Type A personality as the principal psychological determinants of left ventricular mass index in hypertensive patients

Introduction: Increased Left Ventricular Mass Index (LVMI) is a well known risk factor for cardiac morbidity and mortality. Furthermore, it is widely recognized that clinical evolution and progression of established CV diseases are related to a range of psychological characteristics, which may partially explain the spread and recurrence of these diseases. Some previous studies evaluated the response to psychological test as a predictor of LVMI with controversial results. Besides this kind of studies, little is known about LVMI and its association with psychological characteristics in arterial Hypertension (HT) patients. Aim: This current cross-sectional study was aimed to evaluate the association between Type A personality, Type D personality, depression, anxiety, perceived stress, and LVMI in a cohort of hypertensive patients, using baseline examination data of the TIPICO project. Methods: A total of 244 outpatients (ages 18-80 years) followed by the Hypertension Unit of S. Gerardo Hospital (Monza, Italy) affected by essential hypertension were recruited. Anamnestic data, clinical BP, and laboratorydata and LVMI were evaluated. Patients were asked to complete a battery of psychological questionnaires under the guidance of a psychologist. The associations between psychological variables and LVMI was explored using multivariate stepwise linear regression analysis and regression coefficients (b) were given. Results: At T0 the mean age was 55.9 ± 10.1 years, SBP and DBP were 135.6 ± 17.7 and 82.5 ± 9.1 mmHg and LVMI was 109.7 ± 26.1 g/m2. The results from the multivariate stepwise linear regression analysis showed that sex (beta = 0.252, P<0.001), age (beta = 0.135, P<0.037), mean blood pressure (beta = 0.178, p = 0.003), family history of CV disease (beta = 0.129, p = 0.027), and Type A personality (beta = 0.148, P = 0.014) were significantly and independently associated with LVMI. Conclusions: The current study shows that, among psychological factors, higher levels of Type A personality is related to higher LVMI, while Type D personality, anxiety, depression, perceived stress are not associated with it. Also if in a cross-sectional design, this study seem to suggest that Type A personality play a role in the presence of hypertension.