The role of the experience and expression of anger and anxiety in elevated blood pressure among black and white adolescents.

Differences between black and white adolescents in the experience and expression of anger and anxiety, traditional risk factors for hypertension, and blood pressure were examined among adolescents enrolled in a health science course in Tampa, Florida. Relationships between blood pressure and anger/anxiety and traditional risk factors were also examined. Black adolescents of both genders experienced feelings of anxiety more frequently and with greater intensity than did their white counterparts. Although black and white adolescents did not differ in their ability to experience anger, blacks experienced more intense reactions in situations involving unfair criticism and time pressure. More importantly, black males and females suppressed the expression of their anger more often than did their white counterparts. The blood pressure of black adolescent males and females was found to be significantly higher than their white counterparts. Blacks were also more likely to have a family history of hypertension, but were less likely to smoke cigarettes. Racial differences on other risk factors were found only among black females who were heavier and consumed more salty junk foods than white females. Although a number of the personality and risk factor measures were significantly correlated with blood pressure, measures of suppressed anger were more strongly correlated with blood pressure for both black and white adolescents. Findings from the multiple regression analyses showed that suppressed anger was the best independent predictor of blood pressure for all groups except white females. Overall, the findings from this study demonstrate that adolescents with elevated blood pressure can be identified by emotional/psychological factors, which are predictive of high blood pressure for both blacks and whites.