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Anger expression and incident hypertension

S A Everson1, D E Goldberg, G A Kaplan

  • 1Department of Epidemiology, University of Michigan, Ann Arbor, USA. severson@umich.edu

Psychosomatic Medicine
|December 10, 1998
PubMed
Summary
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Expressing anger, whether outwardly or inwardly, significantly increases the risk of developing hypertension in middle-aged men. This study found a clear link between anger expression styles and the onset of high blood pressure.

Area of Science:

  • Cardiovascular Health
  • Psychosomatic Medicine
  • Epidemiology

Background:

  • Essential hypertension is a prevalent condition with multifactorial causes.
  • The role of anger in hypertension development has been debated due to inconsistent research findings.

Purpose of the Study:

  • To prospectively investigate the association between anger expression styles and the incidence of hypertension.
  • To examine if anger expression independently predicts hypertension risk in a population sample.

Main Methods:

  • A cohort of 537 initially normotensive middle-aged men from eastern Finland was studied.
  • Anger expression was measured using Spielberger's Anger-out and Anger-in scales at baseline.
  • Participants underwent medical examinations and psychological assessments at baseline and a 4-year follow-up.

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Main Results:

  • Hypertension developed in 19.4% of participants over 4 years.
  • Increased Anger-out scores correlated with a 12% higher risk of hypertension per point increase (p < .002).
  • Increased Anger-in scores also correlated with a 12% higher risk of hypertension per point increase (p < .01).

Conclusions:

  • The study provides strong epidemiological evidence linking anger expression styles to subsequent hypertension.
  • These associations remained significant after adjusting for major cardiovascular risk factors.
  • Extreme anger expression, in either direction, appears to have detrimental cardiovascular consequences.