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Excerpt
Background. A small but growing number of epidemiologic studies have suggested that anger and hostility are related to the incidence of coronary heart disease.
Methods. The authors prospectively assessed the relationship of anger to coronary heart disease incidence in the Veterans Administration Normative Aging Study, an ongoing cohort of older (mean age, 61 years), community-dwelling men. A total of 1,305 men who were free of diagnosed coronary heart disease completed the revised Minnesota Multiphasic Personality Inventory (MMPI-2) in 1986. Subjects were categorized according to their responses on the MMPI-2 Anger Content Scale, which measures the degree to which individuals have problems controlling their anger.
Results. During an average of 7 years of follow-up, 110 cases of incident coronary heart disease occurred, including 30 cases of nonfatal myocardial infarction, 20 cases of fatal coronary heart disease, and 60 cases of angina pectoris. Compared with men reporting the lowest levels of anger, the multivariate-adjusted relative risks among men reporting the highest levels of anger were 3.15 for total coronary heart disease and 2.66 for combined incident coronary events including angina pectoris. A dose-response relation was found between level of anger and overall coronary heart disease risk.
Conclusion. These data suggest that high levels of expressed anger may be a risk factor for coronary heart disease among older men.
Comments. These data again demonstrate the importance of measuring behavioral variables (including hostility, anger, and depression) in patients with coronary heart disease, as cardiac rehabilitation provides an opportune period both to assess these modifiable risk factors and to intervene to change them.
