Self-Rated Health and Age-Related Differences in Ambulatory Blood Pressure: The Mediating Role of Behavioral and Affective Factors.

OBJECTIVE: Despite the well-established association between SRH and health, little is known about the potential psychobiological mechanisms responsible for such links, and if these associations differ by age. The main goals of this study were to investigate the links between SRH and ambulatory blood pressure (ABP), if age moderated the risk, and the health behavior/affective mechanisms responsible for such links. METHODS: 188 men and women (94 married couples, ages 18 to 63) completed a standard measure of self-rated health and a one-day ABP assessment. Multilevel models were run to examine if SRH was associated with daily ABP and if these links were moderated by age. The Monte Carlo method was used to construct confidence intervals for mediation analyses. RESULTS: Results indicated that poor SRH was associated with higher ambulatory SBP (b=3.14, SE=.68, p<.001) and DBP (b=1.34, SE=.43, p=.002) levels. Age also moderated the links between SRH and ambulatory SBP (b=.19, SE=.08, p=.011) and DBP (b=.14, SE=.05, p=.004), with links being stronger in relatively older individuals. However, only daily life negative affect significantly mediated the age X SRH interaction for both ambulatory SBP and DBP. CONCLUSIONS: These results highlight the potential psychobiological mechanisms linking SRH to longer-term health outcomes. Such work can inform basic theory in the area as well as intervention approaches that target such pathways.