Anger inhibition and family history as modulators of cardiovascular responses to mental stress in adolescent boys.

Sixty boys aged 12-16 took part in an experiment in which physiological and subjective measures were obtained at rest and in response to mental arithmetic and mirror drawing tasks. Blood pressure was recorded from biological parents, and subjects were subsequently categorized as being at high family risk for cardiovascular disease if either parent had a history of coronary heart disease or hypertension, or a resting blood pressure > or = 140/85 mmHg. Twenty boys were classified as high family risk and forty as low risk. A significant interaction between family risk and a disposition towards anger inhibition was observed, with the greatest systolic blood pressure responses to tasks being recorded in high risk boys who reported high levels of anger inhibition. This effect was maintained after controlling for initial blood pressure level, age and body mass. The cardiac baroreceptor reflex was inhibited during tasks, and was lower in high than low family risk subjects. The results suggest that the tendency to inhibit anger expression interacts with familial factors in determining reactivity patterns that may be indicative of raised risk of future cardiovascular disease.