Hostility may speed death from heart disease

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A hostile temperament may shorten the lives of middle-aged adults with Heart disease, new research suggests.

In a study of more than 1,300 men and women with diseased heart arteries, researchers found that younger patients with an antagonistic personality had a higher risk of dying over the next 14 years than did their more mellow peers.

However, when it came to older patients—those 61 years of age or older—there was no clear effect of hostility on the risk of death.

It’s not surprising that hostility might have different health effects at different ages, said Dr. Stephen H. Boyle, the study’s lead author.

A possible explanation, he told, is that heart patients who are particularly vulnerable to the effects of their own hostility, which include blood pressure spikes and stress hormone surges, often don’t make it to old age.

On the other hand, Boyle explained, those who reach their 60s may be a “hardier subgroup” whose health is less affected by their quick-tempered ways.

Boyle and his colleagues at Duke University Medical Center in Durham, North Carolina, report the findings in the American Journal of Cardiology.

A number of studies have linked chronic anger and hostility to an increased risk of developing Heart disease and of dying prematurely. It’s thought, according to Boyle, that the reasons lie in both behavior and biology.

Anger triggers physiological effects, such as elevations in blood pressure and a release of so-called stress hormones, which can be hard on the cardiovascular system over time. In addition, heart patients with hostile tendencies may be less likely to follow a doctor’s advice, such as admonitions to stop smoking.

The current study included 1,328 men and women with coronary artery disease who underwent a battery of standard psychological tests between 1985 and 1989. The test that measured hostility focused largely on respondents’ views of other people, as well as how they tended to react in various situations.

Hostile people, Boyle explained, are generally cynical and suspicious of other people’s motives—a trait that tends to spark conflict and confrontations.

Overall, the study found that patients’ risk of dying during the follow-up period, from Heart disease or other causes, climbed in tandem with hostility scores. But further analysis showed this was only true of patients who were about 60 years old or younger at the study’s outset.

However, Boyle noted, “That doesn’t mean it’s OK to be hostile if you’re older.”

No studies, he said, have yet shown whether anger management can help heart patients live longer. But even if it doesn’t, Boyle added, other potential benefits, such as improved relationships, are important in and of themselves.

SOURCE: American Journal of Cardiology, July 2005.

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