Training helps teens manage anger, lower blood pressure

A 10-week program that fits easily into the high school curriculum could give students a lifetime of less anger and lower blood pressure, researchers report.

Health and physical education teachers taught anger and stress management to 86 ninth graders in Augusta, Ga., and found their ability to control anger increased, their anxiety decreased and their blood pressures were generally lower over the course of a day compared to 73 of their peers who received no intervention, according to a study published in the journal Translational Behavioral Medicine.

Among the 30 percent of participants with higher blood pressures, the diastolic measure – the bottom number reflecting pressure inside blood vessels when the heart is relaxed and filling with blood – decreased about two points, said Dr. Vernon A. Barnes, physiologist at the Institute of Public and Preventive Health at Georgia Health Sciences University.

Even a small downward shift in blood pressure in youth could substantially reduce hypertension risk and related cardiovascular disease risk over the long term and improve public health, the researchers said. The benefits held up at six months.

"We believe we have an effective method that any school could use to help curtail violence and keep adolescents out of trouble with an improved mental state that benefits their physical well-being," Barnes said. Further study is needed to measure the program's impact in hypertensive schoolchildren, he noted.

Escalating anger and violence among youths have been associated with increased levels of stress and anxiety, which in turn increases blood pressure in adolescents, the researcher said. Additionally, self-reported feelings of anger have been shown to predict aggression in youth.

The program taught in 10, 50-minute sessions at two high schools in 2005 and 2006 is protocol-driven, fits easily into the school day and has implications for improved decision making and coping skills for adolescents in any venue, the researchers said. It appears to be the first study to examine the impact of stress management on blood pressure and indices of anger and anxiety in schoolchildren.

Drs. Redford B. Williams and Virginia P. Williams, founders of Williams LifeSkills Inc. and study co-authors, developed the 10 skills taught in William LifeSkills workshops. The former directs Duke University's Behavioral Medicine Research Center and the latter led efforts to adapt the training for adolescents, citing its ability to lower blood pressure and improve overall health and well-being in adults.

The lessons help adolescents learn to be assertive without being aggressive, make sound decisions about whether to act on negative thoughts and increase their positive interactions. Some stressful situations students worked through in class were real-life situations they shared with classmates. Their blood pressure was measured around the clock and they received pre- and post-testing to assess anger and anxiety levels.

High blood pressure problems in children are becoming increasingly common. About 30 percent of U.S. adults are hypertensive, according to the Centers for Disease Control and Prevention, while about 5 percent of children already show evidence of high blood pressure.