title: 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 that 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. 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-mm Hg (standard error = 0.09, p < .001) increase in ASBP, and the interaction of high self-esteem and momentary anxiety was significant, such that this effect was 0.48 (standard error = 0.20, p = .015) less in individuals with high self-esteem compared with 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.
authors.affiliation: From the Center for Behavioral Cardiovascular Health (Edmondson, Alcántara, Schwartz), Columbia University Medical Center, New York, New York; Department of Psychological Sciences (Arndt), University of Missouri at Columbia, Columbia, Missouri; Department of Psychology (Chaplin), St John's University, Jamaica, New York; and Department of Psychiatry and Behavioral Science (Schwartz), Stony Brook University, Stony Brook, New York.
authors.forename: Donald
authors.initials: D
authors.lastname: Edmondson
authors.forename: Jamie
authors.initials: J
authors.lastname: Arndt
authors.forename: Carmela
authors.initials: C
authors.lastname: Alcántara
authors.forename: William
authors.initials: W
authors.lastname: Chaplin
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012649:Self Concept