Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Göttingen, Germany.
Psychosom Med. 2013 May;75(4):422-8. doi: 10.1097/PSY.0b013e31828ef0c2.
Quality of life is often impaired in patients with known hypertension, but it is less or not at all reduced in people unaware of their elevated blood pressure. Some studies have even shown less self-rated distress in adults with elevated blood pressure. In this substudy of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KIGGS), we addressed the question whether, also in adolescents, hypertensive blood pressure is linked to levels of distress and quality of life.
Study participants aged 11 to 17 years (N = 7688) received standardized measurements of blood pressure, quality of life (using the Children's Quality of Life Questionnaire), and distress (Strengths and Difficulties Questionnaire).
Elevated blood pressure was twice as frequent as expected, with 10.7% (n = 825) above published age-, sex- and height-adjusted 95th percentiles. Hypertensive participants were more likely to be obese and to report on adverse health behaviors, but they showed better academic success than did normotensive participants. Elevated blood pressure was significantly and positively associated with higher self- and parent-rated quality of life (for both, p ≤ .006), less hyperactivity (for both, p < .005), and lower parent-rated emotional (p < .001), conduct (p = .021), and overall problems (p = .001). Multiple regression analyses confirmed these findings.
Our observation linking elevated blood pressure to better well-being and low distress can partly be explained by the absence of confounding physical comorbidity and the unawareness of being hypertensive. It also corresponds to earlier research suggesting a bidirectional relationship with repressed emotions leading to elevated blood pressure and, furthermore, elevated blood pressure serving as a potential stress buffer.
已知高血压患者的生活质量常常受损，但那些未察觉自己血压升高的人群的生活质量受损程度较低或不受影响。一些研究甚至表明，血压升高的成年人自评的苦恼程度较低。在全国范围的德国儿童和青少年健康访谈和体检调查（KIGGS）的这项子研究中，我们探讨了在青少年中，高血压与苦恼程度和生活质量之间是否存在关联的问题。
研究对象为年龄在 11 至 17 岁的参与者（N=7688），他们接受了血压、生活质量（使用儿童生活质量问卷）和苦恼程度（长处和困难问卷）的标准化测量。
血压升高的频率是预期的两倍，超过公布的按年龄、性别和身高调整的第 95 百分位数的青少年占 10.7%（n=825）。高血压患者更有可能肥胖，并报告存在不良健康行为，但他们的学业成绩优于血压正常的参与者。与血压正常的参与者相比，血压升高与更高的自我和家长报告的生活质量（两者均 p≤.006）、较少的多动（两者均 p<.005）和更低的家长报告的情绪问题（p<.001）、行为问题（p=.021）和整体问题（p=.001）显著正相关。多元回归分析证实了这些发现。
我们观察到血压升高与更好的幸福感和较低的苦恼程度相关，这部分可以通过不存在混杂的身体合并症和对高血压的未察觉来解释。这也与早期研究相呼应，即情绪压抑会导致血压升高，而血压升高又可能成为潜在的应激缓冲，两者之间存在双向关系。
