Psychosocial Factors and Personality Traits and the Prevalence of Arterial Hypertension Among 35- and 55-Year-Old Men and Women in Sweden and Estonia: a SWESTONIA Longitudinal Study.

INTRODUCTION: Psychosocial factors influence the risk of developing hypertension. Personality traits have a modulating effect against the harmful influences of psychosocial factors. AIM: Through a longitudinal clinical study consisting of men and women aged 35 and 55 at the baseline in Estonia and Sweden, to assess the influence of psychosocial factors and personality traits resulting in arterial hypertension. METHODS: Data analysis based on the cross-sectional study with 2 assessments over 13 years of a sample comprising 158 individuals from Estonia and 213 individuals from Sweden. The Pearlin Mastery Scale, Rosenberg Self-esteem Scale, Depression Model and Gothenburg Quality of Life Instrument were used. RESULTS: Throughout the follow-up period, a higher depressive mood and lower self-assessed quality of life score prevailed among the 35-year-old and 55-year-old Estonians compared with the Swedish study participants (p < 0.001). Among the 55-year-old Estonian study participants with diagnosed hypertension, but not among the Swedish, negative stressful life events had a significantly stronger effect (p < 0.001) on the risk of developing hypertension. In addition, lower mastery (p < 0.05) dominated among study participants diagnosed with hypertension. CONCLUSIONS: The combined effects of psychosocial factors and personality traits are important variables in predicting the risk of developing arterial hypertension. The study results are relevant to clinical practice and provide suggestions for employing successful preventive measures.

Rapid socio-economic changes, psychosocial factors and prevalence of hypertension among men and women aged 55 years at baseline in Estonia: a 13-year follow-up study.

BACKGROUND: Hypertension is an important public health problem which causes premature morbidity and mortality. Cardiovascular diseases are responsible for about 55% of deaths in Estonia. THE PURPOSE OF THE STUDY: was to assess, through a follow-up period, the prevalence of hypertension and to observe which risk factors of cardiovascular disease impact the occurrence of the disease. The second aim of the study was to evaluate the role of psychosocial factors and personality traits among individuals with a diagnosis of hypertension. MATERIALS AND METHODS: The 330 subjects from Estonia, aged 55 years at baseline, from among whom 219 participated at follow-up. A cross-sectional study based on a self-reported questionnaire was conducted. RESULTS: Over 13 years, the prevalence of hypertension increased from 4% to 53%. Obese (body mass index ≥30 kg/m2) individuals were four times more likely to belong to the hypertension group (p < .01). Among individuals with hypertension the depressed mood score was ≥4 points (max. 9 points) in 54.3% of participants. Depressed mood was linked with experiencing negative stressful life events (B = 0.047, 95% CI 0.016; 0.079; p < .01). Mastery had a protective impact on depressed mood. The self-rated quality of life score was lower among subjects with hypertension than among those who were not diagnosed with hypertension (p < .05). CONCLUSIONS: According to the 13-year follow-up study, rapid socio-economic changes in Estonia have affected psychosocial health factors among 55-year-old individuals with a diagnosis of hypertension. There is a significant relationship between obesity and the development of hypertension.

Impact of smoking: all-cause and cardiovascular mortality in a cohort of 55-year-old Swedes and Estonians.

AIM: In the 1990s, several studies noted a large gap in life expectancy between Western and Eastern European countries. It was speculated that this could be explained by environmental pollution, socioeconomic factors, lifestyle and psychosocial stress. A weakness in addressing the issue has been the lack of prospective studies with mortality as end point. METHODS: We used the national population registries (between 1996 and 1998) to screen a cohort of 269 55-year-old subjects in Sweden and Estonia. We assessed conventional risk factors, lifestyle and socio-economic factors. A 13-year follow-up regarding all-cause and cardiovascular mortality was done. RESULTS: Smoking and, to a lesser extent, plasma levels of interleukin-6 were significant predictors for CVD and non-CVD mortality in men, but none of the other conventional risk factors reached statistical significance. During the follow-up period, 22 of the 52 male smokers died compared to 8 of the 85 male non-smokers (p<0.01). Ten of the smokers died of CVD compared to three of the non-smokers (p<0.002). In total, only two women died. CONCLUSIONS: These data emphasize that smoking prevention is extremely important in preventing premature death. Although smoking prevalence is diminishing, it is still the most important risk factor to treat.