Test-Taking Behaviors by Hypertensive and Normotensive Individuals

Systematic ratings were made on the Tulane Test-Behavior Scale of the global and integrated behaviors observable for hypertensive and normotensive subjects as they worked to complete a battery of neuropsychological tests—the degree of attention and effort displayed, for example, self-confidence and self-criticism. The results for 82 subjects (41 subject pairs matched for age, race, and education) revealed substantial and consistent differences between groups. Early, mild hypertensive subjects (unmedicated) displayed significantly less optimal behaviors than did normotensive controls. These may be best understood as subtle functional consequences of the abnormal physiological state imposed on the brain by a chronically elevated blood pressure, just as the functional disruptions of reduced kidney filtration fraction or minor abnormalities of the electrocardiogram appear early in the course of the disorder for other target organs. Certain testable implications of this hypothesis are discussed.