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(Hypertension. 2001;38:997.)
© 2001 American Heart Association, Inc.

Scientific Contributions

Gender Differences in Associations of Diurnal Blood Pressure Variation, Awake Physical Activity, and Sleep Quality With Negative Affect

The Work Site Blood Pressure Study

Kazuomi Kario; Joseph E. Schwartz; Karina W. Davidson; Thomas G. Pickering

From the Zena and Michael A. Wiener Cardiovascular Center, Behavioral and Integrative Cardiology Program, Mount Sinai School of Medicine (K.K., K.W.D., T.G.P.), New York, NY; and the Department of Psychiatry, State University of New York (J.E.S.), Stony Brook.

Correspondence to Kazuomi Kario, MD, PhD, FACC, or Joseph E. Schwartz, PhD, Integrative and Behavioral Cardiology Program, Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, 50 East 98th St, Suite 1B, New York, NY 10029. E-mail kkario{at}jichi.ac.jp or jschwartz@mail.psychiatry.sunysb.edu

Abstract—— This study reports on the associations among depression, anxiety, awake physical activity, sleep quality (assessed by nocturnal physical activity), and diurnal blood pressure (BP) variation in a nonpsychiatric sample (The Work Site Blood Pressure Study). We conducted ambulatory BP (ABP) monitoring and actigraphy in 231 working men and women. Depression and anxiety were measured by the Brief Symptom Inventory. There were gender-specific associations between depression or anxiety and ABP parameters. In men, depression was associated positively with the sleep/awake systolic BP (SBP) ratio (r=0.24, P=0.006). After controlling for age, body mass index, and awake and sleep activity, depression remained significantly associated with the sleep/awake SBP ratio (r=0.25, P=0.005) and was also significantly related to sleep SBP (r=0.21, P=0.02). Anxiety, which was related to depression (r=0.73, P<0.0001), had a similar but slightly weaker pattern of associations with ABP and activity. These associations were not found in women, but there were associations of anxiety with awake SBP (r=0.24, P=0.01) and pulse rate (r=0.27, P=0.006). In conclusion, depression is associated with disrupted diurnal BP variation independent of ambulatory physical activity in working men, whereas anxiety is associated with awake SBP and pulse rate in women.

Key Words: blood pressure • blood pressure monitoring, ambulatory • gender

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