Essential hypertension and psychological functioning: a study of factory workers.

This study was designed to examine the links between psychological characteristics and mild essential hypertension. Hypertensives were identified through mass screening of industrial populations. Sixteen men under the age of 56 whose blood pressure remained above 145/90 (145/95 for the 45-55 age group) on three separate occasions were compared with 13 age-matched normotensives from the same population. Participants completed a series of personality questionnaires, and carried out concurrent mood ratings and blood pressure self-monitoring four times daily for 14 days. Subjects remained unaware of their diagnostic status until the procedure was completed. No differences between groups were found on measures of trait anxiety, total hostility or direction of hostility. State anxiety and Type A (coronary-prone) scores were significantly higher in normotensives than in hypertensives. Analysis of mood and self-monitored blood pressure revealed consistent correlations between negative mood and higher pressure in both groups. Comparison of correlations between blood pressure, tension and anger with the correlations of pressure with a control mood scale permitted spurious associations based on expectancies or reporting biases to be distinguished from genuine effects. Only the correlation between tension and systolic pressure in the hypertensive group exceeded the correlation with the control mood scale. Self-monitored pressure also correlated with pressure levels recorded in the laboratory. These results suggest that examination of blood pressure variations and psychological factors on a longitudinal basis may be valuable, particularly in the development of self-management procedures for essential hypertensives.