The blood pressure response to daily stress in normotensive female nurses

Abstract

Blood pressure variability as it relates to the psychological and behavioral correlates of stress may be an important risk factor in the development of hypertension in women as they assume more diverse roles in both the home and the workplace. The physiological stress response in women differs from that in men and may contribute to an increased risk of morbidity and mortality after menopause. The purposes of this study were (1) to compare the effects of management and shift designation on perceived stress and on blood pressure levels during work, home and sleep in healthy normotensive female registered nurses, (2) to examine the effects of suppressed anger, and anxiety coping styles on average work, home, and sleep blood pressure, and (3) to examine the association among lifestyle, psychological, and behavioral factors and their effects on blood pressure variation throughout the day.;The relationship between stress covariates and blood pressure change over the day was examined using a natural experimental design and multivariate techniques. Three sample groups, 24 day shift nurses, 18 night shift nurses, and 21 nurse managers were compared. Blood pressure was measured over one workday with the SpaceLabs 90207 ambulatory blood pressure monitor. Perceived stress at work and at home was measured by self-report. Anger expression was assessed using Spielberger's Anger Expression Scale. Trait levels of depression, anxiety, and hostility were assessed using Derogatis's Symptom Checklist-90-Revised. Anxiety coping styles were assessed using the Taylor Manifest Anxiety and the Marlowe-Crowne Social Desirability Scales.;The results showed that among women of comparable socioeconomical and educational status, managerial versus staff designation had no significant effect on perceived stress and blood pressure variability. However, anxiety coping styles, specifically defensiveness, significantly effected systolic and diastolic blood pressure at work and at home. Furthermore, being married, having children, and keeping anger in rather than expressing it predicted greater changes in blood pressure between work and home and home and sleep conditions. These data suggest that stress among working women associated with repressed anxiety and suppressed anger coping combined with the responsibilities of managing home and work demands may have a detrimental effect on the cardiovascular system.