To investigate the potential effect of test anxiety on the changes in 24-hour ambulatory blood pressure (ABP) and serum angiotensin II (Ang II) in high school students.Design and Method:
Exam anxiety was evaluated in 344 high school students using Sarason test anxiety scale (TAS) at one week before season examinations between November 2012 and December 2014. All students were divided into three: control group (n = 83), middle anxiety group (n = 176), and high anxiety group (n = 85) according to their TAS scores. 24-h ABP and serum Ang II were measured in all students.Results:
Twenty-four-hour systolic blood pressure (SBP), night-time SBP , and serum Ang II in middle and high anxiety groups were significant higher than that in control group (all P < 0.001). In high anxiety group, day-time SBP was higher, nocturnal fall rates of SBP and diastolic (D)BP were significant lower than that in control group (all P < 0.05). In high anxiety group, 24-h, day-time, night-time SBP and Ang II were significant higher, while nocturnal fall rates of SBP and DBP were significant lower than that in middle anxiety group (all P < 0.05). TAS score was positively associated with 24-h, day-time, night-time SBP and Ang II (r = 0.505, 0.397, 0.578, and 0.390, respectively ), and negatively associated with the nocturnal fall rates of SBP and DBP (r = -0.489 and -0.346, respectively), all P < 0.05. TAS score was an independent risk factor of 24-h, day-time and night-time SBP, night-timeDBP, nocturnal fall rates of SBP and DBP, and Ang II after adjusting for confounding factors.Conclusions:
Exam anxiety is an important risk factor for elevated BP and serum Ang II levels, and abnormal 24-h BP rhythm variation in high school students.