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Study links hostility in young adults with heart disease


May 16, 2000
Web posted at: 6:36 p.m. EDT (2236 GMT)

(CNN) -- Young women and men who rate high in aggression, anger and other forms of hostility are more likely to develop hardening of heart arteries at an early age, according to a report released Tuesday in The Journal of the American Medical Association.

"Even when you're young, the more hostile you are, the greater your chances of developing coronary artery calcification, the beginning stage of heart disease," said Dr. Carlos Iribarren, who led the research team comparing hostility and heart disease.

The study included 374 women and men who were 18 to 30 years old at the beginning of the program in 1985. They took a well-established psychological test to measure hostility. Five years and 10 years after the first tests, they again completed the Cook-Medley hostility test of 50 true-false questions.

Scientists then used electron-beam tomography to measure heart artery calcification, or hardening. They compared those measurements with the results of the hostility tests, said Dr. Iribarren, who works for the Kaiser Permanente Medical Care Program in Oakland, California.

"The researchers found that those subjects who had hostility scores above the median had about 2.5 times the risk of having any coronary artery calcification than those with scores below the median," said a JAMA statement.

The study adjusted for factors like smoking, diet and exercise, which can also contribute to hardening of the arteries.

Doctors said they hope the research will inspire young people who exhibit constant hostility to learn how to manage their anger and possibly reduce their risk of heart attack later in life. But they advised that more research is necessary.

"Clinical trials are needed to test whether reduction in hostile attitudes and behavior is an effective means of preventing atherosclerosis and thus ameliorating the burden of coronary disease," Dr. Iribarren said.

The article described hostility as a personality and character trait with these components: anger, cynicism and mistrust of others, and aggressive behavior, both overt and repressed. The hostility questionnaire asks for true or false responses to statements like "I think most people would lie to get ahead," "Most people are honest chiefly through fear of getting caught" and "When a man is with a woman, he is usually thinking about things related to her sex."

Other studies on the same subject also have shown a link between high hostility levels and coronary artery hardening, high blood pressure and earlier death rates.

Several theories have been put forward to explain why hostility may increase cardiovascular risk. For instance, unhealthy behaviors like smoking and alcohol use are often associated with hostility. However, the scientists cautioned that chemical and hormonal effects from hostility might also be involved.

"Stress hormones cause the blood pressure to go up and increase the tendency of platelets (which are the blood cells responsible for blood clotting) to stick together," said Dr. Iribarren. "These changes in the body may then be responsible for the hardening of the arteries, including calcium deposits."

The study was funded by National Heart, Lung, and Blood Institute, a part of the National Institutes of Health.

CNN Correspondent Holly Firfer contributed to this report.

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Journal of the American Medical Association
American Heart Association National Center
Anger and Health--An Update

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