Anger response styles and blood pressure: at least don't ruminate about it!

Ann Behav Med. 2004 Feb;27(1):38-49. doi: 10.1207/s15324796abm2701_6.


Background: Research on anger suggests a link with blood pressure (BP), but the findings are complex and highly variable; this is at least partly attributable to measurement issues.

Purpose: In this study we used a new model of anger responding that comprises 6 independent anger response styles in 2 dimensions: Aggression, Assertion, Social Support Seeking, Diffusion, Avoidance, and Rumination. Linear and interactive relations between the anger response styles and resting and ambulatory BP were tested, controlling for traditional risk factors and level of hostility.

Methods: Data from 2 samples of different cardiovascular health status were examined. In Study 1, 109 healthy participants (45 men and 64 women) were recruited. Study 2 involved a sample of 159 hypertensive patients (90 men and 69 women). All participants provided demographic and health information; completed the Behavioral Anger Response Questionnaire, a hostility measure; and underwent resting BP measurement. Study 2 participants also provided 24-hr ambulatory BPs.

Results: Examination of linear effects revealed inconsistent associations between anger response styles and BP. The moderating effect of Rumination on the relationship between the other anger response styles and BP was examined next. Rumination had a deleterious influence on the relation between Avoidance and Assertion and resting and ambulatory BP levels. The moderating influence of Rumination on Social Support Seeking varied between the genders.

Conclusions: Overall, the results suggest that rumination is a critical moderating variable in the relation of anger and BP.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Aged
  • Aggression / psychology
  • Anger*
  • Arousal*
  • Assertiveness
  • Blood Pressure*
  • Defense Mechanisms
  • Female
  • Hostility
  • Humans
  • Hypertension / diagnosis
  • Hypertension / psychology*
  • Male
  • Middle Aged
  • Personality Inventory / statistics & numerical data
  • Psychometrics
  • Reference Values
  • Risk Assessment
  • Social Support
  • Type A Personality*