Pergamon Brla~. Res. T/W-. Vol. 32. No. 6, pp. 593-603. I994 zyxwvutsrqp C o p yrig ht I(’ 1 9 9 4 Else vie r Sc ie nc e Ltd Printed in G re a t Brita in. All rights reserved 0005.7967/94 $7.00 + 0.00 CHANGES TN PHYSICAL SYMPTOMS, BLOOD PRESSURE AND QUALITY OF LIFE OVER 30 DAYS ACHIM MOLLER,’ PEDRO MONTOYA, 2* RAINER SCHANDRY,’ and LYDIA HARTL’ ‘Institute of Psychology. University of Munich, Leopoldstr. 13, 80802 Munich. Germany ‘Institute of Medical Psychology, University of Tiibingen, Gartenstr. 29, 72074 Tubingen, Germany ‘Max-Planck-Institute of Psychiatry, Munich. Germany zyxwvutsrqponmlkjihgfedcbaZYXWV (Receired 2 June 1993; receked .for publication 27 August 1993) Summary-The existence of subjective symptoms arising from high blood pressure (BP) remains controversial. Few studies have been performed which compare symptoms of hypertensives and normotensives. The results of these studies are inconsistent. The present study investigates the intensities and prevalences of symptoms of hypertensives and normotensives and the relationship between symptoms and BP for both groups. During a 30-day period, 45 patients with primary hypertension and 45 normotensive controls documented BPS and intensities of 13 symptoms daily as well as mood and life satisfaction weekly. Starting on day 3 hypertensives received beta-blocker therapy (bopindolol. 1 mg/day). The BP values of the hypertensives normalized during the study, while the BPS of the no rm o te nsive s did not change. At the beginning, hypertensives showed higher prevalences and intensities of the symptoms and poorer mood and life satisfaction. After normalization of BP, hypertensives attained scores similar to those of normotensives in all measured categories. Calculating within-S correlations between symptom intensities and systolic BPS, 70% of the hypertensives, but only 27% of the normotensives. showed at least one significant correlation. The differences observed between untreated hypertensives and the normotensive control group with respect to the prevalence and intensity of symptoms provide convincing evidence that untreated hypertensives are by no means symptom-free. The within-S correlations of the present study documented well the close relationship between symptoms and actual BP for a percentage of hypertensives. INTRODUCTION In 1913, Janeway (1913) described symptoms of arterial hypertension such as ‘dyspnea’, ‘palpitations’ and ‘headaches’; nevertheless, the existence of subjective symptoms arising from blood pressure (BP) remains questionable to this day. In fact, Hollenberg (1987) recently claimed that “there are no symptoms directly related to hypertension”. Several studies, however, have reported differing prevalence rates fro specific symptoms between hypertensives and normotensives (e.g. Bulpit, Dollery & Carne, 1976; Chatellier, Degoulet, Devriese, Vu, Plouin & Menard, 1982; Dimenas, Wiklund, Dahlof, Lindvall, Olofsson & De Faire, 1989). The results of these studies provide evidence that, as a rule, untreated hypertonics experience considerably more symptoms than normotonics. The question as to whether a causal relationship exists between these symptoms and hypertension was not addressed by these studies. A promising approach to this problem would be to study changes in symptoms during the introduction of antihypertensive therapy. If untreated hypertensives report certain symptoms more frequently than a comparable random sample of normotensives, and if antihypertensive therapy results in a reduction in frequency of these symptoms to a level similar to symptom frequency among normotensives, this could be an indication that the symptom was related to hypertension. Moreover, establishing a significant correlation between the subjectively experienced intensity of a symptom and BP values would provide evidence that this symptom is related to hypertension. Quality of life in addition to physical symptoms has recently been the subject of a number of studies. Several studies could show differences between patient groups under different therapy protocols (Croog, Levine, Testa & Brown, 1986; Welzel & Brautigam, 1988). As such, it may be *Author to whom reprint requests should be addressed. 593