Personality and cardiovascular risk: Association between hypertension and affective temperaments-a cross-sectional observational study in primary care settings

Background : Affective temperaments can be considered the subclinical manifestations of affective disorders, which have a bidirectional relationship with cardiovascular diseases. Objectives: Aim of this study was to assess the role of affective temperaments in primary hypertension, which is the leading risk factor of cardiovascular morbidity and mortality. Methods: In total, 251 consecutive patients, including 179 patients being treated for primary hypertension with anti-hypertensives, with chronic disorders without diagnosed depression were enrolled in a primary care setting. Patients completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). Lifestyle-related risk factors, chronic diseases including cardiovascular complications were also recorded. Logistic regression analysis was used to determine the relationship of affective temperaments and lifestyle-related risk factors on hypertension. Results: Dominant cyclothymic temperament-with instability and rapid mood swings as main characteristics-had a significant association with hypertension (P = 0.006) even after the adjustment of correlation for known risk factors such as age, diabetes mellitus and obesity (OR: 11.88, 95% CI: 1.27-111.17). This association remained significant after controlling for the family wise error rate. The obtained adjusted P value was 0.024 at a 0.05 error rate. Conclusion: Results indicate that dominant cyclothymic affective temperament may be an additional risk factor in cardiovascular morbidity, and it may be worthy of further assessment to identify patients at risk and formulate a more individualized treatment approach.