Pain, Fear, and Anger in Hypertensives and Normotensives

Abstract

Subjects were: 18 hypertensives whose pressures averaged 180/119 mm Hg seated; 15 potential hypertensives with transient pressure elevations whose pressures averaged 151/93 mm; and 15 normotensives whose pressures averaged 123/80 mm. Each subject was studied during a single experimental period when pain was induced by a cold pressor test, and fear and anger were stimulated by staged situations. Verbal responses were recorded and rated independently by 3 judges for emotional intensity of fear and anger. Five out of 12 variables significantly differentiated the group''s responses to pain, fear and anger: peripheral resistance index, cardiac output index, stroke volume index, heart rate, hand temperature, psychogalvanic skin response and respiratory rate. In fear 35 of the 48 had a predominantly epinephrine-like cardiovascular response; in pain 31 of the 47 had a predominantly norepinephrine-like reaction; in anger responses were mixed. Different psychological intensities of anger tend to be associated with different cardiovascular responses. Hypertensives showed greater rises in blood pressure during pain, fear and anger, as noted by other investigators. This group of hypertensives tended to express psychologically more fear and anger than the normotensives, though the differences were not statistically significant. For the total group, mean blood pressure correlated significantly with ratings of psychological intensity of fear and anger.