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Hostility, coronary heart disease, and total mortality: a 33-year follow-up study of university students
M D Hearn1, D M Murray, R V Luepker
1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55455.
Insights
This study found no link between hostility scores and coronary heart disease (CHD) or mortality in men. Hostility may not be a universal risk factor for cardiovascular disease or overall mortality.
Area of Science:
- Psychosomatic Medicine
- Cardiovascular Epidemiology
- Psychological Assessment
Background:
- The Cook-Medley Hostility (HO) Scale, part of the Minnesota Multiphasic Personality Inventory (MMPI), has been proposed as a risk factor for coronary heart disease (CHD) and mortality.
- Previous research suggested a potential association between hostility and adverse health outcomes.
Purpose of the Study:
- To investigate the association between hostility, as measured by the HO scale, and the risk of developing coronary heart disease (CHD) and all-cause mortality.
- To test the HO-CHD hypothesis in a longitudinal cohort of men.
Main Methods:
- A cohort of 1399 men completed the MMPI, including the HO scale, in 1953.
- Health status, including CHD morbidity and mortality, was assessed 33 years later via telephone interviews for 94% of the sample.
- Statistical analyses were performed to determine if higher HO scores predicted CHD or total mortality, with and without adjustment for baseline risk factors.
Main Results:
- Higher scores on the Cook-Medley Hostility (HO) Scale did not significantly predict coronary heart disease (CHD) mortality.
- Higher HO scores did not predict CHD morbidity.
- Higher HO scores did not predict total mortality, even after adjusting for baseline risk factors.
Conclusions:
- The study did not find evidence supporting hostility as a risk factor for CHD or mortality in this specific population.
- Potential explanations include population-specific effects, the stability of hostility measures over time, or limitations of the HO scale in assessing hostility.
Abstract:
Hostility as measured by the Cook-Medley Hostility (HO) Scale on the Minnesota Multiphasic Personality Inventory has been suggested as a risk factor for coronary heart disease (CHD) and total mortality. This study tested the HO-CHD hypothesis in a sample of 1399 men who entered the University of Minnesota in 1953 and, as part of freshman orientation, completed the MMPI. Current health status was ascertained for 94% of the sample through telephone interviews 33 years later. Higher HO scores did not predict CHD mortality, CHD morbidity, or total mortality either before or after adjustment for baseline risk factors. Among the plausible explanations for these results are that (1) hostility is not a risk factor in all populations, (2) the HO scale at age 19 does not assess a stable psychological characteristic, or (3) the HO scale is not an adequate measure of hostility.