AWARENESS OF BLOOD-PRESSURE - INTEROCEPTION OR CONTEXTUAL JUDGMENT

Most patients with mild to moderate hypertension are asymptomatic but some patients report symptoms and seem to be aware of their blood pres sure. The research question is whether the estimation of blood pressur e is primarily derived from interoception or is inferred by contextual judgement. A psychophysiological ambulatory assessment was conducted with 51 male hypertensive patients and 30 either normotensive or hypot ensive student subjects employing (1) a multichannel recording system for blood pressure, heart rate and physical activity; and (2) a pocket computer for assessing estimated BP, setting variables and self-ratin gs of subjective state. Within-subject correlations revealed that ther e was no significant relationship between estimated BP and concurrentl y recorded systolic BP. Estimated BP is, however, related to self-rati ngs of feeling physically tense and self-ratings of physical activity. Blood pressure awareness appears to be a rather inconsistent and subj ective phenomenon, based on contextual judgements and inferences inste ad of ''perception'', but it is a relevant methodological issue (and p ossible bias) in hypertension research.