You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 290 No. 16, October 22, 2003 TABLE OF CONTENTS
  JAMA
  •  Online Features
  Original Contribution
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Citing articles on ISI (57)
 •Contact me when this article is cited
 Related Content
 •Related letters
 •Related article
 •Similar articles in JAMA
 Topic Collections
 •Psychosocial Issues
 •Psychiatry
 •Depression
 •Randomized Controlled Trial
 •Hypertension
 •Alert me on articles by topic

Psychosocial Factors and Risk of Hypertension

The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Lijing L. Yan, PhD, MPH; Kiang Liu, PhD; Karen A. Matthews, PhD; Martha L. Daviglus, MD, PhD; T. Freeman Ferguson, MPH, MSPH; Catarina I. Kiefe, MD, PhD

JAMA. 2003;290:2138-2148.

Context  Although psychosocial factors are correlated, previous studies on risk factors for hypertension have typically examined psychosocial factors individually and have yielded inconsistent findings.

Objective  To examine the role of psychosocial factors of time urgency/impatience (TUI), achievement striving/competitiveness (ASC), hostility, depression, and anxiety on long-term risk of hypertension.

Design, Setting, and Study Population  A population-based, prospective, observational study using participant data from the Coronary Artery Risk Development in Young Adults (CARDIA) study. A total of 3308 black and white adults aged 18 to 30 years (when recruited in 1985 and 1986) from 4 US metropolitan areas and followed up through 2000 to 2001.

Main Outcome Measures  Fifteen-year cumulative incidence of hypertension (systolic blood pressure of 140 mm Hg or higher, diastolic blood pressure of 90 mm Hg or higher, or taking antihypertensive medication).

Results  The incidence of hypertension at year 15 was 15% from baseline and 13.6% from year 5. After adjusting for the same set of hypertension risk factors and each of the psychosocial factors of TUI, ASC, hostility, depression, and anxiety in 5 separate logistic regression models, higher TUI and hostility were significantly associated with risk of developing hypertension at 15-year follow-up for the total sample. Compared with the lowest score group, the adjusted odds ratio (OR) for TUI was 1.51 (95% confidence interval [CI], 1.12-2.03) for a score of 1; 1.47 (95% CI, 1.08-2.02) for a score of 2; and 1.84 (95% CI, 1.29-2.62) for a score of 3 to 4 (P for trend = .001). Compared with the lowest quartile group, the adjusted OR for hostility was 1.06 (95% CI, 0.76-1.47) for quartile 2; 1.38 (95% CI, 1.00-1.91) for quartile 3; and 1.84 (95% CI, 1.33-2.54) for quartile 4 (P for trend <.001). No consistent patterns were found for ASC, depression, or anxiety. Race- and sex-specific analyses and multivariable models with simultaneous adjustment for all 5 psychosocial factors and other hypertension risk factors had generally similar results.

Conclusion  Among young adults, TUI and hostility were associated with a dose-response increase in the long-term risk of hypertension.


Author Affiliations: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill (Drs Yan, Liu, and Daviglus); Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pa (Dr Matthews); and Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham (Ms Ferguson and Dr Kiefe) and Birmingham Veterans Affairs Medical Center (Dr Kiefe).


RELATED LETTERS

Hostility and Impatience as Risk Factors for Hypertension

JAMA. ;291():692-692.
FULL TEXT  

Hostility and Impatience as Risk Factors for Hypertension--Reply
, , , , and
JAMA. ;291():692-692.
FULL TEXT  

RELATED ARTICLE

Psychosocial Risk Factors for Cardiovascular Disease: More Than One Culprit at Work
, , and
JAMA. ;290():2190-2192.
FULL TEXT  


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effect of anxiety and depression on blood pressure: 11-year longitudinal population study
Hildrum et al.
Br. J. Psychiatry 2008;193:108-113.
ABSTRACT | FULL TEXT  

Positive and negative affect and risk of coronary heart disease: Whitehall II prospective cohort study
Nabi et al.
BMJ 2008;337:a118-a118.
ABSTRACT | FULL TEXT  

Neurovascular responses to mental stress in the supine and upright postures
Kuipers et al.
J. Appl. Physiol. 2008;104:1129-1136.
ABSTRACT | FULL TEXT  

Infant Growth and Hostility in Adult Life
Rikkonen et al.
Psychosom. Med. 2008;70:306-313.
ABSTRACT | FULL TEXT  

