Emotional Factors in Essential Hypertension

Alexander, Franz

doi:10.1097/00006842-193901000-00013

Cited by 261 publications

(69 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…First, much of the extant literature on the role of anger and hostility in cardiovascular mortality and morbidity, and particularly hypertension, has focused on the association between inhibition or suppression of anger and cardiovascular end points (see References 6,7,36,and 37). This is driven partly by Alexander's classic hypothesis 38 that postulated that chronic inhibition of anger would lead to sustained blood pressure elevations. However, several studies have identified a significant relationship between expressed anger and higher resting blood pressure levels or cardiovascular disease (see References 2,8,and 34).…”

Section: Discussionmentioning

confidence: 99%

Anger Expression and Incident Stroke

Everson

Kaplan

Goldberg

et al. 1999

Stroke

View full text Add to dashboard Cite

Background and Purpose-High levels of anger are associated with an increased risk of coronary heart disease and hypertension, but little is known about the role of anger in stroke risk. Methods-Anger expression style and risk of incident stroke were examined in 2074 men (mean age, 53.0Ϯ5.2 years) from a population-based, longitudinal study of risk factors for ischemic heart disease and related outcomes in eastern Finland. Self-reported style of anger expression was assessed by questionnaire at baseline. Linkage to the FINMONICA stroke and national hospital discharge registers identified 64 first strokes (50 ischemic) through 1996. Average follow-up time was 8.3Ϯ0.9 (meanϮSD) years. Results-Men who reported the highest level of expressed anger were at twice the risk of stroke (relative hazard, 2.03; 95% CI, 1.05 to 3.94) of men who reported the lowest level of anger, after adjustments for age, resting blood pressure, smoking, alcohol consumption, body mass index, low-density and high-density lipoprotein cholesterol, fibrinogen, socioeconomic status, history of diabetes, and use of antihypertensive medications. Additional analysis showed that these associations were evident only in men with a history of ischemic heart disease (nϭ481), among whom high levels of outwardly expressed anger (high anger-out) predicted Ͼ6-fold increased risk of stroke after risk factor adjustment (relative hazard, 6.87; 95% CI, 1.50 to 31.4). Suppressed anger (anger-in) and controlled anger (anger-control) were not consistently related to stroke risk. Conclusions-This is the first population-based study to show a significant relationship between high levels of expressed anger and incident stroke. Additional research is necessary to explore the mechanisms that underlie this association. (Stroke. 1999;30:523-528.)

show abstract

Section: Discussionmentioning

confidence: 99%

Anger Expression and Incident Stroke

Everson

Kaplan

Goldberg

et al. 1999

Stroke

View full text Add to dashboard Cite

show abstract

“…29 Longitudinal studies attempting to verify that high reactivity to the cold pressor test predicts risk of later hypertension have yielded inconsistent results. 30 " 34 However, this inconsistency may be due to the unusual nature of this stressor, which has no common parallels in real life.…”

Section: Discussionmentioning

confidence: 99%

Effects of race and marginally elevated blood pressure on responses to stress.

et al. 1987

View full text Add to dashboard Cite

SUMMARY A total of 228 men, aged 18 to 22 years (109 black and 119 white), underwent monitoring of heart rate (HR) and systolic (SBP) and diastolic blood pressure (DBP) responses during several stressor conditions and a 30-minute posttask rest period. Stressors included the cold pressor test and three reaction-time tasks: noncompetitive, competitive, and competitive plus money incentive. Substantial within-subject variations in blood pressure and heart rate were induced, varying from 119/70 to 148/94 mm Hg and from 63 to 91 beats/min on the average. Men (25 black and 39 white) with marginal SBP elevations during initial casual determinations had higher SBP under all conditions compared with men whose casual SBP levels were normal, and they also showed greater elevations over baseline levels in heart rate, SBP, and DBP during the stressors and the initial casual determination. Black and white subjects did not differ in their blood pressures at baseline or during the initial casual determinations, although blacks had slightly lower heart rates. Blacks did show greater SBP elevations over baseline levels than whites during the stressors, primarily because the blacks with marginally elevated SBP showed substantially greater stress-induced increases than whites with marginally elevated SBP. This enhanced pressor response to stress in blacks with marginal blood pressure elevations may be due to higher vascular resistance during enhanced sympathetic activity and could contribute to the higher incidence of hypertension among blacks. (Hypertension 10: 555-563, 1987) KEY WORDS • race • borderline hypertension • psychological stress • sympathetic nervous system • black population • cardiovascular reactivity

show abstract

“…91 Suppressed anger was hypothesized 5 to have a maladaptive effect on blood pressure while expressed anger was thought to have the opposite. This distinction between suppressed and expressed anger was further developed by Funkenstein et al in 1954.…”

Section: Historical Context and Definitionsmentioning

confidence: 99%

Evaluating Psychosocial Variables and Their Link to Hypertension Using Mindfulness-Based Stress Reduction

Blom

Nolan

et al. 2013

Canadian Journal of Cardiology

View full text Add to dashboard Cite

Previous research has reported positive associations between anger, perceived stress and blood pressure. These associations have largely been based on cross-sectional data and a small number of longitudinal works. Using a prospective longitudinal cohort design, this study more directly tested the relationships between anger, perceived stress and blood pressure by using a psychological therapeutic intervention (mindfulness-based stress reduction) to manipulate anger and perceived stress. Anger and perceived stress were in turn evaluated for association with blood pressure. Despite improvements in psychosocial functioning and reductions in blood pressure, findings from this study failed to demonstrate an association between change in anger or perceived stress with change in daytime or 24-hour ambulatory blood pressure. A model where these variables interact indirectly via stress coping mechanisms or health behaviours may be the linking mechanism in this study. Results from this thesis have contributed evidence to a divided field dominated by cross-sectional research.iii

show abstract

Emotional Factors in Essential Hypertension

Cited by 261 publications

References 0 publications

Anger Expression and Incident Stroke

Anger Expression and Incident Stroke

Effects of race and marginally elevated blood pressure on responses to stress.

Evaluating Psychosocial Variables and Their Link to Hypertension Using Mindfulness-Based Stress Reduction

Contact Info

Product

Resources

About