title: Hypertension labeling and well-being: alternative explanations in cross-sectional data.
abstract: We attempted to replicate recent cross-sectional findings suggesting that the process of being labeled a hypertensive may result in reductions in the perception of well-being among normotensives. From a community survey, 1849 normotensives were categorized by the presence or absence of either a provider message about hypertension (history) or the belief that they have hypertension (self-diagnosis). Normotensives with any label reported greater numbers of depressive and medical symptoms, poorer self-perceived health and more disability than those with neither label. Multiple regression analysis showed that whereas a history was significantly associated only with symptoms, a self-diagnosis was more strongly associated with measures of morbidity. In addition, there was a significant positive relationship between a hypertensive history and the number of physician visits in the previous year. Because the described associations are cross-sectional, labeling may undermine one's sense of well-being, or, individuals with greater self-perceived morbidity may visit physicians more frequently and, as a result, have a greater opportunity for a blood pressure elevation to be detected.
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008487:Medical History Taking; D008603:Mental Health; D008875:Middle Aged; D012649:Self Concept; D012650:Self Disclosure; D012647:Self-Assessment