People under age 50 with heart disease are significantly more hostile than older patients, which perhaps places an extra burden on their heart, according to new study findings.

However, young patients who receive diet and exercise therapy after a Heart attack or other major event can reduce their hostility and improve their cardiovascular risk factors, the authors report in the journal Mayo Clinic Proceedings.

“We believe that reducing hostility and other distress, particularly in young coronary artery disease patients, should be emphasized in rehabilitation following Heart attack ,” write study authors Drs. Carl J. Lavie and Richard V. Milani of the Ochsner Clinic Foundation in New Orleans.

Previous research has shown that young people diagnosed with coronary artery disease (CAD) often have a poor long-term prognosis, Lavie and Milani note. In addition, reports have shown that people with “type A” personalities, the characteristics of which include easily triggered hostility, have a more than five-fold increased risk of CAD. Hostility has also been linked to increases in blood pressure, Obesity and blood vessel disease.

Lavie and Milani surveyed 500 people, 81 of whom were younger than 50, who recently experienced a heart attack, coronary bypass surgery or another serious cardiac event, and were diagnosed with CAD.

The investigators found that the rate of hostility symptoms was more than three times higher in young patients, compared with elderly people with CAD. Young heart patients with signs of hostility tended to have higher cholesterol compared with young patients with few signs of hostility.

Young people with hostility also tended to be more anxious and depressed than other young CAD patients.

However, after completing a 12-week rehabilitation program in which they learned proper ways to exercise and diet, young heart patients with hostility showed significant improvements in CAD risk factors, anxiety and depression. Overall, young people cut their hostility symptoms by 50 percent.

Furthermore, more than one half of young people considered hostile at the outset of the rehabilitation program decreased their symptoms enough that they no longer met the criteria for hostility.

SOURCE: Mayo Clinic Proceedings, March 2005.