The Impact of Psychological Distress on the Control of Hypertension

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Abstract
Previous research has yielded inconsistent results in the control of essential hypertension. One explanation for response to drug or behavioral therapy may be the patient's psychological status upon entering treatment. Thirty-five borderline hypertensive males entered into a self-management program with biofeedback and cognitive restructuring components. The SCL-90 (Symptom Checklist-90) and the Holmes' Schedule of Recent Events were used to determine if responders and non-responders could be distinguished prior to treatment on the basis of psychological status. Patients whose hypertension was resistant to treatment (diastolic ≥ 90 mm Hg) reported signficantly greater levels of psychological distress and greater life changes than did controlled patients. Pre-treatment differences could not be explained by compliance or expectation of success. This study suggests that a relationship exists between psychological distress, life changes and the subsequent control of hypertension; this has implications for treatment selection and design for psychologically distressed individuals.