The Role of Personality Dimensions in the Etiopathogenesis of Primary Hypertension

BACKGROUND: Although hypertension is the most important cardiovascular risk factor, we still do not understand all the factors that contribute to the disease onset. The aim of this study was to examine the association between personality dimensions and primary hypertension. METHODS: In total, 310 participants were recruited in a case–control design. The association of personality dimensions with primary hypertension was examined in normotensive (n = 156) and hypertensive (n = 120) patients following assessment of the 5 personality dimensions with the DECAS Personality Inventory. A binary logistic regression model was used to assess the predictive value of personality traits for hypertension, controlling for recognized confounders such as age, gender, obesity, smoking history, parental history of hypertension, and education. RESULTS: Low or very low emotional stability was almost twice as frequent in the hypertensive group (71.7%) as in the normotensive study population (43.5%). The binary logistic regression model showed that low emotional stability is a significant predictor for hypertension, the risk of being hypertensive decreasing by 7% with each point increase on the emotional stability score. Very low or low emotional stability increased the odds of being hypertensive by 3.55 times (odds ratio: 3.55, 95% CI: 2.18-9.35, P < .001). No association between the severity of hypertension and personality traits was found. CONCLUSIONS: People with low emotional stability/high neuroticism have more than 3-fold increased odds of developing primary hypertension. The assessment of personality traits could be used as a tool to identify individuals at risk to develop primary hypertension as well as patients with primary hypertension where psychotherapy could be of potential value. This study highlights the need for further research, in order to establish effective, patient-oriented prevention strategies and treatment options.