The Role of Hostility in Hypertension

敵意在高血壓的角色探討

呂碧鴻(Bee-Horng Lue) ； 陳秀蓉(Hsiu-Jung Chen)

《臺灣家庭醫學研究》 5卷3期&4 (2007/10) Pp. 108-118

https://doi.org/10.29475/TFMR.200710.0002

摘要

敵意與心血管疾病的關連性備受國內外研究者的重視。本研究依據敵意多向度的概念，檢視敵意的元素與高血壓的關係，以及探討心理社會因素包括敵意、日常瑣事、社會支持與健康行為對本態性高血壓之相對危險性。以立意取樣方式在家庭醫學科門診取得46位高血壓病患及41位健康者為控制組，研究樣本接受結構式問卷調查，包括日常生活瑣事量表、社會支持量表與敵意量表。其內容涵蓋健康行為，自覺生活壓力狀態，社會支持與敵意測量。結果顯示兩組在健康行為及心理社會變項，包括敵意各元素之得分均無顯著差異。但高血壓家族史是高血壓的顯著預測因子，其相對危險性高達10倍(OR=10.07, 95% CI=3.09~32.86)。結論：本研究指出高血壓家族史比敵意變項在本態性高血壓的發展具更重要的角色。對具高血壓家族史之病患，評估心理社會因素及提供有效之日常壓力因應策略是必要的非藥物性處置。

並列摘要

Background and Purpose: Research on a potential link between hostility and cardiovascular disease has received considerable attention. This study examines the association between the components of hostility and hypertension and explores the relative risk of psychosocial factors including hostility, daily hassles, social support and health behaviors to essential hypertension.
Methods: A purposive sampling of 46 hypertensive and 41 healthy subjects at the outpatient clinic of the Department of Family Medicine was conducted. The subjects were assessed using several structured questionnaires. The survey was desgined to collect information regarding health behaviors, perceived daily stress, social support and measures of hostility by Daily Hassles Scale, Social Support Scale and Hostility Inventory. Data were analyzed using univariate analysis and multivariate logistic regression.
Results: There were no significant differences in health behavior or the mean score of any psychosocial variable, including hostile cognition, affect and behavior, and daily stress and social support between hypertensive and healthy subjects. However, family history of hypertension was a significant variable among hypertensive subjects (78.3% vs. 29.3%) (p＜0.001), demonstrating significant predictive power. The relative risk to hypertension was ten-fold (OR=10.07, 95% CI=3.09-32.86).
Conclusion: This study indicates that family history of hypertension rather than hostility plays a significant role in the development of hypertension. However, assessing psychosocial factors and providing effective coping strategies to daily stress, particularly for people with positive family history, is essential.

並列關鍵字

hypertension ； hostility ； daily stress ； social support