Natural history of male psychological health, XIII: Who develops high blood pressure and who responds to treatment.
OBJECTIVE
This study was an effort to clarify both the psychological contributions to and the long-term consequences of uncomplicated essential hypertension.


METHODS
The subjects were 193 healthy college students selected as sophomores and prospectively followed for over 50 years. Independent assessments of physical and mental health were made.


RESULTS
Although objective indices of psychopathology predicted both physical morbidity and mortality, they did not predict hypertension. When pyknic somatotype, college diastolic blood pressure, and well-integrated personality in college were controlled, no other preadult variable predicted hypertension. As expected, heart disease, obesity, and alcohol abuse were each correlated with hypertension. After roughly 20 years, 14 of the 41 men with treated hypertension were in stable remission, and 13 men had developed cardiac complications. No differences between these groups could be discerned.


CONCLUSIONS
Over time, hypertension appeared to be more a product of biological than of psychosomatic variables. Good psychological health did not diminish the risk of hypertension.
Vaillant
G E
GE
Department of Psychiatry, Harvard Medical School, Boston, USA.
Gerber
P D
PD
D000328:Adult; D000367:Age Factors; D000368:Aged; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology; D001835:Body Weight; D003674:Defense Mechanisms; D015444:Exercise; D006305:Health Status Indicators; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008136:Longevity / Q000235:genetics; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D010551:Personality; D011446:Prospective Studies; D011602:Psychophysiologic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012907:Smoking / Q000453:epidemiology; D013008:Somatotypes; D016896:Treatment Outcome