The impact of affective temperaments on total mortality and cardiovascular outcome in patients with hypertension: a new step for temperament-based preventive care

Background Cross-sectional studies on hypertensive patients previously described associations between different affective temperaments (depressive, anxious, irritable, cyclothymic, hyperthymic) and hypertension-mediated organ damage. The aim of our study was to evaluate the impact of affective temperaments on all-cause mortality and different cardiovascular (CV) outcomes in hypertensive patients. Methods In our prospective study between August 2012 and March 2020 different phenotypes of hypertensive patients were included in three general practitioner practices. Affective temperaments were evaluated with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire. Total mortality, CV mortality and non-lethal CV events were collected. Patient follow-up was ended on 1st of December 2025. Results Altogether 288 patients were included with the mean age of 57 ± 14.5 years and 134 (46.5%) of them were men. The average time of follow-up was 10.3 ± 1.6 years. During follow-up 37 patients died and 29 patients suffered CV event. In the total population hyperthymic affective temperament was inversely associated with all-cause mortality, and cyclothymic temperament was positively associated with stroke. These associations were missing in women, while in men hyperthymic temperament remained inversely associated with all-cause mortality and multiple positive associations were found between CV events and stroke as well as cyclothymic temperament. Conclusions These are the first results which verified in prospective study the inverse association of hyperthymic temperament and the positive association of cyclothymic temperament with CV events and stroke in hypertensive patients. This is a step forward in the development of temperament-based preventive strategies in hypertension.