Alexithymia, hypertension, and subclinical atherosclerosis in the general population

J Psychosom Res. 2010 Feb;68(2):139-47. doi: 10.1016/j.jpsychores.2009.07.015. Epub 2009 Nov 17.

Abstract

Objectives: As a personality trait, alexithymia is assumed to present a longstanding risk factor for emotional dysregulation that also affects the autonomic nervous system. Therefore, we hypothesize that alexithymia is associated with hypertension and carotid atherosclerosis in the general population.

Methods: A total of 1168 subjects (age <65 years) from the Study of Health in Pomerania (SHIP) were eligible for complete case analyses. Alexithymia was assessed with the 20-item Toronto-Alexithymia-Scale (TAS-20). An extensive interview and physical examination were performed. Extracranial carotid arteries were examined bilaterally with B-mode ultrasonography. Regression models were adjusted for sociodemographic factors and classical risk factors for cardiovascular diseases and mental distress.

Results: In the adjusted logistic regression models, alexithymia was significantly associated with hypertension (OR=1.60; 95% CI=1.14-2.25) and with atherosclerotic plaques (OR=1.70; 95% CI=1.14-2.54). Hypertension changed the effect of alexithymia on atherosclerosis only marginally (OR=1.76 to 1.70).

Conclusion: Alexithymia may represent a relevant and independent risk factor for hypertension and carotid atherosclerosis at the population level. None of the putative confounders mediated a relevant proportion of the risk. Prospective studies are needed to confirm this association.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affective Symptoms / diagnostic imaging
  • Affective Symptoms / epidemiology*
  • Atherosclerosis / diagnostic imaging
  • Atherosclerosis / epidemiology*
  • Blood Pressure / physiology
  • Carotid Arteries / diagnostic imaging
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / epidemiology*
  • Comorbidity
  • Female
  • Germany / epidemiology
  • Health Surveys
  • Humans
  • Hypertension / diagnostic imaging
  • Hypertension / epidemiology*
  • Male
  • Middle Aged
  • Personality / physiology
  • Population Surveillance
  • Prevalence
  • Regression Analysis
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Ultrasonography