Endothelial stress response in hypertensive patients with type D personality

Objective. To assess stress changes in haemodynamic parameters and endothelial function during muscular relaxation and mental arithmetic counting in hypertensive patients regarding type D personality. Design and methods. 20 patients (mean age — 48,5 ± 1,7 years, 11 males, 9 females) with stage I—II arterial hypertension were examined. The patients were divided into 2 groups: type D personality group (n = 10) and the group with non-type D personality (the control group, n = 10). Personality type was assessed by DS-14 questionnaire. The changes in systolic and diastolic blood pressure, heart rate, baseline brachial artery diameter, brachial artery diameter during muscular relaxation, mental arithmetic counting and the reactive hyperemia test were performed. Results. Patients with type D personality developed higher diastolic blood pressure increase during mental arithmetic counting compared to controls (15,2 ± 1,8 versus 7,2 ± 3,3 mmHg, р = 0,046). There was a correlation between type D personality and blood pressure changes during mental stress (r = 0,34; p < 0,05). The reactive hyperemia test showed a significant increase in brachial artery diameter in type D personality patients (by 22,0 ± 4,3 %, р = 0,0076) while in the control group this was less obvious. The change in the vasodilator response assessed by the reactive hyperemia test during muscular relaxation and mental stress was significant in patients with type D personality (р = 0,0498). Conclusions. The presence of type D personality in hypertensive patients is associated with the more marked diastolic blood pressure response to mental stress and the changes in vasodilator response during the tests. These stress haemodynamic responses could be one of the mechanisms of the adverse effects of type D personality on cardiovascular disease development and progression.