title: Anger expression styles and blood pressure: evidence for different pathways.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University of Helsinki, Helsinki 00014, Finland.
authors.forename: Cornel V
authors.initials: CV
authors.lastname: Igna
authors.forename: Juhani
authors.initials: J
authors.lastname: Julkunen
authors.forename: Hannu
authors.initials: H
authors.lastname: Vanhanen
mesh_terms: D000328:Adult; D000374:Aggression; D000786:Anger; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D019260:Expressed Emotion; D015438:Health Behavior; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires