title: Alexithymia, hypertension, and subclinical atherosclerosis in the general population.
abstract: OBJECTIVE
  As a personality trait, alexithymia is assumed to present a longstanding risk factor for emotional dysregulation that also affects the autonomic nervous system. Therefore, we hypothesize that alexithymia is associated with hypertension and carotid atherosclerosis in the general population.
  
  
  METHODS
  A total of 1168 subjects (age <65 years) from the Study of Health in Pomerania (SHIP) were eligible for complete case analyses. Alexithymia was assessed with the 20-item Toronto-Alexithymia-Scale (TAS-20). An extensive interview and physical examination were performed. Extracranial carotid arteries were examined bilaterally with B-mode ultrasonography. Regression models were adjusted for sociodemographic factors and classical risk factors for cardiovascular diseases and mental distress.
  
  
  RESULTS
  In the adjusted logistic regression models, alexithymia was significantly associated with hypertension (OR=1.60; 95% CI=1.14-2.25) and with atherosclerotic plaques (OR=1.70; 95% CI=1.14-2.54). Hypertension changed the effect of alexithymia on atherosclerosis only marginally (OR=1.76 to 1.70).
  
  
  CONCLUSIONS
  Alexithymia may represent a relevant and independent risk factor for hypertension and carotid atherosclerosis at the population level. None of the putative confounders mediated a relevant proportion of the risk. Prospective studies are needed to confirm this association.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany. grabeh@uni-greifswald.de
authors.forename: Hans Joergen
authors.initials: HJ
authors.lastname: Grabe
authors.forename: Christian
authors.initials: C
authors.lastname: Schwahn
authors.forename: Sven
authors.initials: S
authors.lastname: Barnow
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Harald J
authors.initials: HJ
authors.lastname: Freyberger
authors.forename: Ulf
authors.initials: U
authors.lastname: Schminke
authors.forename: Stephan
authors.initials: S
authors.lastname: Felix
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D001794:Blood Pressure / Q000502:physiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010551:Personality / Q000502:physiology; D011159:Population Surveillance; D015995:Prevalence; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014463:Ultrasonography