Anger expression and cardiovascular reactivity to mental stress: a spectral analysis approach

The cardiovascular reactivation to a recently described videogame task i.e. a maze test was evaluated in the time and frequency-domain using finger blood pressure (BP) measurement in 25 subjects on no medication, including 6 subjects with mild hypertension. Prior to BP measures subjects completed the items of the State-Trait Anger Expression Inventory questionnaire corresponding to the trait anger and anger expression scales. The BP recording session was divided into resting, test and recovery periods. A detrending procedure was applied to each recording prior to the fast Fourier transform. Systolic BP (SBP) and heart rate (HR) were increased during the test. The mid-frequency (MF, 0.1 Hz) components of SBP and HR variability were also elevated during the stressful period. In resting conditions SBP levels of subjects with low trait anger was lower than in subjects with high trait anger (128 +/- 4 mmHg, n = 14 versus 148 +/- 4 mmHg, n = 11, P < 0.01, Student t test). Nevertheless the average SBP increase due to the stress was of similar magnitude in these two subgroups (14 mmHg). A significant negative relationship was observed between anger-out expression score and the MF SBP variation (r = 0.46, P < 0.05). A significant negative relation was found between anger-in mode of expression and the HR peak during the test (r = 0.43, P < 0.05). In conclusion, our data suggest that individuals who are often in anger-provoking situations (high trait anger) should have heightened BP. Two different patterns of cardiovascular responses (SBP variability and HR levels) were observed for the outward and inward mode of expression of anger. This may reflect a different psychological control of HR levels and BP variability.