Key result
Anger suppression was significantly associated with extreme nocturnal blood pressure dipping after controlling for confounding variables, whereas trait anger was not.
Why the study?
Altered circadian blood pressure dipping increases cardiovascular risk, but the few studies examining the influence of psychological dimensions on dipping patterns have yielded inconsistent results.
Is anger expression associated with nocturnal blood pressure dipping patterns?
Observational (n=44)
Is anger expression associated with nocturnal blood pressure dipping patterns?
Suppression of anger is associated with extreme nocturnal blood pressure dipping, suggesting psychological factors may contribute to maladaptive circadian blood pressure patterns.
Should not yet change practice; leaves open whether anger suppression can help phenotype maladaptive nocturnal BP dipping.
INTRODUCTION: The circadian pattern of blood pressure is characterized by a physiological drop occurring after sleep onset. The alteration of this phenomenon (non-dipping, extreme dipping, or reverse dipping) is associated with an increased cardiovascular risk. Besides altered autonomic and endocrine circadian rhythms, psychological aspects seem to play a role in this modification. However, the few studies that have analyzed the influence of psychological dimensions on the dipping phenomenon have reported inconsistent results. This study aimed to examine the relationship between anger expression and blood pressure (BP) dipping. METHODS: = 44). Sociodemographic and anamnestic information was collected, and the State-Trait Anger Expression Inventory was used to assess anger. RESULTS: Analysis of variance evidenced significant higher scores for Trait Anger Temperament and Anger Expression in Extreme Dippers than in both Dippers and Non-Dippers. However, after controlling for confounding variables, there was no significant relationship with trait anger, and only the result concerning the suppression of anger was confirmed. CONCLUSIONS: These findings suggest that the analysis of some psychological factors, such as anger, could be necessary to better understand differences in nocturnal BP alterations. Trait anger and suppression of anger may contribute to the description and classification of patients who exhibit a maladaptive dipping phenomenon. However, modifiable (i.e., cigarette consumption) and unmodifiable (i.e., age) risk factors appear to mediate this relationship. Although further studies are necessary to explore this association, these results highlight that some aspects of anger can represent risk factors or markers of maladaptive modulation of the dipping phenomenon.
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Casagrande et al. (2020) conducted an observational in Nocturnal blood pressure dipping alterations (n=44). Anger expression and trait anger vs. Normal dipping or non-dipping patterns was evaluated on Association between anger scores and blood pressure dipping status. Anger suppression was significantly associated with extreme nocturnal blood pressure dipping after controlling for confounding variables, whereas trait anger was not.
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