Pent-Up Emotions

Katherine was determined that her marriage would not be like her parents': full of quarreling, bitterness and hostility. But a shotgun wedding tied her to a man who proved to be a rigid, demanding and critical husband. In order to keep peace, she had to defer to him in everything. While he worked, she sat home nursing the baby and her grievances.

Katherine threw herself into community activities. She became a compulsive eater, and over the years puffed herself up into a caricature of the professional clubwoman. Amid economic troubles, sexual discontent and her husband's surly behavior, she appeared affable and relaxed. But by 48, she had dangerously high blood pressure, recurrent states of depression and other disturbing symptoms.

In Life Stress and Essential Hypertension, Drs. Stewart Wolf, Philippe V. Cardon Jr., Edward M. Shepard and Harold G. Wolff, teachers of medicine and practicing physicians, bring together many of the elusive facts about Katherine's main trouble--a trouble shared by 6% of the U.S. population. Katherine suffered from essential hypertension, persistent high blood pressure without known cause.

Topics of Conflict. By studying hypertensive patients over a period of several years at New York Hospital and introducing topics of conflict while recording their blood pressure, the authors confirmed what doctors have long believed: hypertension is closely related to underlying emotional disturbances. When Katherine's suppressed resentment finally exploded and she vented her temper on her husband, her blood pressure dropped sharply. After she divorced him and remarried, it became normal, and most of her other symptoms disappeared.

Bottled-up emotions seem to be the most common personality trait of hypertensive people. More women than men suffer from the disorder. Although often gentle and apparently easygoing, they are filled with aggressive drives that they tightly restrain because of a need to please. Inwardly tense and suspicious, they are "mobilized for combat, but do not engage in it against the pertinent adversary." Many of them suffer from migraine headaches and other side symptoms. As children, they were frustrated and shy.

Will to Health. Doctors are not sure how hypertension gets started or how it can be cured. In its early stages, it is often ignored. Said one doctor: "The kindest thing to do when one discovers a patient with hypertension but no [obvious] symptoms is to keep the information to oneself." Damage to the overworked heart and degeneration in body cells may eventually follow. Then hypertension is frequently a killer.

Drug therapy, diets and even surgery have been used to relieve hypertension. But the knowledge that hypertension (and probably many other cardiovascular disorders) is closely tied to the emotions points to the most promising treatment yet: a cooperative relationship between patient and doctor aimed at lessening the patient's emotional difficulties. The patient's faith in himself may be an invaluable aid. When an associate discovered elevated blood pressure in Dr. W. W. Keene, a Philadelphia physician who used one of the earliest blood-pressure recorders, he suggested a further examination. "Not necessary," said Dr. Keene. "What I lack in capacity to regulate my blood pressure, I make up in pertinacity." He lived to be 93.

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