Psychosocial Stress and Low Resilience: a Risk Factor for Hypertension (original) (raw)
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Does psychosocial stress cause hypertension? A systematic review of observational studies
Journal of Human Hypertension, 2009
Acute stress promotes transient elevation of blood pressure, but there is no consistent evidence that this effect results in hypertension. In this systematic review of cohort and case-control studies that investigated the association between psychosocial stress and hypertension, we conducted a complete search up to February 2007 in MEDLINE, EMBASE, PSYCINFO and LILACS, through a search strategy that included eight terms to describe the exposure, six related to the design of the studies and one term for outcome. The quality was assessed by the Newcastle-Ottawa Quality Assessment Scale. The selection was done in duplicate by two teams of independent reviewers. Among 82 studies selected in the second phase, only 14 (10 cohort studies and 4 case-control studies), totalling 52 049 individuals, fulfilled the selection criteria. The average quality of the studies was 6.6 ± 1.3 in a 9-point scale. Acute life events were associated with hypertension in one and were not associated in two studies. Five out of seven studies found a significant and positive association between measures of chronic stress and hypertension, with risk ratios ranging from 0.8 to 11.1. Three out of five studies reported high and significant risks of affective response to stress for hypertension, one a significant risk close to a unit and one reported absence of risk. Acute stress is probably not a risk factor for hypertension. Chronic stress and particularly the non-adaptive response to stress are more likely causes of sustained elevation of blood pressure. Studies with better quality are warranted.
Examining the Role of Psychosocial Stressors in Hypertension
Journal of Preventive Medicine and Public Health
Despite advances in medicine and preventive strategies, fewer than 1 in 5 people with hypertension have the problem under control. This could partly be due to gaps in fully elucidating the etiology of hypertension. Genetics and conventional lifestyle risk factors, such as the lack of exercise, unhealthy diet, excess salt intake, and alcohol consumption, do not fully explain the pathogenesis of hypertension. Thus, it is necessary to revisit other suggested risk factors that have not been paid due attention. One such factor is psychosocial stress. This paper explores the evidence for the association of psychosocial stressors with hypertension and shows that robust evidence supports the role of a chronic stressful environment at work or in marriage, low socioeconomic status, lack of social support, depression, anxiety, post-traumatic stress, childhood psychological trauma, and racial discrimination in the development or progression of hypertension. Furthermore, the potential pathophysi...
Blood Pressure Reactivity to Psychological Stress Predicts Hypertension in the CARDIA Study
Circulation, 2004
Background— A longstanding but controversial hypothesis is that individuals who exhibit frequent, large increases in blood pressure (BP) during psychological stress are at risk for developing essential hypertension. We tested whether BP changes during psychological stress predict incident hypertension in young adults. Methods and Results— We used survival analysis to predict hypertensive status during 13 years of follow-up in a sample of >4100 normotensive black and white men and women (age at entry, 18 to 30 years) enrolled in the CARDIA study. BP responses to 3 psychological challenges—cold pressor, star tracing, and video game tasks—were measured. Hypertensive status was defined as use of antihypertensive medication or measured BP ≥140/90 mm Hg. After adjustment for race, gender, covariates (education, body mass index, age, and resting pressure), and their significant interactions, the larger the BP responses were to each of the 3 tasks, the earlier hypertension occurred ( P &...
Psychological Resilience, Cardiovascular Disease, and Metabolic Disturbances: A Systematic Review
Frontiers in Psychology, 2022
BackgroundPositive psychosocial factors can play an important role in the development of cardiovascular disease (CVD). Among them, psychological resilience (PR) is defined as the capacity of responding positively to stressful events. Our aim was to assess whether PR is associated with CVD or metabolic disturbances through a systematic review.MethodsWe gathered articles from PubMed, Web of Science, PsycInfo, and Google Scholar up to October 28, 2021. We included articles that were in English, were observational, and had PR examined as exposure. The CVD outcomes were either clinical or metabolic outcomes (i.e., dyslipidemia, obesity, metabolic syndrome, hypertension, and diabetes).ResultsOur literature search identified 3,800 studies, of which 17 met the inclusion criteria. Of them, seven were longitudinal and 10 cross-sectional, and 13 were on adults and four on children. The exposure assessment was heterogeneous, i.e., 12 studies used different kinds of self-administered questionnai...
