title: Introversion associated with large differences between screening blood pressure and home blood pressure measurement: The Ohasama study.
abstract: OBJECTIVE
  To explore the effect of personality on screening blood pressures measured in clinical settings and home blood pressure measurements.
  
  
  METHODS
  From 1997 to 1999, 699 participants underwent screening and home blood pressure measurements and completed the Japanese version of the short-form Eysenck personality questionnaire. An increased screening blood pressure was defined as screening blood pressure > or = 140/90 mmHg and an increased home blood pressure was defined as home blood pressure > or = 135/85 mmHg.
  
  
  RESULTS
  Participants with lower extroversion scores (i.e., introversion) showed a greater difference between screening and home systolic blood pressure. The association between introversion and differences was statistically significant, even after adjustment for other possible factors (younger age, female, wide screening pulse pressure, never smoked, and no antihypertensive medication). The adjusted means of SBP differences were 7.3 and 4.4 mmHg among the lowest and highest extroversion quartiles, respectively (P for trend = 0.02). Other personality scores (psychoticism or neuroticism) were not associated with screening and home blood pressure differences. The incorporation of an extroversion score in the basic model consisting of the above factors that affected the difference between screening and home blood pressure slightly improved the prediction of a high home blood pressure. The area under the receiver operating characteristic curve increased by 0.037 among participants with high screening blood pressure and 0.006 for those with normal screening blood pressure compared with the basic model.
  
  
  CONCLUSIONS
  Physicians may need to be aware of 'introverted' patients who have high blood pressure in clinic settings, because they have the potential for 'white-coat' hypertension.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Shiga, Japan. hozawa-thk@umin.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hozawa
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Arai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Toru
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods / Q000523:psychology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000523:psychology*; D007439:Introversion, Psychological; D007564:Japan; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010817:Physician-Patient Relations; D011237:Predictive Value of Tests; D012372:ROC Curve