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Anger suppression: its relationship to β-adrenergic receptor sensitivity and stress-induced changes in blood pressure

Published online by Cambridge University Press:  09 July 2009

Paul J. Mills  and
Joel E. Dimsdale
Paul J. Mills*
Affiliation:
Department of Psychiatry, UCSD Medical Center, University of California, San Diego, California, USA
Joel E. Dimsdale
Affiliation:
Department of Psychiatry, UCSD Medical Center, University of California, San Diego, California, USA
*
1Address for correspondence: Dr Paul J. Mills, UCSD, Department of Psychiatry (0804), La Jolla, California 92093, USA.
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Synopsis

While studies from diverse fields of research suggest a relationship between problems expressing anger and cardiovascular illness, few studies have provided a potential pathophysiological link of such a relationship. Forty-five males were classified according to one of three anger expression categories: those who did not suppress their anger (N = 13), those who partially suppressed their anger (N = 19), and those who definitely suppressed their anger (N = 13). For each, we determined lymphocyte β-adrenergic receptor function and blood pressure responsiveness to a standardized mathematics stressor. Those subjects who routinely suppressed their expression of anger had increased β-adrenergic receptor sensitivity (P = 0·01) (isoproterenol-stimulated cyclic AMP production) and a greater systolic blood pressure response to the stressor (P = 0·001). Anger suppression was unrelated to the subject's age, weight, or socioeconomic status. These findings may be germane to prior clinical and epidemiologic observations relating anger expression and cardiovascular illness.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 3 , August 1993 , pp. 673 - 678
Copyright
Copyright © Cambridge University Press 1993

