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To examine the relationships between anger expression and blood pressure (BP) levels and their effect modification by stress coping behaviors, the authors analyzed data from a cross-sectional study of 790 Japanese male workers aged 20-60 years. We used the Spielberger anger expression scales to measure anger-out, anger-in, and anger-control. Relationships between anger expression scales and mean systolic and diastolic BP levels were examined in the total sample and in two subgroups of high and low stress coping behaviors (low coping behavior group: having none, one, or two coping behaviors; and high coping behavior group: having three or more coping behaviors). Anger expression scales were not associated with BP levels in the total sample. Among men who reported only two or fewer coping behaviors, however, the anger-out score was significandy associated with systolic blood pressure (SBP) levels while no association was found among men who reported the larger number of coping behaviors. Anger-in and anger-control were not associated with BP levels in either low or high coping behavior groups. This study suggests that male workers who do not express their anger have a higher probability of developing high BP when they have no or few stress coping behaviors.

Impact of anger expression on blood pressure levels in white-color workers with low-coping behavior