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Anger Inhibition Potentiates the Association of High End-Tidal CO₂ With Blood Pressure in Women

From the Laboratory of Cardiovascular Science (A.S., D.P., D.A.E.), National Institute on Aging, Baltimore, Maryland; and the Department of Medicine (M.A.C.), School of Medicine, University of California, San Francisco, California.

Address reprint requests to: David E. Anderson, PhD, Laboratory of Cardiovascular Science, National Institute on Aging, 5600 Nathan Shock Dr., Baltimore MD 21224. Email: AndersoD{at}grc.nia.nih.gov

OBJECTIVE: High resting end-tidal CO₂ (PetCO₂) has been shown to be an independent predictor of systolic blood pressure (SBP) in women, particularly older women. The study reported in this article investigated whether the tendency to experience, express, and/or suppress anger contributes to the association of PetCO₂ and SBP in women and in men.

METHODS: The Spielberger Anger Expression Inventory was administered to 403 healthy male and female participants in the Baltimore Longitudinal Study on Aging. Resting PetCO₂ was obtained by means of a respiratory gas monitor, and resting blood pressure was obtained with an oscillometric device. The associations of resting PetCO₂ and the anger scales with SBP and diastolic blood pressure (DBP) were investigated using multivariate regression analyses.

RESULTS: PetCO₂, as well as age and body mass index, was an independent predictor of SBP in women with low, but not high, trait anger and in women with low, but not high, anger-out. PetCO₂ was not an independent predictor of SBP in men with either high or low anger. In addition, PetCO₂ was not an independent predictor of DBP in either men or women.

CONCLUSIONS: The results of this study indicate that inhibition of anger potentiates the relationship of high PetCO₂ with SBP in women but not men. Additional studies are needed to determine the origins of the observed gender differences and the psychophysiological pathways by which high resting PetCO₂ contributes to elevated resting blood pressure in women.

Key Words: anger • breathing • blood pressure • end-tidal CO₂ • hypertension • women.

Abbreviations: BMI = body mass index; DBP = diastolic blood pressure; pCO₂ = partial pressure of CO₂; PetCO₂ = end-tidal CO₂; SBP = systolic blood pressure.

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