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Relationships Between Hostility, Anger Expression, and Blood Pressure Dipping in an Ethnically Diverse Sample

From the San Diego State University and University of California, San Diego Joint Doctoral, Program in Clinical Psychology (K.S.T.), and the Department of Psychiatry, University of California, San Diego (R.A.N., J.E.D.), San Diego, CA.

Address correspondence and reprint requests to KaMala S. Thomas, MA, UCSD Mail Code 0804, La Jolla, CA 92093-0804. E-mail: ksthomas{at}ucsd.edu

OBJECTIVE: The purpose of this study was to examine relationships between hostility, anger expression, and blood pressure (BP) dipping.

METHODS: A 24-hour ambulatory BP was obtained from 34 African Americans and 52 white Americans who were enrolled in a study of sleep, stress, and BP. Self-report measures were used to assess anger expression and hostility.

RESULTS: After controlling for body mass index and BP status, African Americans were more likely to be classified as nondippers than white Americans. However, when hostility and anger expression were included in the model, there was no longer a significant relationship between ethnicity and BP dipping. Irrespective of race, high levels of hostility and anger were associated with less nocturnal dipping.

CONCLUSIONS: These findings suggest that psychological factors may be important in understanding ethnic differences in nocturnal BP decline.

Key Words: African Americans, • anger expression, • blood pressure dipping, • hostility.

Abbreviations: BP = blood pressure;; BMI = body mass index;; MAP = mean arterial pressure.

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