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Hostility, risk of coronary heart disease, and mortality
Insights
High hostility levels correlate with increased risk of coronary heart disease (CHD) events and overall mortality in middle-aged men. Lower hostility scores are associated with better long-term survival outcomes.
Area of Science:
- Psychological Medicine
- Cardiology
- Epidemiology
Background:
- Hostility is a personality trait that has been investigated for its potential links to cardiovascular disease.
- Previous research suggests a connection between hostility and coronary atherosclerosis.
Purpose of the Study:
- To investigate the association between hostility levels and the incidence of coronary heart disease (CHD) events.
- To examine the relationship between hostility and long-term mortality in middle-aged men.
Main Methods:
- Assessed hostility using a 50-item subscale of the Minnesota Multiphasic Personality Inventory in 1877 healthy middle-aged men.
- Tracked major CHD events (myocardial infarction, CHD death) over 10 years and all-cause mortality over 20 years.
- Adjusted for risk factors including age, blood pressure, cholesterol, smoking, and alcohol intake.
Main Results:
- The lowest incidence of CHD events was observed in the lowest hostility quintile, with the highest incidence in the middle quintile.
- Men with lower hostility scores (≤10 points) had a significantly reduced relative odds (0.68) of a major CHD event after risk factor adjustment.
- The hostility scale showed a positive association with crude 20-year mortality from CHD, cancers, and other causes, and a statistically significant positive association with all-cause mortality after adjustment.
Conclusions:
- Higher hostility levels are linked to an increased risk of major coronary heart disease events.
- Hostility appears to be a significant predictor of long-term all-cause mortality, independent of traditional cardiovascular risk factors.
- The findings suggest that hostility may influence broader aspects of survival beyond cardiovascular health.
Abstract:
Level of hostility (Ho) was assessed by a 50-item subscale of the Minnesota Multiphasic Personality Inventory at the initial examination of 1877 employed middle-aged men who were free of coronary heart disease (CHD). Ten-year incidence of major CHD events (myocardial infarction and CHD death) was lowest in the first quintile of the Ho scale's distribution, highest in the middle quintile, and intermediate in the other three quintiles. After adjustment for age, blood pressure, serum cholesterol level, cigarette smoking, and intake of ethanol, the relative odds of a major CHD event was 0.68 for men with Ho scores less than or equal to 10 points in comparison to men with higher scores. The Ho scale was positively associated with crude 20-year mortality from CHD, malignant neoplasms, and causes other than cardiovascular--renal diseases and malignant neoplasms. After adjustment for the risk factors listed above, the Ho scale had a statistically significant, positive, monotonic association with 20-year risk of death from all causes combined. A difference of 23 points on the Ho scale, i.e., the difference between the means of the first and the fifth quintiles, was associated with a 42% increase in the risk of death. These results support the previous findings of Williams et al. with respect to the Ho scale and coronary atherosclerosis, and also suggest that the Ho scale may be associated with factors having broad effects on survival.