Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study

Area of Science:

• Cardiology
• Psychosocial Medicine
• Epidemiology

Background:

• Conflicting literature exists regarding type A behavior, anger, and hostility as predictors of coronary heart disease (CHD).
• No prior prospective studies have linked these psychosocial factors to the development of atrial fibrillation (AF).

Purpose of the Study:

• To investigate the relationship between type A behavior, anger, hostility, and the incidence of CHD, AF, and total mortality.
• To determine if psychosocial factors predict cardiovascular outcomes and mortality in a prospective cohort.

Main Methods:

• The Framingham Offspring Study prospectively monitored 3873 participants (aged 18-77) for 10 years.
• Baseline assessments included measures of type A behavior, anger, hostility, and cardiovascular risk factors.
• Cox proportional hazards models were used to analyze the association between psychosocial variables and outcomes, adjusting for confounders.

Main Results:

• In men, trait-anger, anger symptoms, and hostility independently predicted the 10-year incidence of AF after controlling for cardiovascular risk factors.
• None of the psychosocial measures predicted incident CHD in men or women.
• Trait-anger was associated with increased total mortality in men, but not in women.
• No significant associations were found between psychosocial variables and the studied outcomes in women.

Conclusions:

• This study provides the first evidence linking anger and hostility to the development of AF in men.
• Anger and hostility, rather than type A behavior, may be more relevant factors for researching arrhythmias and mortality risk in men.