Association between psychosocial stress and hypertension: a systematic review and meta-analysis
Neurological research, 2017
The etiology of hypertension is various and complex, involving both genetic and behavioral factors. The relationship between psychosocial stress and hypertension has been hypothesized. More and more people experience increased anxiety, depression, and chronic psychosocial stress brought on by globalization, cultural changes, socioeconomic changes, and stress at the work place. Although a plethora of studies have investigated the interaction between psychosocial stress and hypertension, this relationship is still contentious. The objective of this study is twofold. First, a review of recent advancements in our understanding of the relationship between psychosocial stress and hypertension. Second, a meta-analysis aiming to assess the relationship between chronic psychosocial stress and blood pressure. We systematically searched and identified relevant studies from five databases, including PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), CQVIP, and the Wanfang...
BMC Public Health, 2008
Background The evidence linking stress to hypertension has been scarcely documented in population-based studies. Methods Participants were selected through a multi-stage probability sampling and interviewed at home, being submitted to measures of demographics, anthropometrics, blood pressure (BP), and risk factors for hypertension. Hypertension was defined as BP ≥ 140/90 mm Hg or use of BP-lowering drugs or as self-reported hypertension. Stressful life events were investigated through an inventory of nine major life events occurring in the year preceding the interview. Psychological distress was evaluated through a facial scale of expression of emotion in the last month. Results In the total, 1,484 adult individuals were investigated. Prevalence of hypertension was lower in individuals who reported any stressful life event in comparison with individuals who did not reported an event (34.3 versus 44.2%, P < 0.01), such as relative or friend death, loss of job, divorce, violence and migration. There was a trend for higher prevalence of hypertension in individuals with higher psychological distress in the last month, which was not longer significant after adjustment for confounding. In contrast, individuals who self-reported hypertension, but actually had normal blood pressure and were not using antihypertensive medication, reported higher numbers of stressful events. Conclusion Recent stressful life events and current psychological distress are not associated with hypertension. Associations between stress events and distress with self-reported hypertension are not intermediated by effects of stress on blood pressure, and may be ascribed to negative feeling about disease and not to the disease itself.
European Journal of Cardiovascular Nursing, 2021
Aims The aim of this systematic review of the literature is to synthesize the evidence regarding the associations between individual-level psychological, social/cultural, behavioral, and biological variables with resilience in patients with CVD. Methods and results A systematic search of PubMed, PsycINFO and CINAHL was conducted from database inception through March 2020. Studies with a quantitative research design were eligible for inclusion if published in English and focused on resilience among adults with CVD. Of the 788 articles retrieved, 34 studies (35 articles) were included in the review. Twenty-three studies focused on psychological factors, with findings of inverse relationships between resilience and depression, anxiety, and stress. Evidence regarding associations between resilience and social/cultural or behavioral variables was scarce. Four of the 6 studies regarding biological factors found low stress resilience in young adulthood was associated with early diagnoses o...
The Influence of Stress on the Quality of Life of Hypertensive Patients
The European Journal of Counselling Psychology, 2013
Hypertension and stress are the most prevalent risk factors in cardiovascular diseases, causing impact on quality of life of hypertensive patients. It is the aim of the study to assess the vulnerability to stress of hypertension patients and identify the factors of vulnerability to stress which interfere with quality of life of hypertension patients. Non experimental study, quantitative, transversal, descriptive and correlational. With a sample of 431 hypertension patients. Data collection took place from June to September 2012, through a questionnaire with questions concerning socio-demographic data, clinical, evaluation of the quality of life of hypertensive patients and evaluation of vulnerability to Stress. The main results are 43,15% were male, 56,84% female aged between 30 and 95 years old. There is influence of gender, age, marital status, education, employment status, cohabitation and monthly income, both in vulnerability to stress as in quality of life. Worse quality of life, female literacy, with average higher than male (M = 8,81 in mental status, M = 3,93 in somatic manifestations and M = 0,73 in overall impact). The vulnerability to stress has also an influence on the quality of life. 44,2% of hypertensive patients are vulnerable to stress, with percentage value for females (51,2%). It is essential to know the factors of vulnerability to stress predictors of quality of life of hypertension patients in order to operate and improve their quality of life.