Individuals with pre-hypertension, a systolic blood pressure between 120 and 140, or a diastolic between 80 and 90, were most at risk.
Anger was defined as those with a generally negative, hostile outlook and angry reactions to perceived slights.
The exact mechanism by which anger and stress increase blood pressure and heart disease is not clear. It's possible that those with such personalities are more resistant to medical advice and therapy. It is also possible that an increased activation of the nervous system in angry and stressed people causes greater catecholamine levels, such as adrenaline, to build up and drive up blood pressure.
The study's authors pointed out that exercise may improve blood pressure and cardiac risk. Additionally, addressing personality traits should probably be incorporated into the treatment of hypertension.
I counsel my patients to incorporate lifestyle modification into the treatment of high blood pressure and coronary heart disease. Stress reduction is a big part of this therapy. The effective method of stress reduction will vary from person to person. Some benefit from aerobic exercise such as jogging, while others lift weights or punch a boxing bag. Sports seem to work for some, while yoga is ideal for others. I do not recommend eating as a stress reducer; the benefits are outweighed by the risk of weight gain and worsening cholesterol.
An exercise regimen I recommend to get my patients started is a 20 minute walk at a comfortable pace several times per week. This can be done during a lunch break, in the morning, or before dinner.
Insufficient sleep can also contribute to stress and anxiety. The cycle of being sleepy and drinking coffee to stay awake is a common one. Talk to your doctor about improving sleep habits and try to decrease your caffeine intake. It is, after all, a stimulant and can elevate your blood pressure.
For those who need more than the above strategies, anxiety medication is an option. As with any medicine, this needs to be taken under supervision of a physician, and possibly a psychiatrist, specializing in such therapy.
Take our Stress Test to find out your level of stress.
Learn more about cardiac stress testing by reading "Questions About Stress Testing."
Learn more about anxiety, it's symptoms and how it can be treated.
Source: Marty S. Player, MD, Dana E. King, MD, MS, Arch G. Mainous, III, PhD and Mark E. Geesey, MS. Psychosocial Factors and Progression From Prehypertension to Hypertension or Coronary Heart Disease. Annals of Family Medicine 5:403-411 (2007)Annals of Family Medicine, Sep/Oct 2007.
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