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Cited by 29Blood Pressure and Hypertension StudiesHeart Rate Variability and Autonomic ControlCardiac Health and Mental Health

Self-Esteem and the Acute Effect of Anxiety on Ambulatory Blood Pressure

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Edmondson, Donald, Arndt, Jamie, Alcántara, Carmela, Chaplin, William, Schwartz, Joseph E·2015·Psychosomatic Medicine
DOI 10.1097/psy.0000000000000219PMC PMC4565744
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Abstract

OBJECTIVES: 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.

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  • The clinical application and accuracy of HBPM may be limited by conditions related to the individual, the procedure, the oscillometric technique, or cuff-related issues.

    “the clinical application and the accuracy of HBPM may be limited by certain conditions related either to the individual [63–66], to the procedure itself [4,67], to the oscillometric technique for BP measurement or to cuff-related issues [4,65,68–74].”

    From Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension (2021) · cites this paper as [66]

    The Results section (‘Momentary anxiety and ambulatory blood pressure’; page not provided) reports that anxiety was associated with higher ambulatory systolic blood pressure, supporting an individual-related influence on a reading. The paper studies ambulatory monitoring, not home blood pressure monitoring (HBPM), and does not establish limits on HBPM accuracy or clinical use from procedural, oscillometric, or cuff-related issues. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Edmondson, D., Arndt, J., Alcántara, C., Chaplin, W., & Schwartz, J. E.
Affiliations
St. John's University (US)
Corresponding author
Edmondson, Donald
ORCID
Venue
Psychosomatic Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2015-09
Volume
77
Issue
7
Pages
833-841
ISSN
0033-3174 (ISSN-L)
DOI
10.1097/psy.0000000000000219
PMC
PMC4565744
OpenAlex
W2468299584
Cited by
29
References
8
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 2 · 2015: 1
FWCI
2.91
Type
journal article
Language
en
Open access
Locations
  • Psychosomatic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Columbia Academic Commons (Columbia University)
Funders
  • National Institutes of Health (UL1TR000040)
  • National Heart, Lung, and Blood Institute (P01 HL47540, R24HL076857, P01HL047540, R01HL117832)
  • National Center for Research Resources (UL1RR024156, M01RR010710, MO1 RR10710)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords
self-esteem, anxiety, ambulatory blood pressure, parasympathetic nervous system, psychological buffering, cardiovascular health, trait self-esteem
MeSH terms
Adult, Anxiety, Blood Pressure, Female, Humans, Male, Middle Aged, Self Concept, Blood Pressure Monitoring, Ambulatory

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