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ARTICLE |

Personality Factors and Pressor Mechanisms in Renal and Essential Hypertension

ADRIAN M. OSTFELD, M.D.; BINYAMIN Z. LEBOVITS, Ph.D.
AMA Arch Intern Med. 1959;104(1):43-52. doi:10.1001/archinte.1959.00270070045006.
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Studies of the personalities of patients with "essential" hypertension conducted by several independent observers have exhibited some agreement.1-11 "What emerges from these studies is evidence of certain kinds of conflictive situations which these patients seem unable to resolve. By and large, they cannot accept either their strong passive dependent attitudes or freely express their hostile impulses." 12 Gressel13 observed a statistically significant association of hypertension with "obsessive-compulsive behavior" and with "subnormal assertiveness."

The evidence that psychological factors are etiologically related to "essential" hypertension has rested on the following observations:

  1. Blood pressure commonly rises in hypertensive subjects during threatening events either occurring in life or contrived in the laboratory.

  2. Blood pressure in hypertensive subjects commonly falls during sleep or after relaxation or reassurance.

  3. Some investigators claim that there is a predictable association of certain specific intrapsychic conflicts or personality traits with elevated blood pressure.

In order to examine the relevance of psychological factors

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