Anger expression, gender, and ambulatory blood pressure in mild, unmedicated adults with hypertension

The suppression of anger has been associated with the development of hypertension. This study evaluated the association between anger management style (anger-in and anger-out) and ambulatory blood pressure (ABP) in patients with repeated clinic diastolic blood pressures (DBPs) between 90-105 mmHg, unmedicated and with no known coronary artery disease. A total of 128 men (46.0 years) and 66 women (46.6 years) participated. Fourteen percent of men and 35% of women were classified as having "white coat" hypertension (daytime DBP < 85 mmHg). Mean awake and sleep DBP and systolic blood pressure (SBP) were evaluated in a repeated measures analysis of variance (ANOVA). Anger-in and anger-out scores were categorized into low, medium, and high t-scores (< 50, 50-59, > or = 60). Results indicated that in women, increasing anger-in is associated with greater SBPs while awake and sleeping, whereas no effect was found for DBP, nor any effect in men. No significant association was found between gender, anger-out, and ABP. The clinical diagnostic status of white coat hypertension was not differentially associated with anger-in or anger-out in men and women. In conclusion, in a sample of mild unmedicated adults with hypertension, suppression of anger is associated with greater ambulatory SBP in women, but not in men.