Anger, Hostility linked to Coronary Heart Disease
By Paula Rasich
Reviewed by Elizabeth Klodas, MD, FACC
 March 9, 2009--Despite ongoing research and interest in negative emotions and heart health, there’s still confusion surrounding this issue. Now a new study suggests that individuals who are chronically angry or hostile may put their heart at risk.
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In a meta-analysis of studies involving nearly 80,000 patients, British researchers from the University College London evaluated whether the tendency to be hostile and angry went along with coronary heart disease (CHD) events. The overall analysis combined 25 studies of otherwise healthy individuals and 19 studies of those with existing heart disease. Anger and hostility were assessed using measures from the Minnesota Multiphasic Personality Inventory (MMPI) and the Cook-Medley hostility Scale (CMHS).The analysis indicated that people with higher levels of anger and hostility fare worse. Researchers found that these emotions were tied to a 20 percent hike in risk of coronary heart events in individuals free from heart disease and, in general, with a poorer long term outcome in those with existing coronary heart disease.
Additionally, the results showed that the negative impact of anger and hostility in the healthy group was greater in men than women. After controlling for risky behaviors such as smoking status, poor sleep, sedentary lifestyle, and an unhealthy diet, the effects of anger and hostility were diminished significantly. The study authors speculate that anger and hostility promote harmful behaviors and that this may explain the link between these emotions and coronary heart disease risk.
“This review provides further evidence that psychological factors do matter in the development and progression of coronary heart disease,” says Johan Denollet, Ph.D., CoRPS research center, Tilburg University, The Netherlands, and co-author of the accompanying editorial. “Clinicians should take symptoms of anger and hostility seriously, and may consider referring their patient for behavioral intervention. We need to closely monitor and study these personality traits in order to do a better job at identifying high-risk patients who are more liable to future fatal and non-fatal coronary events.”
This study and editorial comment are published in the March 17, 2009 issue of the Journal of the American College of Cardiology.
Sources:
Chida Y and Steptoe A. The Association of Anger and Hostility with Future Coronary Heart Disease: A Meta-Analytic Review of Prospective Evidence. Journal of the American College of Cardiology, 2009.
Denollet J and Pedersen SS. Editorial Comment: Anger, Depression, and Anxiety in Cardiac Patients. The Complexity of Individual Differences in Psychological Risk. Journal of the American College of Cardiology, 2009.
Johan Denollet, PhD, Head, Department of Medical Psychology, Tilburg University, Tilburg, the Netherlands.