Anxiety is not manifested by elevated heart rate and blood pressure in acutely ill cardiac patients

Marla J. De Jong, Debra K. Moser, Kyungeh An, Misook L. Chung

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Background: Accurate assessment of anxiety in cardiac patients is important because anxiety is associated with adverse outcomes. Clinicians often use heart rate and blood pressure as indicators of anxiety; however, little is known about whether these measures accurately reflect anxiety in acutely ill patients. Aims: The purpose of this study was to determine whether heart rate and blood pressure were related to level of anxiety in patients with chronic advanced heart failure (HF), patients with acute myocardial infarction (AMI), and healthy individuals. Methods and Results: In this descriptive, correlational study, anxiety, heart rate, and blood pressure were measured at the same time in three groups of individuals: (1) 54 patients hospitalized for AMI; (2) 32 patients with chronic advanced HF; and (3) 31 healthy individuals. State anxiety was measured using the anxiety subscale of the Brief Symptom Inventory. Heart rate and blood pressure data were collected immediately prior to the anxiety assessment. Data were collected in the outpatient setting for patients with HF and healthy individuals. For patients with AMI, data were collected a mean of 48±33 h after admission. There were no correlations between anxiety and heart rate or diastolic blood pressure. Higher anxiety was associated with lower systolic blood pressure in patients with AMI (r=-0.23, P<0.05) and in healthy individuals (r=-0.27, P<0.05). Conclusion: Elevated heart rate and blood pressure do not accurately reflect level of anxiety as reported by patients with HF or AMI and healthy individuals, and thus cannot be used to assess anxiety in acutely ill patients. Clinicians who use changes in heart rate or blood pressure as indicators of anxiety may fail to recognize and treat anxiety, placing their patients at high risk for both immediate and long-term complications.

Original languageEnglish
Pages (from-to)247-253
Number of pages7
JournalEuropean Journal of Cardiovascular Nursing
Issue number3
StatePublished - Sep 2004

Bibliographical note

Funding Information:
This study was funded by grants from the American Heart Association (Established Investigator Award to Debra Moser) and the American Association of Critical Care Nurses (AACN Sigma Theta Tau Research Grant to Debra K. Moser; Bennett-Puritan AACN Mentorship to Kyungeh An Kim and Debra K. Moser), and was supported in part by funds from the General Clinical Research Center at The Ohio State University M01RR00034.


  • Anxiety
  • Blood pressure
  • Heart failure
  • Heart rate
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medical–Surgical
  • Advanced and Specialized Nursing


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