Alexithymia, hypertension, and subclinical atherosclerosis in the general population☆☆☆
Received 10 March 2009; received in revised form 13 July 2009; accepted 21 July 2009. published online 18 November 2009.
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.
aDepartment of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
bInstitute for Community Medicine, University of Greifswald, Greifswald, Germany
cDepartment of Clinical Psychology, University of Heidelberg, Heidelberg, Germany
dDepartment of Psychosomatic Medicine and Psychotherapy, University of Hamburg, Hamburg, Germany
eInstitute of Epidemiology and Social Medicine, University of Greifswald, Greifswald, Germany
fDepartment of Neurology, University of Greifswald, Greifswald, Germany
gDepartment of Internal Medicine B, University of Greifswald, Greifswald, Germany
Corresponding author. Department of Psychiatry, HANSE-Klinikum Stralsund, University of Greifswald, Rostocker Chaussee 70, 18437 Stralsund, Germany. Tel.: +49 (0) 3831/45 2106; fax: +49 (0) 3831/45 2105.
☆ The work is part of the Community Medicine Research Net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant no. ZZ9603), the Ministry of Cultural Affairs, as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania.
☆☆ There are no conflicts of interest. See Appendix A for financial support in the past 3 years.
ABSTRACT