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Ambulatory Blood Pressure Responses and the Circumplex Model of Mood: A 4-Day Study

From the Departments of Psychiatry (R.G.J., L.K.T., D.M.W., Y.D.) and Medicine (M.F.M.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania (S.B.M.); National Institute of Aging, Gerontology Research Center, Baltimore, Maryland (J.F.T.); and Center for Statistical Science, Brown University, Providence, Rhode Island (C.G.).

Address reprint requests to: Rolf G. Jacob, MD, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 51213-2593.

BACKGROUND: The relation between mood or emotions and concurrent ambulatory blood pressure responses holds both fundamental and clinical interest.

METHODS: The primary sample consisted of 69 normotensive or borderline hypertensive but otherwise healthy adult males. The validation sample consisted of 85 healthy male undergraduate college students. Both samples underwent half-hourly 24-hour ambulatory blood pressure measurements on four separate workdays, 1 week apart. At each ambulatory measurement, subjects recorded their behavior, environment, and mood. The circular mood scale, a circular visual analogue scale based on the circumplex model of mood, was used to reflect the totality of a participant’s affective state space. Longitudinal random effects regression models were applied in the data analysis.

RESULTS: The results for both samples were quite similar. Sleep and posture had the greatest influence on ambulatory blood pressure and heart rate. The effects of the environmental setting, social setting, and consumption were modest but statistically significant. Independent of these covariates, mood exerted a significant effect on blood pressure and heart rate. Relative to the "mellow" default category, blood pressure increased both for "anxious/annoyed" and "elated/happy" and decreased during "disengaged/sleepy" mood. The range of mood-related blood pressure estimates was 6.0/3.7 mm Hg.

CONCLUSIONS: The pattern of blood pressure responses suggests that they were related to the degree of engagement of a mood rather than the degree of unpleasantness. The hypothesis that posits that negative affect–related cardiovascular reactivity mediates the observed correlation between negative affect and disease risk should be reconsidered.

Key Words: ambulatory blood pressure • ambulatory heart rate • ambulatory mood • circumplex mood model

Abbreviations: ABP = ambulatory blood pressure; HR = heart rate; CMS = circular mood scale; DBP = diastolic blood pressure; SBP = systolic blood pressure; bpm = beats per minute; MAP = mean arterial pressure; REML = restricted maximumlikelihood.

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