The Association Between Trait Anger and Incident Stroke Risk

Abstract

Background and Purpose-This study examined the relation between trait anger and incident stroke risk among participants without a history of stroke at the first follow-up examination of the Atherosclerosis Risk in Communities (ARIC) study. Methods-The study sample included 13 851 black and white men and women, aged 48 to 67 years, who completed the Spielberger Trait Anger Scale. Median follow-up time was 77.3 months. Results-In the full cohort, Cox proportional hazards regression analyses showed a modest increase in the risk for stroke among individuals with high trait anger, though the association did not remain statistically significant after multivariate adjustment. Participants Յ60 years of age who reported having high trait anger had a 2.82 (95% CI, 1.65 to 4.80) times greater risk for hemorrhagic and ischemic strokes combined (any) and a 2.93 (95% CI, 1.64 to 5.22) times greater risk for ischemic strokes alone than their counterparts who reported having low trait anger (hazard rate ratios adjusted for sex and race/ethnicity). Similarly, among participants with HDL cholesterol levels Ͼ47, the risk for any stroke was 2.86 (95% CI, 1.56 to 5.25) times greater for those who reported having high trait anger, whereas the risk for ischemic strokes alone was 2.98 (95% CI, 1.58 to 5.61) times greater (hazard rate ratios adjusted for age, sex, and race/ethnicity). These associations remained strong and statistically significant after further adjustment for several established biological and sociodemographic risk factors for stroke and were absent among older participants and those with lower HDL cholesterol values. Conclusions-Trait anger was associated with an increased risk for incident stroke in the ARIC study among younger participants and those with higher HDL cholesterol levels.

Psychosocial Factors and Progression From Prehypertension to Hypertension or Coronary Heart Disease

“…19,20 A high trait anger level has also been shown to be associated with increased risk of stroke in persons younger than 60 years. 21 Still further, anger and hostility have been shown to predict the development of atrial fi brillation in the Framingham Offspring Study. 22 Symptoms of anxiety and depression in the National Health and Nutrition Examination Survey follow-up study 23 and hostility and depressive symptoms in the Coronary Artery Risk Development in Young Adults were shown to be associated with incident hypertension in previously normotensive persons.…”

“…21,22,26 The Lubben Social Network score was not included in the models as it was not associated with either outcome. We stratifi ed by sex because previous studies using this anger scale have shown differences between men and women.…”

“…21 Still further, anger and hostility have been shown to predict the development of atrial fi brillation in the Framingham Offspring Study.…”

“…21 To our knowledge, no study has assessed its association with development of hypertension in a population with prehypertension.…”

Hypertension and white matter lesions are independently associated with apathetic behavior in healthy elderly subjects: the Sefuri brain MRI study

“…4,5 Apathy is one of the most common neuropsychiatric symptoms present in 3.2% of the general population, 14.7% of subjects with mild cognitive impairment and 35.9% of subjects with dementia. 6 Multiple lacunes and leukoaraiosis cause various neuropsychiatric symptoms [7][8][9][10] as well as cognitive impairment. [11][12][13] According to the vascular depression hypothesis, small vessel diseases such as silent brain infarction (that is, subcortical lacunes) and/or white matter lesions (WMLs) may disrupt frontal-subcortical circuits and generate depressive symptoms.…”