Anger, hostility, and visceral adipose tissue in healthy postmenopausal women

Central obesity is an important risk factor for chronic disease. Its etiology remains unclear. We examined whether anger and hostility, ie, psychological attributes that influence cardiovascular morbidity and mortality, prospectively predict central visceral obesity across 13 years. Visceral adipose tissue (VAT) was determined by x-ray computed tomography (CT) at the L4-L5 disc space in a population-based sample of 157 postmenopausal Healthy Women Study participants. Standardized tests were completed to measure separately trait anger (anger frequency and intensity), style of anger expression (holding anger in and expressing it outwardly), and hostile (mistrustful) attitudes. The higher the VAT score, the higher the trait anger and anger-out scores measured 13 years earlier (Ps < .04) and the higher the concurrent hostile attitudes score (P < .02). Moreover, the higher the VAT score, the greater the increase in trait anger over the study period (P < .03). Trait anger and hostility predicted VAT independent of fasting insulin levels, although both predicted an increase in fasting insulin over time. Women were categorized into three groups according to the distribution of the average percent increase in trait anger and in weight across the study period, respectively. The mean VAT scores increased with the likelihood of being in the highest tertile of increasing trait anger (means: 129.1, 131.1, and 155.8, P < .048) and in the highest tertile of increasing weight (means: 122.4, 131.1, and 162.2, P < .003). The association between a high trait anger score and VAT remained significant, controlling for weight gain. We conclude that hostile attributes, fasting insulin, and weight gain in midlife may contribute to the development of VAT in healthy Caucasian women.