Self-Esteem and the Acute Effect of Anxiety on Ambulatory Blood Pressure

Abstract

Objective Recent research suggests that self-esteem may be associated with improved parasympathetic nervous system functioning. This study tested whether high self-esteem is associated with decreased ambulatory systolic blood pressure (ASBP) reactivity to anxiety in healthy adults during the waking hours of a normal day. Methods Each of 858 participants completed a short version of the Rosenberg Self-Esteem Scale and then wore an ABP monitor which took two blood pressure readings per hour for 24 hours. Immediately after each blood pressure reading, participants completed an electronic diary report that included an anxiety rating on a 100-point visual analog scale (VAS). Using multilevel models, we assessed the association of momentary anxiety, high trait self-esteem, and their interaction on momentary ASBP, with adjustment for age, sex, race, ethnicity, and body mass index. Sensitivity analyses were conducted examining psychological factors associated with self-esteem: sense of mastery, optimism, social support, and depressive symptoms. Results On average, a 1-point increase in cube root-transformed anxiety was associated with a 0.80 mmHg (SE=0.09, p<0.001) increase in ASBP, and the interaction of high self-esteem and momentary anxiety was significant, such that this effect was 0.48 (SE=0.20, p=0.015) less in individuals with high self-esteem compared to all others. Results for self-esteem remained significant when adjusting for sex and psychological factors. Conclusions Momentary increases in anxiety are associated with acute increases in ASBP, and high self-esteem buffers the effect of momentary anxiety on blood pressure. Thus, high self-esteem may confer cardiovascular benefit by reducing the acute effects of anxiety on systolic blood pressure.

Between-person and within-person approaches to the prediction of ambulatory blood pressure: the role of affective valence and intensity

“…Although much is known at the between-person level, far fewer studies have examined inthe-moment effects of ABP (for exceptions see Brondolo et al, 2003;Edmondson et al, 2015;Jacob et al, 1999;Kamarck et al, 2002;Ottaviani et al, 2011;Smith et al, 2012). Thus, there is continued need to test momentary relationships with ABP.…”

“…In addition, by examining anger and ABP over time, one gains better access to the extent to which these variables dynamically co-vary indicating precise moments when a person may be vulnerable (e.g., when anger is high). Work in this area has found in-the-moment associations between more socially evaluative threats (Smith et al, 2012), higher anxiety (Edmondson et al, 2015), rumination (Ottaviani et al, 2011), negative social interactions (Brondolo et al, 2003), and negative affect, arousal, task demand, and social conflict (Kamarck et al, 2002) with higher levels of momentary ABP, thus suggesting the viability of such an approach. Moreover, recent work has advocated for the use of within-person assessments and analyses to examine psychosomatic questions, such as how affect and BP relate (Blackwell et al, 2006;Myers et al, 2012).…”

Effect of Situational Anxiety and Depression on 24-Hour Ambulatory Blood Pressure Monitorization in Patients with Hypertension

“…25 It has been proven that brief episodes of anxiety cause increase in ambulatory systolic blood pressure in healthy adults. 26 Sunbul et al investigated the association between depression, anxiety and abnormal nocturnal blood pressure fall in hypertensive patients. Patients' anxiety and depression level measured by hospital anxiety and depression scale.…”

Power-assisted exercise for people with complex neurological impairment: a feasibility study

“…One participant specifically commented upon the downward trend in blood pressure over the course of the four weeks. It is possible that blood pressure may have been elevated during the initial sessions due to anxiety related to the new intervention (Edmondson et al 2015); therefore, the observed reduction in blood pressure cannot be directly attributed to the exercise programme. Saunders et al (2014) identify limited evidence related to exercise and blood pressure amongst the stroke population, particularly interventions which have included strength training.…”