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J Psychosom Res. 1998 Aug;45(2):139-48.

Defensiveness and essential hypertension.

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Department of Medicine, Hypertension Center, New York Hospital-Cornell Medical Center, New York 10021, USA.


The purpose of this study was to investigate the association between essential hypertension and defensiveness. Fifty normotensive and 74 hypertensive subjects completed the State-Trait Personality Inventory (STPI) and State-Trait Anger Expression Inventory (STAXI) to assess perceived anger and anxiety, and the Marlowe-Crowne Scale of Social Desirability as an indicator of defensiveness. Hypertensive and normotensive groups did not differ in their scores on the anger, anger expression, and anxiety scales. In contrast, Marlowe-Crowne scores were higher in the hypertensive group (18.1+/-5.5 vs. 15.4+/-5.1) (p=0.006). Stepwise logistic regression that included age, gender, BMI, and Marlowe-Crowne scores (dichotomized at 18) showed that a high Marlowe-Crowne score was associated with a relative risk of 3.63 (CI 1.49-8.83) of being hypertensive, independent of age, gender, and BMI. Anger and anxiety scores did not predict hypertensive status and did not affect the relationship between Marlowe-Crowne score and hypertensive status. We conclude that defensiveness is more closely related to essential hypertension than is self-reported anger or anxiety. Better understanding of conscious and unconscious mechanisms of defensiveness are likely to be important in clarifying the link between emotions and hypertension.

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