Gender differences apparent in psychological factors that predict later hypertension

Women who were depressed and felt socially alienated and men who felt inadequate in their jobs were more likely than their peers to develop high blood pressure decades later, according to a new study.

The study also showed that in women, much of the association between psychosocial factors and high blood pressure was the result of unhealthy behaviors such as smoking, obesity and a sedentary lifestyle.

"There have been hints in the literature of such differential risk factor patterns, men appearing more sensitive to work-related threats to autonomy, and women to difficulties in relationships with family and friends," says Susan Levenstein, M.D., of the Human Population Laboratory in Berkeley.

The study is published in the May issue of the Archives of Internal Medicine.

In the survey of 2,357 Alameda County, California, residents originally questioned in 1974 and then again in 1994, the researchers found that African-Americans had a 70 percent higher likelihood of hypertension than others; low job status raised the likelihood by 50 percent and low job security by 40 percent.

Looking at the sexes separately, womens incidence of hypertension 20 years later rose substantially in relation to psychological factors such as feeling socially alienated, depression and low-status work.

In men, job insecurity was associated with a 50 percent increase in hypertension, unemployment a 130 percent increase and feeling that they werent good at their job a 110 percent increase, Levenstein found.

Adjusting for blood-pressure-raising health behaviors, such as smoking and obesity, reduced the impact of the psychosocial factors on the incidence of hypertension, but the effect of these factors was still statistically significant.

"The excess hypertensive risk related to psychological distress is thus chiefly mediated by increases in health risk behaviors among distressed individuals or due to confoundin

Contact: Susan Levenstein, M.D.
Center for the Advancement of Health

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