Alexithymia and night blood pressure: the role of emotional dysregulation in the dipping phenomenon

Introduction. An abnormal overnight Blood Pressure (BP) functioning allows to alterations of the physiological night decrease of BP (Dipping) and predicts a higher cardiovascular risk. Many findings underlined a positive relationship between BP and Alexithymia. However, no study has ever considered whether Alexithymia influences the night trend of BP. Aim: to assess the relationship between Alexithymia and the Dipping phenomenon. Methods: One-hundred ninety-nine people were submitted to Ambulatory Blood Pressure Monitoring and completed the Toronto Alexithymia Scale (TAS-20). According to the overnight BP variations, the participants were splitted into three groups: Extreme Dipper (ED; N = 53), Dipper (D; N = 85), Non-Dipper (ND; N = 61). They were identified as ED when they had a night decrease of BP higher than 20%; participants were considered as D when they presented a BP night decrease of 10–20%, while they were classified as ND when they showed a BP night decrease of less than 10%. Results: MANCOVA, considering the Dipping status as an independent variable, the BMI as covariate, and the TAS-20 facets as dependent variables, showed a significant effect (k6,386 = 0.91; p = 0.005): ED individuals had more difficulty in identifying emotions (P\0.05) than D; further , individuals ED (P\0.01) and ND (P\0.01) showed greater difficulty in describing emotions than subjects D. ANCOVA, on the total score of TAS-20, showed a significant difference (F2,195 = 4.74;p = 0.009): individuals ND (P\0.05) and ED (P\0.05) were more alexithymics than D individuals. Conclusions: Changes of Dipping phenomenon were associated with emotional dysfunctions. The higher levels of Alexithymia were observed either when BP decrease overnight was limited or when it was very high. Therefore, Alexithymia could be considered a risk factor for both Dipping phenomenon and cardiovascular health.