Differences in Perception Between Hypertensive and Normotensive Populations

Abstract

A group of hypertensive patients (N = 19) and a control group of normotensive patients (N = 15) were shown two movies depicting two types of doctor-patient interaction. In the first movie, the doctor was rude and disinterested in the patient (the bad doctor). In the second movie, the doctor was relaxed and warm (the good doctor). After viewing the two movies, all patients were interviewed as to their impressions of the two scenes. During the viewing, blood pressure and pulse rate responses in the hypertensive group were small but significantly greater than those in the normotensive group; during the interview, the significantly greater response in the hypertensives was physiologically meaningful. The urinary catecholamine and cortisol excretion rates were no different between the 2 groups. Most striking was the finding that the hypertensive group tended to deny seeing any differences between the doctors depicted in the two movies, while the normotensive group could clearly identify differences in the behavior of the good doctor versus that of the bad doctor. In a second experiment, the same movies were shown to a hypertensive group and to 3 normotensive groups. The patients were asked to fill out a questionnaire derived from auditing the tape recordings in the first experiment. This questionnaire made it possible to differentiate significantly between the hypertensive and normotensive groups. These data are compatible with the hypothesis that the hypertensive patient may perceptually screen out potentially noxious stimuli as a behavioral response to his hyperteactive pressor system.