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References

Aarons, R., Nies, A., Gerber, J. & Molinoff, P. (1983). Decreased β-adrenergic receptor density on human lymphocytes after chronic treatment with agonists. Journal of Pharmacology and Experimental Therapeutics 224, 1–6.Google ScholarPubMed
Barefoot, J., Dohlstrom, W. & Williams, R. (1983). Hostility, coronary heart disease incidence and total mortality: a 25-year follow-up study of 255 physicians. Psychosomatic Medicine 45, 59–69.CrossRefGoogle ScholarPubMed
Blumenthal, J., Emery, C., Walsh, M., Cox, D., Kuhn, C., Williams, R. & Williams, S. (1988). Exercise training in healthy Type A middle-aged men: effects of behavioral and cardiovascular responses. Psychosomatic Medicine 50, 418–433.CrossRefGoogle ScholarPubMed
Brodde, O., Bekeringh, J. & Michel, M. (1987). Human heart β-adrenoceptors: a fair comparison with lymphocyte β-receptors? Trends in Biological Science 8, 403–407.Google Scholar
Butler, J., O'Brien, M., O'Malley, K. & Kelly, J. G. (1982). Relationship of β-adrenoceptor density to fitness in athletes. Nature 298, 60–62.CrossRefGoogle Scholar
Cameron, O., Smith, C., Lee, M., Hollingsworth, P., Hill, E. & Curtis, G. (1990). Adrenergic status in anxiety disorders: platelet α2-adrenergic receptor binding, blood pressure, pulse, and plasma catecholamines in panic and generalized anxiety disorder patients and in normal subjects. Biological Psychiatry 28, 3–20.CrossRefGoogle Scholar
Chesney, M. & Rosenman, R. (eds.) (1985). Anger and Cardiovascular and Behavioral Disorders. Hemisphere: Washington.Google Scholar
Dembroski, T., MacDougall, J., Williams, R., Harvey, T. & Blumenthal, J. (1985). Comparison of Type A, hostility, and anger-in: further relation to angiographic findings. Health Psychology 4, 137–152.Google Scholar
Dembroski, T. M., MacDougall, J., Shields, J., Petitto, J. & Lushese, R. (1978). Components of the Type A coronary-prone behavior pattern and cardiovascular responses to pyschomotor performance challenge. Journal of Behavioral Medicine 1, 159–176.CrossRefGoogle Scholar
Dimsdale, J. (1984). Generalizing from laboratory studies to field studies of human stress physiology. Psychosomatic Medicine 46, 463–469.CrossRefGoogle ScholarPubMed
Dimsdale, J. (1989). Anger and blood pressure. Drug Therapy 06, 105–109.Google Scholar
Dimsdale, J., Pierce, C., Schoenfeld, D., Brown, A., Zisman, R. & Graham, R. (1986). Suppressed anger and blood pressure: effects of race, sex, social class, and age. Psychosomatic Medicine 48, 430–436.CrossRefGoogle ScholarPubMed
Esler, M., Julius, S., Zweifler, A., Randall, O., Harburg, E., Gardiner, H. & DeQuattro, V. (1977). Mild high-renin essential hypertension. New England Journal of Medicine 296, 405–411.CrossRefGoogle ScholarPubMed
Fredrikson, M. & Matthews, K. (1990). Cardiovascular responses to stress and hypertension: a meta-analytic review. Annals of Behavioral Medicine 12, 30–39.CrossRefGoogle Scholar
Gentry, W., Chesney, A., Gary, H., Hall, R. & Harburg, E. (1982). Habitual anger-coping styles: I. Effect on mean blood pressure and risks for essential hypertension. Psychosomatic Medicine 44, 195–202.CrossRefGoogle Scholar
Graafsma, S. J., Lenders, J. W., Peters, J. H., van Tits, L. J., Pieters, G. F., Rodrigues de Miranda, J. F. & Thien, T. (1988). Role of adrenaline in the short-term upregulation of beta-adrenoceptors in essential hypertensive and adreaalectomized females. Journal of Hypertension 6(suppl 4), 578–580.CrossRefGoogle ScholarPubMed
Graafsma, S. J., van Tits, L. J., van Heijst, P., Reyenga, J., Lenders, J. W., Rodrigues de Miranda, J. F. & Thien, T. (1989). Adrenoceptors on blood cells in patients with essential hypertension before and after mental stress. Journal of Hypertension 7, 519–524.CrossRefGoogle ScholarPubMed
Harburg, E., Erfuit, J., Houenstein, L., Chape, C., Schull, W. & Schork, M. (1973). Socioeconomic stress, suppressed hostility, skin color and black/white male blood pressure. Psychosomatic Medicine 35, 276–298.CrossRefGoogle ScholarPubMed
Helmer, D., Ragland, D. & Syme, L. (1991). Hostility and coronary artery disease. American Journal of Epidemiology 133, 112–122.CrossRefGoogle ScholarPubMed
Hoffman, J., Benson, H., Arns, P., Stainbrook, G., Landsberg, L., Young, L. & Gill, A. (1982). Reduced sympathetic nervous system responsivity associated with the relaxation response Science 215, 190–192.CrossRefGoogle ScholarPubMed
Hollingshead, A. (1957). Two Factor Index of Social Position: New Haven, Conn.Google Scholar
Homey, C. (1991). The β-adrenergic signaling pathway in the heart. Hospital Practice 15 05, 43–50.Google Scholar
