Alexithymia, hypertension, and subclinical atherosclerosis in the general population.
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.
Grabe
Hans Joergen
HJ
Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany. grabeh@uni-greifswald.de
Schwahn
Christian
C
Barnow
Sven
S
Spitzer
Carsten
C
John
Ulrich
U
Freyberger
Harald J
HJ
Schminke
Ulf
U
Felix
Stephan
S
Völzke
Henry
H
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