Hostility Predicts Recurrent Events among Postmenopausal Women with Coronary Heart Disease

Abstract

Psychosocial characteristics may be associated with an increased risk of coronary heart disease (CHD). Whether hostility predicts recurrent coronary events is unknown. A total of 792 women in the Heart and Estrogen/progestin Replacement Study (HERS) were evaluated prospectively to determine the role of hostility as a risk factor for secondary CHD events (nonfatal myocardial infarction and CHD death). The mean age of study participants was 67 years, and the average length of follow-up was 4.1 years. The study was conducted between 1993 and 1998, and all study sites were in the United States. High Cook-Medley hostility scores were associated with greater body mass index (p = 0.01) and higher levels of serum triglycerides (p = 0.05), and they were inversely associated with high density lipoprotein cholesterol (p = 0.04), self-rated general health (p < 0.001), age (p = 0.05), and education (p = 0.001). Compared with women in the lowest hostility score quartile, women in the highest quartile were twice as likely to have had a myocardial infarction (relative hazard = 2.03, 95% confidence interval: 1.02, 4.01). The relation between hostility and CHD events was not mediated or confounded by the biologic, behavioral, and social risk factors studied. In this study, hostility was found to be an independent risk factor for recurrent CHD events in postmenopausal women.

Women with coronary artery disease and depression: A neglected risk group

“…This was supported by a population-based study of Haas et al (2005). In contrast, other studies indicate that hostility is independently of other CAD risk factors associated with nonfatal myocardial infarction and recurrent events in postmenopausal women with CAD (Lahad et al 1997;Chaput et al 2002).…”

Anger, Hostility, and Cardiac Symptoms in Women with Suspected Coronary Artery Disease: The Women's Ischemia Syndrome Evaluation (WISE) Study

“…6 In healthy postmenopausal women, anger suppression and hostility predicted carotid intima-media thickness (IMT), 14 and hostility was predictive of recurrent CAD events in postmenopausal women with coronary disease. 15 Hostility also was related to ambulatory ischemia in a small sample of female subjects 16 but was not predictive of myocardial infarction (MI) in a small sample of women with premature acute MI. 17 Prior studies have demonstrated that hostility is moderately associated with other measures of negative emotion, such as anxiety and depression, 18 and that measures of negative emotion can be associated with anginal symptom reports and poor quality of life.…”

Patterns of Change in Hostility from College to Midlife in the UNC Alumni Heart Study Predict High-Risk Status

“…The preponderance of evidence supports an important role for hostility. It is associated with the development of CHD (18 -20), recurrent CHD (21), coronary artery calcification (22), CHD risk factors (23)(24)(25)(26)(27) and all-cause mortality (18,19,28), especially in prospective studies started on older samples (29,30). There are also four negative prospective studies (31)(32)(33)(34) that are discussed by Barefoot in (35).…”