Kahn, J., Perumal, A., Gully, R., Smith, T., Cooper, T., Klein, D. F. (1987). Correlation of Type A behaviour with adrenergic receptor density: implications for coronary artery disease pathogenesis. Lancet ii, 937–939.CrossRefGoogle Scholar
Khan, M. M., Sanson, P., Silverman, E. D., Engleman, E. G. & Melmon, K. L. (1986). β-adrenergic receptors on human suppressor, helper, and cytolytic lymphocytes. Biochemical Pharmacology 35, 1137–1142.CrossRefGoogle ScholarPubMed
Landmann, R. M., Portenier, M., Staehelin, M., Wesp, M. & Box, R. (1988). Changes in β-adrenoceptors and leucocyte subpopulations after physical exercise in normal subjects. Naunyn-Schmiedebergs Archiv für experimentelle Pathologie und Pharmakologie 337, 261–266.Google ScholarPubMed
Maisel, A. S., Harris, T., Reardon, A. & Martin, M. C. (1990). β-adrenergic receptors in lymphocyte subsets after exercise: Alterations in normal individuals and patients with congestive heart failure. Circulation 82, 2003–2010.CrossRefGoogle ScholarPubMed
Manuck, S., Kasprowicz, A. & Muldoon, M. (1990). Behaviorally-evoked cardiovascular reactivity and hypertension: conceptual issues and potential associations. Annals of Behavioral Medicine 12, 17–29.CrossRefGoogle Scholar
Metropolitan Life Foundation (1983). Metropolitan height and weight tables. Statistical Bulletin 64, 1.Google Scholar
Michel, M., Otto-Erich, O. & Insel, P. (1990). Peripheral adrenergic receptors in hypertension. Hyper 16, 107–120.CrossRefGoogle ScholarPubMed
Mills, P. & Dimsdale, J. E. (1988). The promise of receptor studies in psychophysiologic research. Psychosomatic Medicine 50, 555–566.CrossRefGoogle ScholarPubMed
Mills, P., Schneider, R. & Dimsdale, J. (1989). Anger assessment and reactivity to stress. Journal of Psychosomatic Research 33, 379–382.CrossRefGoogle ScholarPubMed
Mills, P., Schneider, R., Hill, D., Walton, K. & Wallace, R. (1990 a). Beta-adrenergic receptor sensitivity in subjects practicing transcendental meditation. Journal of Psychosomatic Research 34, 29–33.CrossRefGoogle ScholarPubMed
Mills, P., Dimsdale, J., Ziegler, M., Berry, C. & Bain, R. (1990 b). β-adrenergic receptors predict heart rate reactivity to a psychosocial stressor. Psychosomatic Medicine 52, 621–623.CrossRefGoogle ScholarPubMed
Mills, P. J., Dimsdale, J. E., Ziegler, M. G., Hauger, R., Nelesen, R. A. & Brown, M. (1993). Sympathetic alterations following sodium restriction and short-term captopril. Journal of the American College of Cardiology 21, 177–181.CrossRefGoogle Scholar
Pacak, K., Nedvidkova, J., Horvath, M., Frantik, E., Husek, P. & Pacovsky, V. (1989). High cardiovascular reactivity to psychological challenge associated alternatively with high density of β-adrenergic receptors or with high resting level of catecholamines. Activitas Nervosa Superior 31, 96–99.Google ScholarPubMed
Pickering, T. G. & Gerin, W. (1990). Cardiovascular reactivity in the laboratory and the role of behavioral factors in hypertension: a critical review. Annals of Behavioral Medicine 12, 3–16.CrossRefGoogle Scholar
Powell, L., Friedman, M., Thoresen, C., Gill, J. & Ulmer, D. (1984). Can the Type A behavior pattern be altered after myocardial infarction? A second year report from the recurrent coronary prevention project. Psychosomatic Medicine 46, 293–313.CrossRefGoogle ScholarPubMed
Sallis, J., Johnson, C., Trevorrow, T., Kaplan, R. & Hovell, M. (1987). The relationship between cynical hostility and blood pressure reactivity. Journal of Psychosomatic Research 31, 111–116.CrossRefGoogle ScholarPubMed
Schneider, R., Egan, B., Johnson, E., Drobny, H. & Julius, S. (1986). Anger and anxiety in borderline hypertension. Psychosomatic Medicine 48, 242–248.CrossRefGoogle ScholarPubMed
Shekelle, R., Gale, M., Ostfeld, A. & Paul, O. (1983). Hostility, risk of coronary heart disease and mortality. Psychosomatic Medicine 45, 109–114.CrossRefGoogle ScholarPubMed
Smith, M. & Houston, B. (1987). Hostility, anger expression, cardiovascular responsivity, and social support. Biological Psychology 24, 39–48.CrossRefGoogle ScholarPubMed
Suarez, E. & Williams, R. (1990). The relationship between dimensions of hostility and cardiovascular reactivity as a function of task characteristics. Psychosomatic Medicine 52, 558–570.CrossRefGoogle ScholarPubMed
Weidner, G., Friend, R. & Ficarotto, T. (1989). Hostility and cardiovascular reactivity to stress in women and men. Psychosomatic Medicine 51, 36–45.CrossRefGoogle ScholarPubMed
Werstiuk, E., Steiner, M. & Burns, T. (1990). Studies on leukocyte β-adrenergic receptors in depression: a critical appraisal. Life Sciences 47, 85–105.CrossRefGoogle ScholarPubMed
Williams, R. B. (1987). Refining the Type A hypothesis: emergence of the hostility complex. American Journal of Cardiology 60, 27J–32J.CrossRefGoogle ScholarPubMed