Associations of Psychosocial Factors With Heart Rate and Its Short-Term Variability: Multi-Ethnic Study of Atherosclerosis
Ohira et al.
Psychosom. Med. 2008;70:141-146.
ABSTRACT | FULL TEXT  

Longitudinal Association of Serum Carotenoids and Tocopherols with Hostility: The CARDIA Study
Ohira et al.
Am J Epidemiol 2008;167:42-50.
ABSTRACT | FULL TEXT  

Alexithymia and Emotional Distress in Patients With Central Serous Chorioretinopathy
Conrad et al.
Psychosomatics 2007;48:489-495.
ABSTRACT | FULL TEXT  

Psychosocial Factors and Progression From Prehypertension to Hypertension or Coronary Heart Disease
Player et al.
Ann Fam Med 2007;5:403-411.
ABSTRACT | FULL TEXT  

Race-Gender Differences in the Association of Trait Anger with Subclinical Carotid Artery Atherosclerosis: The Atherosclerosis Risk in Communities Study
Williams et al.
Am J Epidemiol 2007;165:1296-1304.
ABSTRACT | FULL TEXT  

Cloninger's Temperament Dimensions, Socio-economic and Lifestyle Factors and Metabolic Syndrome Markers at Age 31 Years in the Northern Finland Birth Cohort 1966
Sovio et al.
J Health Psychol 2007;12:371-382.
ABSTRACT  

Adverse psychological and coronary risk profiles in young patients with coronary artery disease and benefits of formal cardiac rehabilitation.
Lavie and Milani
Arch Intern Med 2006;166:1878-1883.
ABSTRACT | FULL TEXT  

Hypertension in older adults and the role of positive emotions.
Ostir et al.
Psychosom. Med. 2006;68:727-733.
ABSTRACT | FULL TEXT  

Effects of Job Strain on Blood Pressure: A Prospective Study of Male and Female White-Collar Workers
Guimont et al.
Am. J. Public Health 2006;96:1436-1443.
ABSTRACT | FULL TEXT  

Prognostic Implications of Left Ventricular Mass Among Hispanics: The Northern Manhattan Study
Rodriguez et al.
Hypertension 2006;48:87-92.
ABSTRACT | FULL TEXT  

Genetic and Environmental Influences on Type A Behavior Pattern: Evidence From Twins and Their Parents in The Netherlands Twin Register
Rebollo and Boomsma
Psychosom. Med. 2006;68:437-442.
ABSTRACT | FULL TEXT  

Violence Exposure and Optimism Predict Task-Induced Changes in Blood Pressure and Pulse Rate in a Normotensive Sample of Inner-City Black Youth
Clark et al.
Psychosom. Med. 2006;68:73-79.
ABSTRACT | FULL TEXT  

Race/Ethnicity, Income, Major Risk Factors, and Cardiovascular Disease Mortality
Thomas et al.
Am. J. Public Health 2005;95:1417-1423.
ABSTRACT | FULL TEXT  

White-Coat Hypertension as a Risk Factor for the Development of Home Hypertension: The Ohasama Study
Ugajin et al.
Arch Intern Med 2005;165:1541-1546.
ABSTRACT | FULL TEXT  

Ethnicity, Education, and Blood Pressure in Cuba
Ordunez et al.
Am J Epidemiol 2005;162:49-56.
ABSTRACT | FULL TEXT  

Hostility Scores Are Associated With Increased Risk of Cardiovascular Events in Women Undergoing Coronary Angiography: A Report from the NHLBI-Sponsored WISE Study
Olson et al.
Psychosom. Med. 2005;67:546-552.
ABSTRACT | FULL TEXT  

Psychosocial stress and cardiovascular diseases
Vale
Postgrad. Med. J. 2005;81:429-435.
ABSTRACT | FULL TEXT  

DS14: Standard Assessment of Negative Affectivity, Social Inhibition, and Type D Personality
Denollet
Psychosom. Med. 2005;67:89-97.
ABSTRACT | FULL TEXT  

Anger Expression and Blood Pressure in Adolescents
Starner and Peters
The Journal of School Nursing 2004;20:335-342.
ABSTRACT  

Hostility and Impatience as Risk Factors for Hypertension
Mann
JAMA 2004;291:692-692.
FULL TEXT  

Hostility and Impatience Linked with Long-Term Risk for Hypertension
Journal Watch Cardiology 2004;2004:4-4.
FULL TEXT  

Psychosocial Risk Factors for Cardiovascular Disease: More Than One Culprit at Work
Williams et al.
JAMA 2003;290:2190-2192.
FULL TEXT  





HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2003 American Medical Association. All Rights Reserved.