Mann S J, James G D
Department of Medicine, Hypertension Center, New York Hospital-Cornell Medical Center, New York 10021, USA.
J Psychosom Res. 1998 Aug;45(2):139-48. doi: 10.1016/s0022-3999(97)00293-6.
The purpose of this study was to investigate the association between essential hypertension and defensiveness. Fifty normotensive and 74 hypertensive subjects completed the State-Trait Personality Inventory (STPI) and State-Trait Anger Expression Inventory (STAXI) to assess perceived anger and anxiety, and the Marlowe-Crowne Scale of Social Desirability as an indicator of defensiveness. Hypertensive and normotensive groups did not differ in their scores on the anger, anger expression, and anxiety scales. In contrast, Marlowe-Crowne scores were higher in the hypertensive group (18.1+/-5.5 vs. 15.4+/-5.1) (p=0.006). Stepwise logistic regression that included age, gender, BMI, and Marlowe-Crowne scores (dichotomized at 18) showed that a high Marlowe-Crowne score was associated with a relative risk of 3.63 (CI 1.49-8.83) of being hypertensive, independent of age, gender, and BMI. Anger and anxiety scores did not predict hypertensive status and did not affect the relationship between Marlowe-Crowne score and hypertensive status. We conclude that defensiveness is more closely related to essential hypertension than is self-reported anger or anxiety. Better understanding of conscious and unconscious mechanisms of defensiveness are likely to be important in clarifying the link between emotions and hypertension.
本研究的目的是调查原发性高血压与防御性之间的关联。50名血压正常者和74名高血压患者完成了状态-特质人格量表（STPI）和状态-特质愤怒表达量表（STAXI），以评估感知到的愤怒和焦虑，并完成了马洛-克劳恩社会期望量表作为防御性的指标。高血压组和血压正常组在愤怒、愤怒表达和焦虑量表上的得分没有差异。相比之下，高血压组的马洛-克劳恩得分更高（18.1±5.5对15.4±5.1）（p = 0.006）。纳入年龄、性别、体重指数和马洛-克劳恩得分（以18分为界进行二分法划分）的逐步逻辑回归分析表明，马洛-克劳恩得分高与患高血压的相对风险为3.63（置信区间1.49 - 8.83）相关，独立于年龄、性别和体重指数。愤怒和焦虑得分不能预测高血压状态，也不影响马洛-克劳恩得分与高血压状态之间的关系。我们得出结论，与自我报告的愤怒或焦虑相比，防御性与原发性高血压的关系更为密切。更好地理解防御性的有意识和无意识机制可能对阐明情绪与高血压之间的联系很重要。
