Ambulatory blood pressure responses and the circumplex model of mood: a 4-day study.

BACKGROUND: The relation between mood or emotions and concurrent ambulatory blood pressure responses holds both fundamental and clinical interest. METHODS: The primary sample consisted of 69 normotensive or borderline hypertensive but otherwise healthy adult males. The validation sample consisted of 85 healthy male undergraduate college students. Both samples underwent half-hourly 24-hour ambulatory blood pressure measurements on four separate workdays, 1 week apart. At each ambulatory measurement, subjects recorded their behavior, environment, and mood. The circular mood scale, a circular visual analogue scale based on the circumplex model of mood, was used to reflect the totality of a participant's affective state space. Longitudinal random effects regression models were applied in the data analysis. RESULTS: The results for both samples were quite similar. Sleep and posture had the greatest influence on ambulatory blood pressure and heart rate. The effects of the environmental setting, social setting, and consumption were modest but statistically significant. Independent of these covariates, mood exerted a significant effect on blood pressure and heart rate. Relative to the "mellow" default category, blood pressure increased both for "anxious/annoyed" and "elated/happy" and decreased during "disengaged/sleepy" mood. The range of mood-related blood pressure estimates was 6.0/3.7 mm Hg. CONCLUSIONS: The pattern of blood pressure responses suggests that they were related to the degree of engagement of a mood rather than the degree of unpleasantness. The hypothesis that posits that negative affect-related cardiovascular reactivity mediates the observed correlation between negative affect and disease risk should be reconsidered.

Neither awake nor sleep blood pressures better predict target-organ effect.

We sought to assess the strengths of commonly used ambulatory blood pressure (ABP) parameters as predictors of transmitral flow/velocity ratio (E/A) and the dimensions that govern the left ventricular (LV) mass index. ABP, E/A, and LV dimensions were assessed in 47 subjects, with inclusion of 45 in the final data analysis. The results of four weekly (96 h total) ABP studies were averaged for each subject. No single ABP parameter immerged as a "best predictor." Furthermore, casual blood pressures taken at the beginning of the echo examination had predictive strength for LV mass which was similar to that of the ambulatory data. In the present study, neither awake nor sleep ABPs differed significantly with respect to correlations with indices of LV structure.