Differences in Emotion Processing in Patients With Essential and Secondary Hypertension

• Published in: American journal of hypertension Vol. 23; no. 5; pp. 515 - 521
• Main Authors: Consoli, Silla M., Lemogne, Cédric, Roch, Bernard, Laurent, Stéphane, Plouin, Pierre-François, Lane, Richard D.
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01.05.2010; Nature Publishing Group
• Subjects: Adult; Affective Symptoms - psychology; Aged; alexithymia; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; blood pressure; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; emotional awareness; Emotions - physiology; Female; Humans; hypertension; Hypertension - drug therapy; Hypertension - psychology; Logistic Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Psychometrics; psychosomatic model; questionnaires; questionnaires; blood pressure; alexithymia; psychosomatic model; emotional awareness; hypertension; Human; Hypertension; Awareness; Alexithymia; Cardiovascular disease; Arterial pressure; Blood pressure
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2010.9

Background An impaired ability to experience and express emotions, known as alexithymia, has previously been associated with hypertension. Alexithymia and related emotion-processing variables, however, have never been examined as a function of the type of hypertension, essential (EH) or secondary (SH). Methods Our working hypothesis was that if dysregulated emotional processes play a key neurobiological role in EH, they would be less present in hypertension due to specific medical causes or SH. A total of 98 consecutive hypertensive patients (73EH, 25SH) with similar blood pressure levels completed two complementary measures of emotion processing: the 20-item Toronto Alexithymia Scale (TAS-20) and the Levels of Emotional Awareness Scale (LEAS). Results After controlling for confounding variables, LEAS score was lower in EH than SH (estimated means: 46.4 vs. 52.0; P = 0.028; effect size 0.52). TAS-20 scores did not differentiate EH from SH, but the differences were in the expected direction, with an effect size of 0.34 for TAS-20 total score. Neither psychometric measure was associated with the duration of hypertension or the presence of cardiovascular (CV) complications. Conclusions These results are consistent with a contribution of an emotional or psychosomatic component in EH and may have practical implications for the nonpharmacological management of hypertension. They also demonstrate the utility of complementary measures of emotion processing in medically ill patients.