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Introversion associated with large differences between screening blood pressure and home blood pressure measurement: the Ohasama study

Hozawa, Atsushia; Ohkubo, Takayoshib,f; Obara, Takuc,f; Metoki, Hirohitoc,f; Kikuya, Masahirob; Asayama, Keic,f; Totsune, Kazuhitoc,f; Hashimoto, Junichirob,f; Hoshi, Haruhisag; Arai, Yumikoh; Satoh, Hiroshid; Hosokawa, Torue; Imai, Yutakac,f

doi: 10.1097/01.hjh.0000249695.81241.35
Original papers: Blood pressure measurement

Objective To explore the effect of personality on screening blood pressures measured in clinical settings and home blood pressure measurements.

Methods From 1997 to 1999, 699 participants underwent screening and home blood pressure measurements and completed the Japanese version of the short-form Eysenck personality questionnaire. An increased screening blood pressure was defined as screening blood pressure ≥ 140/90 mmHg and an increased home blood pressure was defined as home blood pressure ≥ 135/85 mmHg.

Results Participants with lower extroversion scores (i.e., introversion) showed a greater difference between screening and home systolic blood pressure. The association between introversion and differences was statistically significant, even after adjustment for other possible factors (younger age, female, wide screening pulse pressure, never smoked, and no antihypertensive medication). The adjusted means of SBP differences were 7.3 and 4.4 mmHg among the lowest and highest extroversion quartiles, respectively (P for trend = 0.02). Other personality scores (psychoticism or neuroticism) were not associated with screening and home blood pressure differences. The incorporation of an extroversion score in the basic model consisting of the above factors that affected the difference between screening and home blood pressure slightly improved the prediction of a high home blood pressure. The area under the receiver operating characteristic curve increased by 0.037 among participants with high screening blood pressure and 0.006 for those with normal screening blood pressure compared with the basic model.

Conclusion Physicians may need to be aware of ‘introverted’ patients who have high blood pressure in clinic settings, because they have the potential for ‘white-coat’ hypertension.

aDepartment of Health Science, Shiga University of Medical Science, Shiga

bDepartments of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai

cDepartment of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai

dDepartment of Environmental Health Sciences, Tohoku University Graduate School of Medicine, Sendai

eDepartment of Psychology and Disability, Tohoku University Graduate School of Education, Sendai

fTohoku University 21st Century COE Program ‘Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation’, Sendai

gOhasama Hospital, Iwate

hDepartment of Gerontological Policy, National Center for Gerontology and Geriatrics, Aichi, Japan

Received 11 April, 2006

Accepted 6 July, 2006

Correspondence and requests for reprints to Atsushi Hozawa, MD, PhD, Department of Health Science, Shiga University of Medical Science, SetaTsukinowa Otsu, 520-2192, Shiga, Japan Tel: +81 77 548 2191; fax: +81 77 543 9732; e-mail:

Sponsorship: This work was supported by: Grants for Scientific Research (14370217, 15790293, 17790381, 18390192 and 18590587) from the Ministry of Education, Culture, Sports, Science, and Technology, Japan; Grants-in-Aid for Japan Society for the Promotion of Science (JSPS) fellows (16.54041, 18.54042); Health Science Research Grants and Medical Technology Evaluation Research Grants (2002–2004, 2002–2004, 2003–2005 and 2005–2006) from the Ministry of Health, Labor and Welfare, Japan; the Japan Atherosclerosis Prevention Fund; the Uehara Memorial Foundation; and the Takeda Medical Research Foundation.

© 2006 Lippincott Williams & Wilkins, Inc.