Hostility, CHD Incidence, and Total Mortality: A 25-Year Follow-Up Study of 255 Physicians

Barefoot, John C.; Dahlstrom, W. Grant; Williams, Redford B.

doi:10.1097/00006842-198303000-00008

Cited by 848 publications

(383 citation statements)

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“…Recently, the most attractive sub-factor of TABP in relation to CHD is the aggression-hostility element in the United States (Barefoot et al, 1983;Shekelle et al, 1983). The results in this study showed no significant relationships between any physiological responses and aggression-hostility.…”

Section: Discussioncontrasting

confidence: 47%

Individual Differences in Physiological Responses and Type A Behavior Pattern.

Oishi

Kamimura²,

Nigorikawa

et al. 1999

Appl Human Sci

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Abstract.The relationships between individual differences in psychophysiological responses and tendency of Type A behavior pattern (TABP) were investigated during mental arithmetic (MA) at a steady rhythm, challenging calculation (Uchida-Kraepelin serial addition test: UK test), music listening, and exposure to an 80 dB SPL of white noise. Each mental task was sustained for 5 minutes. Sixteen healthy Japanese adults, (10 males and 6 females) with an age from 18 to 36 years old volunteered for this study. The KG's Daily Life Questionnaire (KG Questionnaire) was used to investigate the tendency toward TABP, which included three sub-factors: aggression-hostility, hard-driving and time urgency, and speed-power items. Recorded physiological variables were respiratory rate (RR), skin resistance response (SRR), eyeblinks, and heart rate (HR) calculated using frequency analysis to render high frequency power (HF) and the ratio of low/high frequencies (L/H ratio). During the MA and UK tests, significant increases in HR, L/H ratio, RR occurred, while significant decreases in HF were observed. Eyeblinks significantly increased during the MA test and significantly decreased during the UK test. During music and white noise, no significant changes occurred except for SRR, which decreased significantly. The coefficient of variances in each response was over 20% for almost all variables, indicating that individual differences in the magnitude of each response were large, even if the direction (increase or decrease) of the change was the same in almost all subjects. The highest correlation coefficients (r) between the mean values of relative magnitude for each variable and TABP scores during the MA and UK tests were obtained for the L/H ratio (MA: r=0.591, UK test: r=0.577) and the RR (MA: r= 0.576, UK test: r= 0.511). These values were statistically significant (p<0.05). Similar results were obtained for TABP sub-factors. Though other investigations have reported relationships between HF and TABP, we found no significant relationship. It was suggested that sympathetic nerve activity became greater for TABP individuals than for Type B individuals under stress conditions.

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Section: Discussioncontrasting

confidence: 47%

Individual Differences in Physiological Responses and Type A Behavior Pattern.

Oishi

Kamimura²,

Nigorikawa

et al. 1999

Appl Human Sci

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“…In combined samples of more than 600 men and 600 women, high levels of internal consistency has been determined for the Ho scale, with Cronbach's alphas ranging from .80 to .82 for both men and women (Smith & Frohm, 1985). The test-retest correlations are high (r>.8) over periods of 1-4 years (Barefoot et al, 1983;Schekelle et al, 1983). Example items include, "It is safer to trust nobody," "I am not easily angered," and "I have at times had to be rough with people who were rude or annoying.…”

Section: Apparatusmentioning

confidence: 96%

“…Numerous studies have established a relationship between the Ho scale and coronary dysfunction. In a prospective study of 255 male physicians, Barefoot, Dahlstrom & Williams (1983) reported that physicians scoring above 13 on the Ho scale in medical school were approximately six times more likely to be diagnosed with CHD 25 years later than physicians scoring below 13 on the Ho scale. Further, the test/retest reliability of the Ho scale across these 25 years was determined to be .85, indicating that this scale measures a stable psychological trait.…”

Section: Hostility Assessmentmentioning

confidence: 99%

Autonomic characteristics of defensive hostility: Reactivity and recovery to active and passive stressors

