Paper
Saturday, July 16, 2005
Ambulatory Blood Pressures of Adolescents in Relation to Hostility and Social Defensiveness
Janet C. Meininger, PhD, RN, FAAN, School of Nursing, University of Texas -Houston Health Science Center, Houston, TX, USA, Patricia Liehr, PhD, RN, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA, Wenyaw Chan, PhD, School of Public Health, University of Texas- Houston Health Science Center, Houston, TX, USA, Thong Q. Nguyen, MS, School of Nursing, University of Texas-Houston Health Science Center, Houston, TX, USA, Heeseung Choi, MPH, DSN, RN, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA, and William H. Mueller, PhD, School of Public Health, University of Texas-Houston Health Science Center, Houston, TX, USA.
| Learning Objective #1: Describe the design and methods of a study that investigated ambulatory blood pressures of adolescents |
| Learning Objective #2: Discuss research findings related to the association of hostility with ambulatory blood pressures in adolescents and the modifying effects of social defensiveness on this association |
The aims of this study were to: 1) investigate hostility in relation to ambulatory systolic (SBP) and diastolic (DBP) blood pressure and 2) test the modifying effects of social defensiveness on this association. A stratified quota sample of adolescents (n=344, 11 to 16 years old) was recruited from public middle and high schools based on gender, ethnic group (African American, Hispanic American, and European American) and age. Ambulatory SBP and DBP were monitored (Spacelabs 90207) every 30 to 60 minutes for a 24-hour interval on a school day (n=13,597 blood pressures). Physical activity (Motionlogger actigraph), posture and location (diary) were recorded at the time of each blood pressure measurement. Sexual maturation (Tanner stage), height and weight were measured during a physical exam by a nurse practitioner on another school day. Self-report questionnaires measured hostility (Cook-Medley Scale, adolescent version) and social defensiveness (Marlowe-Crowne Social Desirability Scale). Scores for both scales were divided into low, medium, and high with the 25th and 75th percentiles as cut-points. Mother's education was ascertained by phone interview. A mixed-model, repeated measures analysis of variance was used to control for demographic variables, BMI, height, Tanner stage, activity, posture and location. There was a significant association of hostility with SBP (p<.0001), but not DBP (p=.43). Controlling for social defensiveness and other variables, adolescents with medium levels of hostility had higher ambulatory SBP (+4.11 mmHg) than those with low levels of hostility. Statistically significant interactions between hostility and social defensiveness were observed for both SBP (p<.0001) and DBP (p<.0001). It is concluded that social defensiveness may help clarify the impact of psychosocial factors such as hostility on ambulatory blood pressures of adolescents.