Dipping Status and Hostility in Newly Diagnosed Essential Hypertension

Abstract

Aim: Personality traits, including hostility, play an important role in the development of cardiovascular disease. Moreover, abnormalities in blood pressure circadian pattern, such as a lack of nocturnal BP fall, are related with target organ damage and increased cardiovascular risk. The aim of this study was to investigate the impact of hostility and its dimensions on dipping status, in newly diagnosed hypertensive patients. Methods: The study population consisted of 114 newly diagnosed untreated essential hypertensives. All participants underwent 24-hour ambulatory blood pressure monitoring (ABPM) in order to assess dipping status. Hostility was assessed by Hostility and Direction of Hostility Questionnaire (HDHQ). The study population was divided in terms of dipping status in two groups, “dippers” and “non-dippers.” Results: The statistical analysis revealed that dippers presented significantly higher score of extrapunitiveness (13.2 + 4.9 vs 11.4 + 3.9, p = 0.032), as well as significantly higher score of the dimension “urge to act out hostility (AH)” (4 + 3 vs 3 + 2, p = 0.025) compared to non-dippers. Multivariate regression analysis revealed extrapunitiveness as the only independent predictor of dipping status. The odds ratio (OR) for dipping status associated with each point increase in extrapunitiveness was 0.912 (95% CI: 0.832–0.992; p = 0.048). Conclusion: The present findings may suggest that hostility and its features affect the circadian variation of blood pressure in hypertensive patients, providing a promising objective for future investigations linking psychological factors and dipping status in essential hypertension.