The role of agonistic striving in the association between cortisol and high blood pressure

Craig K. Ewart, Gavin J. Elder, Randall S. Jorgensen, Sheila T. Fitzgerald

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Objective: A social action theory of chronic stress proposes that agonistic striving (seeking to influence or control others) impairs cardiovascular health by magnifying the impact of high adversity-induced cortisol levels on blood pressure. We tested three predictions of social action theory: (1) the social action theory taxonomy of regulatory strivings characterizes young adults from high-adversity neighborhoods; (2) high cortisol levels predict high blood pressure more reliably in the subgroup with the agonistic striving profile than in subgroups with other profiles; (3) the association of higher cortisol and higher blood pressure with agonistic striving is not explained by negative affect (depressive symptoms/dysphoria, anger, hostility). Methods: Participants were young adults (N = 198, mean [SD] age = 32 [3.4] years); 71% female; 65% black) from disadvantaged urban neighborhoods. Motive profiles (including agonistic strivings) were assessed using the Social Competence Interview. Cortisol levels were derived from saliva samples; blood pressure level was obtained during two days of ambulatory monitoring. Psychological measures of negative affect were assessed using questionnaires. Results: The predicted taxonomy of regulatory strivings was replicated in this sample; the interaction between cortisol and motive profile was significant (F(2, 91) = 6.72, p =.002); analyses of simple effects disclosed that higher cortisol levels predicted higher ambulatory blood pressure only in individuals who exhibited agonistic striving. Depressive symptoms/dysphoria, trait anger, and hostility were not correlated with agonistic striving, cortisol, or blood pressure. Conclusions: Agonistic striving may represent a distinctive (and novel) social-cognitive mechanism of toxic stress and cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)416-425
Number of pages10
JournalPsychosomatic Medicine
Issue number4
StatePublished - 2017


  • Agonistic striving
  • Anger
  • Cortisol
  • Depression
  • Hostility
  • Hypertension
  • Implicit goals

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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