title: The relationship between affective symptoms and hypertension-role of the labelling effect: the 1946 British birth cohort.
abstract: To investigate the association between repeated measures of affective symptoms collected over 2 decades and hypertension (clinically ascertained or self-report); to test whether, among people with hypertension, affective symptoms are associated with awareness of hypertension, and to evaluate the longitudinal effects of the label of hypertension on affective symptoms.
  
  
  
  Multivariable logistic regression, accounting for confounders and mediators, were used to test the aforementioned associations in 1683 participants from a national British cohort.
  
  
  
  Weak evidence of a cumulative impact of affective symptoms across adulthood on self-reported hypertension at age 60-64 years was observed (OR 1.40 (95% CI 1.10 to 1.78) and 1.19 (0.79 to 1.80) for symptoms at 1-2 time points and at 3-4 time points vs no symptoms, respectively). Study members with affective symptoms in recent times were more likely to have self-reported hypertension at age 60-64 years than those without symptoms (OR 1.47 (1.10 to 1.96)). Similar results were observed for awareness of hypertension (OR 2.00 (1.30 to 3.06)). Conversely, no associations were found with clinically ascertained hypertension. The act of labelling someone as hypertensive at age 53 years was associated with affective symptoms at age 60-64 years, independently of antihypertensive treatment and affective symptoms at the time of the diagnosis (OR 2.40 (1.32 to 4.36)).
  
  
  
  Our findings suggest that elevated risk of hypertension in participants with affective symptoms might be explained by awareness of hypertension and by exposure to medical attention, though not by a direct effect of affective symptoms on blood pressure. Conversely, long-term psychological consequences of the label of hypertension are observed.
authors.affiliation: MRC Unit for Lifelong Health, Ageing at UCL, London, UK; Department of Medicine, University of Padova, Padova, Italy.
authors.forename: Valérie
authors.initials: V
authors.lastname: Tikhonoff
authors.affiliation: MRC Unit for Lifelong Health , Ageing at UCL , London , UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hardy
authors.affiliation: National Centre for Cardiovascular Prevention and Outcomes , Institute of Cardiovascular Science, University College London , London , UK.
authors.forename: John
authors.initials: J
authors.lastname: Deanfield
authors.affiliation: Department of Clinical Physiology , Sahlgrenska University Hospital , Gothenburg University , Gothenburg , Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Friberg
authors.affiliation: MRC Unit for Lifelong Health , Ageing at UCL , London , UK.
authors.forename: Graciela
authors.initials: G
authors.lastname: Muniz
authors.affiliation: MRC Unit for Lifelong Health , Ageing at UCL , London , UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Kuh
authors.affiliation: Department of Psychological Medicine , King's College London Institute of Psychiatry , London , UK.
authors.forename: Carmine M
authors.initials: CM
authors.lastname: Pariante
authors.affiliation: Department of Psychological Medicine , King's College London Institute of Psychiatry , London , UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
authors.affiliation: MRC Unit for Lifelong Health , Ageing at UCL , London , UK.
authors.forename: Marcus
authors.initials: M
authors.lastname: Richards
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