Effectiveness of an Anger and Stress Management Program on Reducing Blood Pressure Levels in Youth

High blood pressure can be caused by many factors, including stress, anxiety, diabetes,
kidney disease, or obesity. In many people, there is no identifiable cause for their high
blood pressure; this is known as essential hypertension (EH). Increasingly, children are
being diagnosed with high blood pressure, which may lead to an increased risk of developing
EH as adults. Therefore, the need exists for an effective blood pressure reduction program
targeted toward youth. Research has shown that improving people's abilities to manage stress
and anger reduces their risk of developing high blood pressure and heart disease. The
Williams LifeSkills (WLS) workshop is a program that teaches people to cope with stressful
situations. It has been shown to improve heart health, including blood pressure levels, in
adults with cardiovascular disease. However, the effect of stress and anger management
programs on blood pressure levels in youth has not been widely studied. Study researchers
have developed and preliminarily tested a school-based anger and stress management WLS
program. This study will evaluate the effectiveness of the school-based WLS program at
reducing blood pressure and anger levels in high school students. If successful, this
program could be implemented in schools across the country.

This study will enroll high school students. Participants will be randomly assigned to
either a 12 lesson WLS program or a control group. Participants in the control group will
attend regular high school classes. Participants in the WLS program will attend 12 sessions
that will focus on coping skills to help manage stress and anger levels. At baseline, the
end of the 12 lesson program, and follow-up visits 3 and 6 months later, participants will
complete questionnaires on anger levels; life skills; hostility; stress; self-esteem; and
attitudes toward school, teachers, and parents. They will also wear a blood pressure monitor
for a 24-hour period.

Inclusion Criteria:

- High school student

Exclusion Criteria:

- History of any chronic illness or any chronic health problem requiring
pharmacological treatment (e.g., asthma, sickle cell disease, epilepsy)

- Adolescents with ambulatory systolic blood pressure greater than the 95th percentile
based on age, sex, and height at screening will be allowed to participate in the
workshop but may be excluded from testing

- Unwilling to be assigned into a specific treatment group