The Article in Brief

Psychosocial Factors and Progression From Prehypertension to Hypertension or Coronary Heart Disease

Marty S. Player, MD , and colleagues

Background There is increasing evidence that people with prehypertension (systolic blood pressure of 120 to 139 mm Hg and diastolic blood pressure of 80 to 89 mm Hg) are at greater risk for developing high blood pressure or cardiovascular disease. This study investigates whether psychosocial factors are associated with the progression from prehypertension to hypertension and prehypertension to heart disease.

What This Study Found Middle-aged men with prehypertension who have high levels of trait anger (a tendency to experience anger across a range of situations) have a higher risk of developing hypertension and coronary heart disease. Men with high trait anger scores have 1.7 times greater odds for developing hypertension than those with low or moderate scores, and high trait anger scores are associated with a 90 percent increase in the risk of progression to coronary heart disease in prehypertensive men. Long-term stress is associated with greater risk of coronary heart disease in both women and men.

Implications

• This study suggests that anger and psychological stress play a role in developing heart disease in individuals with prehypertension.
• Further research is needed to determine whether treating anger and psychological stress helps slow the progression of prehypertension to hypertension and coronary heart disease.