Psychosocial Stress and Low Resilience: a Risk Factor for Hypertension

pp 425-431

Abstract

Background
Chronic psychosocial stress (CPSS) has been proposed as a risk factor for cardiovascular disease (CVD); yet there are not conclusive studies supporting this theory due to the complexity and the lack of objective assessment measures, together with the absence of homogeneous reactions towards CPSS.

Objectives

To determine the presence of an association between low resilience (LR) to chronic PSS and hypertension and target organ damage in untreated outpatients undergoing a routine health examination, and to determine whether this association is related to the pattern of neurohumoral activation.

Material and Methods
We conducted a preliminary observational and cross-sectional study that enrolled 53 consecutive patients, 32 men and 21 women. The patients answered two questionnaires: one measured CPSS and the other the Connor-Davidson Resilience Scale. Patients were divided into four groups: 1, no CPSS and normal resilience (NR); 2, no CPPS and low resilience (LR) 3, with CPSS and NR; 4 with CPSS and LR.

Results

The prevalence of hypertension and increased waist circumference (IWC) was greater in group 4 (p<0.001 and p=0.05, respectively). The plasma levels of norepinephrine, cortisol and vanillyl mandelic acid were slightly increased in group 4, yet these differences were not significant. A logistic regression model was used to control for confounding in order to determine whether CPPS together with LR constitute a risk factor for the development of hypertension; odds ratio, 10.9, 95% CI: 1.7-65.2.

Conclusions
These preliminary data suggest that subjects with CPPS and LR have high risk for the development of hypertension.