Anger expression styles and blood pressure: evidence for different pathways

To investigate comparative models that could clarify the relationship between ways of anger expression and blood pressure (BP). It was hypothesized that the impact of the anger expression on BP is distinct for different styles of anger expression, including mediated effects through health behavior and overweight, and direct links to BP.The study sample comprised of 705 middle-age men who participated in a trial aimed at preventing the metabolic syndrome, type 2 diabetes and cardiovascular diseases. BP was measured by study nurses. Participants completed self-report questionnaires assessing health behavior and anger expression styles. Statistical analyses involved descriptive analyses, correlations and path analysis.Individual measures of anger expression related differently with adverse lifestyle factors and also with SBP and DBP. The association of anger-in with elevated BP seems to be mediated by adverse lifestyles. For anger-control, we found statistically significant direct pathways to elevated BP but no significant links with lifestyles. Open expression of anger seems to have a beneficial direct effect on BP.It is concluded that among a sample of men, different ways of anger expression are linked to SBP and DBP through several direct or mediated pathways.