Alexithymia and Hypertension: Does Personality Matter? A Systematic Review and Meta-analysis

Abstract

Purpose of review: Personality characteristics, such as alexithymia, may lead to alterations in the autonomic nervous system functionality, predisposing individuals to an increased risk of hypertension (HTN). The present meta-analysis aimed to quantify the presence of alexithymia in people with HTN and to assess for potential sources of heterogeneity between studies. PubMed, PsycINFO and Scopus databases were systematically searched, using the following strings: ("alexithymia" OR "alexithymic") AND ("hypertension" OR "hypertensive"). Data were meta-analyzed with random-effects models.

Recent findings: A total of 13 studies met the inclusion criteria. The prevalence of alexithymia in people with and without HTN were obtained from 5 studies (26.3% vs 15.0%; pooling of odd ratios, 3.15 [95% CI, 1.14;8.74]), whereas the mean level of alexithymia between people with and without HTN was obtained from 7 studies Hedges g, 1.39 [95% CI, -0.39;3.16]). There was a significant association between alexithymia prevalence and year of article publication (ĝ = -0.04; 95% CI, -0.07;-0.01), whereas no significant relationship was detected between the former and both sex and age. Findings revealed a greater prevalence of alexithymia in people with HTN than in participants without HTN. These findings suggest that alexithymia may contribute to both the onset and persistence of HTN symptomatology. However, future research is needed to clarify this association.

Keywords: Alexithymia; Hypertension; Meta-analysis; Psychological factors; Systematic review.

Fig. 1

PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only [21]

Fig. 2

(a) Forest plot of the pooled prevalence of alexithymia in people with HTN. (b) Forest plot of the pooling of odd ratios (ORs) of alexithymia prevalence in people with vs. without HTN. (c) Forest plot of the standardized mean difference (SDM) of alexithymia in people with vs. without HTN; (d) Forest plot of the SDM of alexithymia in people with vs. without HTN (sensitivity analysis)