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Hypertension in Older Adults and the Role of Positive Emotions

From the Sealy Center on Aging (G.V.O., I.M.B., K.J.O.), the Division of Geriatrics, Department of Medicine (G.V.O., K.S.M.), the Department of Preventive Medicine and Community Health (G.V.O., K.S.M.), and the Division of Rehabilitation Sciences (K.J.O.), University of Texas Medical Branch, Galveston, Texas.

Address correspondence and reprint requests to Glenn V. Ostir, PhD, UTMB, 301 University Blvd., Galveston, TX 77555-0460. E-mail: gostir{at}utmb.edu

Objective: Negative emotions have been linked to increases in blood pressure, but relations between positive emotion and blood pressure have not been investigated. Our aim was to test the hypothesis that high positive emotion would be associated with lower blood pressure in older adults.

Methods: A cross-sectional study included 2564 Mexican Americans aged 65 or older living in one of five southwestern states. Primary measures included blood pressure and positive emotion score. Data analyses included descriptive and categorical statistics and regression and cumulative logit analysis.

Results: The average age was 72.5 years, 52.8% were women, and 32.8% were on antihypertensive medication. For individuals not on antihypertensive medication, increasing positive emotion score was significantly associated with lower systolic (b = –0.35, standard error (SE) = 0.10) and diastolic (b = –0.56, SE = 0.07) blood pressure after adjusting for relevant risk factors; for those on antihypertensive medication, increasing positive emotion score was significantly associated with lower diastolic (b = –0.46, SE = 0.11) blood pressure, but not systolic blood pressure. Positive emotion was significantly associated with a four-level joint blood pressure variable. Each one-point increase in positive emotion score was associated with a 3% and 9% decreased odds of being in a higher blood pressure category for those on (odds ratio (OR) = 0.97; 95% confidence interval (CI) = 0.93–1.00) and not on (OR = 0.91; 95% CI = 0.89–0.93) antihypertensive medication, respectively.

Conclusions: Findings indicate an association between high positive emotion and lower blood pressure among older Mexican Americans. Targeting the emotional health of older adults might be considered part of nonpharmacologic hypertension treatment programs or as part of adjunctive therapy for those on antihypertensive medication.

Key Words: hypertension • blood pressure • aging • positive emotion • Mexican Americans

Abbreviations: BMI = body mass index; CES-D = Center for Epidemiologic Studies–Depression; CI = confidence interval; H-EPESE = Hispanic Established Population for the Epidemiologic Study of the Elderly; JNC = Joint National Committee; SD = standard deviation; SE = standard error.

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