Absorption in self-selected activities is associated with lower ambulatory blood pressure but not for high trait ruminators.

Original article Absorption in Self-Selected Activities Is Associated With Lower Ambulatory Blood Pressure but Not for High Trait Ruminators Matthew J. Zawadzki, 1 Joshua M. Smyth, 1 Marcellus M. Merritt, 2 and William Gerin 1 methods Participants (n = 38) reported engagement in SSAs and how absorbing they were, responded to trait rumination and perceived stress ques- tionnaires, wore an ABP monitor for 24 hours, and at each ABP meas- urement answered electronic diary questions assessing activity levels, affect, social interactions, and caffeine and tobacco use. results Regression analyses tested whether the reported absorption of SSAs, trait rumination, and their interaction predicted daytime and nighttime systolic and diastolic ABP. Greater absorption predicted lower daytime and nighttime ABP (bs = −18.83 to −8.79; Ps < .05), but this relation- ship was moderated by trait rumination (bs = 3.72 to 9.97; Ps < .05). Follow-up analyses revealed that absorption was unrelated to ABP for those with high trait rumination but that more absorption predicted lower ABP for those less prone to rumination. conclusions Our results suggest that regular engagement in absorbing SSAs is related to lower ABP. These findings have implications for the devel- opment of nonpharmacological interventions and suggest SSAs may serve as an adjuvant intervention strategy to lower BP. Keywords: absorption; ambulatory blood pressure; blood pressure; hypertension; intervention; nonpharmacological; rumination. doi:10.1093/ajh/hpt118 Hypertension affects approximately 30% of Americans, 1,2 and is a risk factor for heart disease and stroke. 1,3 Nonpharmacological (behavioral) interventions, includ- ing meditation and controlled breathing, have shown effectiveness in reducing blood pressure (BP) 4,5 and are recommended for BP control programs. 6 Moreover, evi- dence suggests that these interventions produce addi- tive effects to drug therapy. 7 Although effective, patients report that these interventions are not always enjoyable and require significant alterations to daily routines. 8–10 These negative experiences may represent barriers to engagement and may predict lowered adherence to these interventions. Notably, nonpharmacological interventions appear to share a common component in requiring individuals to direct and sustain their attention away from their thoughts, which are often negative, 11 and become absorbed in the intervention activity. Diverting attention away from negative thoughts is potentially quite important. For example, rumi- nating or brooding about negative experiences can elicit and maintain a stress response, including autonomic and immu- nological activation, that can elevate acute BP and lead to sustained BP elevations over time. 12–14 Conversely, provid- ing a positive or enjoyable way to absorb one’s attention after a stressor prevents rumination and speeds up BP recovery subsequent to the stressor. 15,16 Thus, we propose that recur- ring engagement in activities that sustain and direct atten- tion away from one’s negative thoughts can have long-term effects in lowering BP that should persist beyond engage- ment in the activity itself. If so, we further propose that individuals could engage in a wide range of activities that absorb attention and thus could Correspondence: Matthew Zawadzki (mjz172@psu.edu). 1 Department of Biobehavioral Health, The Pennsylvania State University, University Park, Pennsylvania; 2 Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, Wisconsin. Initially submitted April 10, 2013; date of first revision May 31, 2013; accepted for publication June 21, 2013; online publication July 16, 2013. © American Journal of Hypertension, Ltd 2013. All rights reserved. For Permissions, please email: journals.permissions@oup.com American Journal of Hypertension 26(11) November 2013 1273 Downloaded from http://ajh.oxfordjournals.org/ at Pennsylvania State University on August 26, 2014 background A range of nonpharmacological interventions (e.g., meditation) have posi- tive effects on blood pressure (BP) but tend to have poor adherence. These interventions may lower BP partly by absorbing and directing attention away from one’s negative thoughts. We hypothesized that recurring self- selected activities (SSAs) that are attentionally absorbing may similarly lower BP. We examined the effect of reported engagement in SSAs dur- ing the previous month prior to participation on ambulatory BP (ABP) and whether those prone to rumination were less likely to show these effects.