title: Dipping status and hostility in newly diagnosed essential hypertension.
abstract: OBJECTIVE
  Personality traits, including hostility, play an important role in the development of cardiovascular disease. Moreover, abnormalities in blood pressure circadian pattern, such as a lack of nocturnal BP fall, are related with target organ damage and increased cardiovascular risk. The aim of this study was to investigate the impact of hostility and its dimensions on dipping status, in newly diagnosed hypertensive patients.
  
  
  METHODS
  The study population consisted of 114 newly diagnosed untreated essential hypertensives. All participants underwent 24-hour ambulatory blood pressure monitoring (ABPM) in order to assess dipping status. Hostility was assessed by Hostility and Direction of Hostility Questionnaire (HDHQ). The study population was divided in terms of dipping status in two groups, "dippers" and "non-dippers."
  
  
  RESULTS
  The statistical analysis revealed that dippers presented significantly higher score of extrapunitiveness (13.2 +/- 4.9 vs 11.4 +/- 3.9, p = 0.032), as well as significantly higher score of the dimension "urge to act out hostility (AH)" (4 +/- 3 vs 3 +/- 2, p = 0.025) compared to non-dippers. Multivariate regression analysis revealed extrapunitiveness as the only independent predictor of dipping status. The odds ratio (OR) for dipping status associated with each point increase in extrapunitiveness was 0.912 (95% CI: 0.832-0.992; p = 0.048).
  
  
  CONCLUSIONS
  The present findings may suggest that hostility and its features affect the circadian variation of blood pressure in hypertensive patients, providing a promising objective for future investigations linking psychological factors and dipping status in essential hypertension.
authors.affiliation: Hypertensive Center, Clinical Therapeutics, Alexandra Hospital, University of Athens, Greece. ekoromp@med.uoa.gr
authors.forename: Koroboki
authors.initials: K
authors.lastname: Eleni
authors.forename: Papageorgiou
authors.initials: P
authors.lastname: Charalabos
authors.forename: Manios
authors.initials: M
authors.lastname: Efstathios
authors.forename: Rotas
authors.initials: R
authors.lastname: Vassilios
authors.forename: Alexaki
authors.initials: A
authors.lastname: Eleftheria
authors.forename: Michas
authors.initials: M
authors.lastname: Fotis
authors.forename: Papadimitriou
authors.initials: P
authors.lastname: George
authors.forename: Zakopoulos
authors.initials: Z
authors.lastname: Nikolaos
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D005260:Female; D006791:Hostility; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis