Page 55 - JCBP-3-4

Journal of Clinical and
Basic Psychosomatics Emotion and blood pressure variability

samples with depression, in which the cognitive processing to affective stimuli. In other words, low affective response
of emotionally laden information may be already impaired, accuracy may inhibit the effects of ER on BPV. According
and the neural mechanisms of the impairment involve to the process model of ER, emotional perception is the
prefrontal deficits and amygdala hyperactivation. 53,54 core of the first phase of successful ER, and misinterpreting
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Our hypotheses about the effects of the habitual use emotions leads to ineffective ER. However, in the present
of different ER strategies were partially supported. In study, we did not observe the relationship between ER
the regression models, although only marginal trends strategies and accuracy or RT in the face perception task.
were evident, both the models of DBP range and SD These null findings suggest that the performance of the
(Models 3 and 4) indicate that individuals using less face perception task may not have involved cognitive
cognitive reappraisal tend to exhibit greater BPV. Within control of emotional responses. Given the short duration
the framework of ER, cognitive reappraisal is considered of face presentation in the task, participants’ responses
an adaptive strategy involving reinterpretation of affective likely relied on perceptual-level processing of affective
stimuli. It focuses on altering one’s initial appraisal of a stimuli. On the other hand, the effects of habitual use of
situation to reduce the intensity of negative affect. 48,49,51 ER strategies on BPV are explained by long-term effects of
While this ER strategy requires higher levels of cognitive psychological processes, such as rumination and anxiety,
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effort, its effects on downregulating negative emotions last on the ANS. The specific roles of perceptual responses
longer compared to other strategies. The present findings and cognitive control in affective processes should be
are consistent with the notion that cognitive reappraisal examined in relation to long-term health outcomes in
is an effective strategy and extends its benefits to future studies.
cardiovascular health. Moreover, the observed interaction The findings of the present study have practical and
between response accuracy and cognitive reappraisal clinical implications. BP status is an important modifiable
indicates a modulation of affective reactivity on the risk factor for CVD. Compared to mean BP, high BPV
ER-BPV relationship, suggesting that the beneficial effect serves as a better predictor for the risks of stroke,
of reappraisal on BP control is greater among individuals myocardial infarction, and cardiovascular mortality. 9-12
who can precisely perceive affective information. In other The current findings suggest that by selecting ER strategies
words, context-proper perception may be a prerequisite for in daily life, BPV can be improved, thereby reducing
the effective use of cognitive appraisal. the risk of multiple types of CVD. Specifically, cognitive
Unlike cognitive appraisal, expressive suppression training, mindfulness practices, and increased social
does not involve altering the interpretation of situations support have been shown to effectively enhance ER. 58-61
but instead focuses on inhibiting emotional expression. Moreover, regular exercise, a healthy diet, and a consistent
It also requires a certain degree of cognitive effort and sleep routine not only facilitate ER but also contribute
may produce faster changes in emotional responses. to direct improvements in BP and BPV regulation. 61,62
However, the duration of the beneficial effects of expressive For individuals already experiencing ER difficulties,
suppression is brief, and it interferes with information there are approaches to adopting adaptive ER strategies,
encoding and retrieval, as well as working memory. such as cognitive behavioral therapy, biofeedback and
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Moreover, chronic use of this ER strategy is linked to neuromodulation, and intervention programs aiming to
elevated levels of negative affect, reduced levels of positive increase emotional awareness. 8,7,63
affect, and increased depressive symptoms over time. The findings in the present study should be interpreted
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Expressive suppression also leads to increased physiological with several methodological limitations. First, the sample
responses to stressors. 55,56 Consistent with these previously size in the present study was small and limited to healthy
reported adverse outcomes, the current findings indicate individuals. Although this sample size was determined
that chronic use of expressive suppression is associated based on the results of a priori power analysis, the small
with increased BPV, which, in turn, may increase the risks sample of healthy young adults limits the external validity
for CVD. 36,57 of our findings. Future studies should aim to replicate
Interestingly, while the indices of behavioral these results in larger and more heterogeneous samples,
performance alone were not directly correlated with including subclinical and clinical populations. Second,
BPV measures (Tables 2 and 3), the interaction terms in the calculation of BPV was based on the assessments
the regression models predicted these outcome variables. within a short time. While our methodology aligns with
These results indicate that the associations between BPV previous studies, future research should include a set of
and different ER strategies were evident only among comprehensive BPV indices to replicate our findings. 35,36
participants who exhibited higher accuracy in responding Third, physiological measures were not recorded during the

Volume 3 Issue 4 (2025) 49 doi: 10.36922/jcbp.8134