Original article
Labelling in hypertension: A review of the behavioural and psychological consequences

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Abstract

Recent evidence has suggested that the detection and treatment of hypertension can result in adverse psychological and behavioural consequences. Furthermore, there is evidence to suggest that these consequences may outweigh the gains in the case of mild hypertension where the benefit of treatment has not yet been established.

This paper reviews the literature to date regarding the behavioural and psychological changes which have occurred upon the detection and labelling of hypertension. In addition, an explanation is posed which may resolve some of the contradictory findings with regard to the phenomenon. Finally, a strategy to alleviate, or at least minimize, the deleterious labelling of individuals as “hypertensive” is proposed for testing in future experiments.

References (34)

  • JM Mossey

    Psychological consequences of labelling in hypertensives

    Clin Invest Med

    (1981)
  • EL Goldberg et al.

    Psychological factors and blood pressure

    Psychol Med

    (1980)
  • S Cobb

    Social support as a moderator of life stress

    Psychos Med

    (1976)
  • ES Gibson et al.

    Absenteeism from work among hypertensives. Newsletter of the Council on Epidemiology of the American Heart Association

    Am Heart Assoc

    (1972)
  • RB Haynes et al.

    Increased absenteeism from work after the detection and labelling of hypertensive patients

    N Engl J Med

    (1978)
  • National Heart, Lung and Blood Institute

    The public and high blood pressure. A Survey

    DHEW Publication No. 74-356

    (1973)
  • MH Alderman et al.

    Hypertension control at the worksite

    J Occup Med

    (1976)
  • PF Stenn et al.

    A study of the labelling phenomenon in school children with elevated blood pressure

    Clin Invest Med

    (1981)
  • DW Taylor et al.

    Longterm follow-up of absenteeism among working men following the detection and treatment of hypertension

    Clin Invest Med

    (1981)
  • MH Aldermann et al.

    Labelling and absenteeism: the Massachusetts Mutual Experience

    Clin Invest Med

    (1981)
  • Five year findings of the hypertension detection and follow-up program. I. Reduction in mortality of persons with high blood pressure

    JAMA

    (1979)
  • BF Polk et al.

    Disability days associated with detection and treatment in a hypertension program

    Am J Epid

    (1984)
    BF Polk et al.

    Circulation

    (1979)
  • BJ Milne et al.

    Alterations in health perception and lifestyle in created hypertensives

    J Chron Dis

    (1984)
  • P Rudd et al.

    Absenteeism and psychological dysfunction after hypertensive screening

    Clin Res

    (1983)
  • ME Johnston et al.

    Effects of labelling on income, work and social function among hypertensive employees

    J Chron Dis

    (1984)
  • K Soghikian et al.

    The effect of high blood pressure awareness and treatment on emotional well-being

    Clin Invest Med

    (1981)
  • M Monk

    Blood pressure awareness and psychological well-being in the Health and Nutrition Examination Survey

    Clin Invest Med

    (1981)
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