Am J Psychiatry 1996; 153:24-29
Copyright © 1996 by American Psychiatric Association
Natural history of male psychological health, XIII: Who develops high blood pressure and who responds to treatment
GE Vaillant and PD Gerber
Department of Psychiatry, Harvard Medical School, Boston, USA.
OBJECTIVE: This study was an effort to clarify both the psychological
contributions to and the long-term consequences of uncomplicated essential
hypertension. METHOD: The subjects were 193 healthy college students
selected as sophomores and prospectively followed for over 50 years.
Independent assessments of physical and mental health were made. RESULTS:
Although objective indices of psychopathology predicted both physical
morbidity and mortality, they did not predict hypertension. When pyknic
somatotype, college diastolic blood pressure, and well- integrated
personality in college were controlled, no other preadult variable
predicted hypertension. As expected, heart disease, obesity, and alcohol
abuse were each correlated with hypertension. After roughly 20 years, 14 of
the 41 men with treated hypertension were in stable remission, and 13 men
had developed cardiac complications. No differences between these groups
could be discerned. CONCLUSIONS: Over time, hypertension appeared to be
more a product of biological than of psychosomatic variables. Good
psychological health did not diminish the risk of hypertension.
