Two hundred three patients with essential hypertension (20- to 55-year-old men) were examined initially and at the end of a 1-year follow-up. Clinical, psychological, and psychophysiological methods were used. In the psychophysiological assessment, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, and respiratory rate were recorded at rest and during various emotional stressors. Patients who exhibited a greater increase in blood pressure during psychological stress, in addition to an inherited predisposition to essential hypertension, had higher levels of assertiveness and interpersonal conflict. The differences in cardiovascular response to various emotional stressors depended on the psychological features of the hypertensive patients. An SBP increase during the performance of mental arithmetic correlated with anxiety level, whereas a DBP increase was associated with assertiveness. Changes in SBP and DBP during a stressful computer game correlated with the level of competitiveness and conflict. Hypertensive patients who exhibited an increase in blood pressure during the follow-up were characterized initially by a greater DBP increase during emotional stress and a longer recovery period.
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