Defensiveness status predicts 3-year incidence of hypertension

Objective A growing body of research indicates that defensive personality s tyles (in particular, self-deception) may be related to higher resting bloo d pressure and stress reactivity levels. This study is the first, however, to examine the value of defensiveness as a prognostic indicator for the dev elopment of clinical hypertension. Methods Participants were 127 initially normotensive male and female adults who completed a comprehensive protocol including psychological testing, as sessment of smoking, physical activity and body fat levels, and 8-12 h ambu latory blood pressure monitoring. Participants returned 3-years later for a n identical follow-up protocol. Defensiveness was assessed using the Balanc ed Inventory of Desirable Responding. Results At 3-year testing, 15 of 127 participants (12%) met criteria for hy pertension (i.e. ambulatory mean blood pressure >140/90). Comparisons betwe en defensiveness groups showed that 12 of 60 (20%) high defensiveness parti cipants met hypertension criteria, whereas only three: of 67 (4.5%) low def ensiveness participants were hypertensive. Logistic regression equations ad justed for age, alcohol usage, bodyfat, self-reported exercise levels, smok ing, and year-1 ambulatory blood pressure, revealed that membership in the high defensiveness group was associated with more than a sevenfold risk of 3-year hypertension (adjusted risk ratio, 7.5; 95% confidence interval, 1.5 -39.2). Conclusions These findings link defensive characteristics to an increased p rospective risk of hypertension using state of the art ambulatory monitorin g techniques, and were robust after controlling for established risk factor s. We conclude that the current results add to the hypertension literature by demonstrating associations between personality and clinically relevant b lood pressure criteria. J Hypertens 2000, 18:153-159 (C) Lippincott William s & Wilkins.