Vella

Friedman

2007

International Journal of Psychophysiology

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Defensive hostility has been attributed as an early risk factor of coronary heart disease.The autonomic characteristics of high defensive, high hostile (HD) and low defensive, high hostile (LD) men and women were assessed with a variety of cardiovascular (CV) measures. Reactivity and recovery to an active laboratory stressor (video game, VG) and a passive laboratory stressor (hand cold pressor, CP) of 15 HD men, 16 LD men, 16 HD women, and 16 LD women were recorded. It was predicted that the CV patterning associated with the HD participants would display more sympathetic and less vagal control as well as the least pronounced recovery from the stressors in comparison to LD participants. Results revealed differential CV responses to the lab tasks by group. HD women displayed consistently high levels of low frequency power heart rate variability (HRV) during baseline and across conditions. HD men exhibited significantly pronounced heart rate reactivity and reduced high frequency power HRV to the CP task in comparison to LD men. Interestingly, LD women displayed weaker blood pressure (BP) recovery to the VG in comparison to HD women, whereas the opposite pattern was observed in BP recovery to the CP. These results suggest that defensiveness and sex may moderate the CV reactivity and recovery to different types of stressors in hostile participants.iii DEDICATION This thesis is dedicated most lovingly to my family, without whose encouragement, love, and support this project would not be possible.iv ACKNOWLEDGEMENTS

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“…Total Ho scores are prospectively associated with coronary heart disease (CHD) and events and all-cause mortality. 25, 26 Although there have been failures to replicate the prospective association between Ho scores and health outcomes, 27 -29 a meta-analysis 30 concluded that the Ho scale is most predictive of all-cause mortality and, to a lesser extent, CHD (after controlling for other CHD risk factors) relative to other measures of hostility. The test/retest reliability of the Ho was 0.84 over 4 years in a sample of 1653 men.…”

Section: Psychological Measuresmentioning

confidence: 99%

Lipid-Lowering Medication Use and Aggression Scores in Women: A Report from the NHLBI-Sponsored WISE Study

Olson

Kelsey

Matthews

et al. 2008

Journal of Women's Health

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Aim-The aim of this study was to examine the association between the use of lipid-lowering medication and aggressive responding, hostility, cynicism, and depression scores in women undergoing coronary angiography.Methods-The cohort included 498 women from the National Heart, Lung and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE) study. WISE is a four-center study of women with chest pain who underwent quantitative coronary angiography for suspected myocardial ischemia. The psychosocial indices included the Cook Medley Hostility questionnaire, measuring aggression, hostility, and cynicism, and the Beck Depression Inventory (BDI).Results-Compared to those not on lipid-lowering medication, women receiving lipid-lowering pharmacotherapy were older (62 vs. 55 years, p < 0.001) and had more hypertension, dyslipidemia, diabetes, and coronary artery disease (CAD, defined as ≥50% stenoses in at least one epicardial artery) (all p < 0.003). Women on lipid-lowering medication had higher aggressive responding scores than those not on medication, 3.0 ± 1.8 vs. 2.7 ± 1.7, respectively (age-adjusted p < 0.003). This association persisted after adjustment for coronary risk factors, education, and extent of angiographic disease (CAD) (p < 0.005), and after exclusion of women using psychotropic medications (p < 0.001). Hostility, cynicism, and depression scores did not differ by medication use.Conclusions-In women, lipid-lowering medication may predispose to aggression without affecting hostility or mood, but this hypothesis requires evaluation in placebo-controlled clinical trials.

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Hostility, CHD Incidence, and Total Mortality: A 25-Year Follow-Up Study of 255 Physicians

Cited by 848 publications

References 0 publications

Individual Differences in Physiological Responses and Type A Behavior Pattern.

Individual Differences in Physiological Responses and Type A Behavior Pattern.

Autonomic characteristics of defensive hostility: Reactivity and recovery to active and passive stressors

Lipid-Lowering Medication Use and Aggression Scores in Women: A Report from the NHLBI-Sponsored WISE Study

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