Testing the Associations Between State and Trait Anxiety, Anger, Sadness, and Ambulatory Blood Pressure and Whether Race Impacts These Relationships

Abstract

Abstract Background Anxiety, anger, and sadness are related to elevated ambulatory blood pressure (ABP), yet it is unclear whether each emotion exerts unique effects. Moreover, an understanding of who might be most susceptible to the negative effects of these emotions is limited, with the trait tendency to experience them or one’s race as potential moderators. Purpose The study examined the potential for differential effects of momentary anxiety, anger, and sadness on ABP. The study assessed whether a trait tendency to experience these negative emotions and/or race (Black vs. non-Black) would moderate these relationships. Methods Participants (n = 153) completed trait anxiety, anger, and depressive symptoms measures at baseline. ABP was collected over two 24-hour periods 3–4 months apart. Momentary measures of anxiety, anger, and sadness were assessed via ecological momentary assessment (EMA) after each ABP reading. Results Momentary anxiety consistently predicted diastolic blood pressure but not systolic blood pressure. Momentary anger and sadness did not predict blood pressure (BP). Conditional effects were found with momentary anxiety and anger predicting elevated BP in those individuals with trait anxiety/anger at its mean. Trait anxiety and depression consistently predicted heightened BP in Black participants. Trait anger did not moderate the relationships between negative emotions and ABP. Conclusions Findings suggest that momentary anxiety and anger should be given attention as potential risk factors for hypertension and highlight the unique perspective of EMA methods. Black participants who were more anxious and depressed experienced heightened BP, with anxiety and depression providing possible intervention targets in improving racial disparities in cardiovascular health.