events and diastolic BP, suggesting that adolescents experiencing more positive life events were more likely to have lower diastolic BP's. Hierarchical regression analyses revealed that physical activity level, dietary sodium-to-potassium ratio, parental history of hypertension, and measures of body composition predicted 24.6% of the variance in systolic BP and 34.6% of the variance in diastolic BP. Moreover, positive life events predicted an additional 4.3% of the variance in diastolic BP when statistically controlling these established risk factors for hypertension. These results suggest that increased perceptions of positive life events may act as a buffer to elevated BP in adolescents.

Blood pressure, self-reported symptoms and job-related problems in schoolteachers

The relationship between blood pressure and self-reports of physical symptoms and job-related problems was investigated in a sample of 262 male and female teachers. The subjects were divided into three groups: treated hypertensives (THT, N = 23); untreated hypertensives (UHT, N = 101); and normotensives (NT, N = 123). After controlling for eight potentially confounding variables, the groups differed significantly with respect to reported physical symptoms, with THT reporting the most and UHT the fewest symptoms. Moreover, after controlling for potential confounders, a multiple regression analysis revealed an inverse association between diastolic blood pressure and the number of reported physical symptoms in untreated subjects. A similar trend for systolic blood pressure did not reach significance. In addition, no significant results with respect to work-related problems were obtained, except for a group x gender interaction on job-related irritation: male THT showed lowest and female THT highest irritation scores. The potential role of altered appraisal, diagnosis, and gender are discussed.

Hypertension and objective and self-reported stressor exposure: a review

A review of the literature on the relationship between blood pressure and stressor exposure revealed a discrepancy between the results of studies based on objective measures of stressor exposure and studies based on self-reports. Whereas in the studies based on objective measures, a clear predominance of positive associations between blood pressure level and stressor exposure was found, in the studies based on self-reports, the results were highly inconsistent. Several moderator variables have been proposed that could explain the discrepancies found in the literature, such as awareness of hypertension and treatment. In studies in which these moderators were taken into account, inverse associations between blood pressure and self-reported stressor exposure have often been found. It is suggested that this result is brought about by altered appraisal of stressors in hypertensives.

On physiological effects of positive and negative life changes--a longitudinal study

A sample of working men and women were followed longitudinally on four occasions during a year with regard to serum triglycerides, plasma prolactin and systolic and diastolic blood pressure at rest. Participants were asked about life changes that they had gone through during the examination year. They were also asked to rate the importance and the direction (positive and negative, respectively) of the changes. On the basis of this information participants were divided into a no event group (N = 20), a positive event group (N = 11) and a negative event group (N = 11). Statistical analyses revealed that prolactin levels tended to increase in the negative event group whereas blood pressure as well as serum triglycerides increased in the negative event group and decreased in the positive event group.

The impacts of positive psychological states on physical health: a review and theoretical framework

While much research has focused on the impacts of negative psychological states, such as stress, on physical health, relatively little research has examined the effects of positive psychological states. We suggest this imbalance is attributable to inadequate theoretical and methodological development regarding the impacts of positive psychological states on health. This paper presents a framework by which positive psychological states may influence physical health. Following this, we review evidence pertaining to this framework. We conclude by discussing methodological issues associated with this relatively new area of inquiry.

Young men with high blood pressure report few recent life events

Men who had high, medium and low blood pressure at age 18 (compulsory screening for military service in Stockholm) were examined ten years later at age 28. Interviewers, having had no information regarding past or present blood pressure, interviewed them about life events experienced during the year preceding the examination. Men with high blood pressure at rest reported fewer life events for the past year than other men. Furthermore, high plasma adrenaline levels at rest were associated with few reported life events.

Stress and breast cancer

In order to assess whether exposure to stress was associated with an increased risk of breast cancer, 100 women presenting with carcinoma of the breast completed a standard life events inventory documenting life stresses experienced during the previous three years. The same questionnaire was completed by 100 women presenting with benign breast lumps and 100 apparently healthy controls. Both groups of patients with breast disease also completed the Eysenck personality inventory. There was no difference in the number of stressful life events experienced by the patients with benign and malignant breast lesions and the nature and severity of those stresses encountered were similar for both groups. The personality indices were also the same for both groups. The controls, however, recorded significantly higher levels of stress exposure than the patients with breast disease. On the basis of this series, there is no evidence to support the hypothesis that stress predisposes to breast cancer development.