Ill-being and well-being in patients with masked hypertension: a controlled study

Introduction. Among patients affected by masked hypertension (MH), psychological variables have been poorly investigated. This research aimed to fill the gap in the literature and to investigate ill-being and well-being in patients with MH, compared with patients with essential hypertension (EH) and normotensive subjects (NS). Methods. 10 patients with MH, enrolled at the Division of Internal Medicine, Sant’Orsola Hospital (Bologna, Italy), were compared with 10 EH patients recruited at Bellaria Hospital (Bologna, Italy), and 10 NS, matched for age and sex. They were administered both observer- and self-rated measures. Results. 70% of MH patients showed ill-being (40% depression, 40% anxiety, 60% at least one psychosomatic syndrome). The most frequent causes of stress were loneliness (70%), work (60%), illness/bereavement (50%) and significant changes in life (50%). 40% of the patients developed allostatic overload (AO) as a consequence of stress. Compared with EH patients and NS, patients with MH reported a higher frequency of psychiatric diagnoses (p<0.05), in particular anxiety disorders. Further, they presented with higher levels of psychological distress (p<0.01), stress (p<0.5) and lower well-being (p<0.01) compared to both EH and NS groups. Conclusion. Despite the small sample size, patients with MH showed high levels of ill-being and impaired well-being. Compared to EH, MH was found to be associated with higher levels of stress in particular for loneliness, psychological distress and psychiatric diagnoses and lower levels of well-being. These findings, if confirmed in further studies, could pave the way for considering psychosocial aspects as vulnerability factors in the course of MH.