Hostility, Incidence of Acute Myocardial Infarction, and Mortality in a Sample of Older Danish Men and Women

An abbreviated version of the Cook-Medley Hostility Scale (ACM) was a predictor of documented acute myocardial infarction and total mortality. The sample consisted of 409 men and 321 women, residents of Glostrup, Denmark, who were 50 years old at the initiation of the study in 1964. Follow-up continued through 1991. Although not significant (relative risk (RR) = 1.22) in a model that contained only age and sex as covariates, the hostility scale scores were associated with increased risk of myocardial infarction in models controlling for traditional risk factors. A two standard deviation difference was associated with a RR of 1.53 (95% confidence interval (CI) 1.04-2.25), an effect that remained after eliminating the data of those with signs of ischemia at baseline. Hostility was also predictive of total mortality with controls for age and sex (RR = 1.35, CI 1.07-1.71), with controls for traditional risk factors (RR = 1.44, CI 1.13-1.83), and with additional controls for baseline ischemia and pulmonary function (RR = 1.36, CI 1.06-1.75). There were no sex differences in effect sizes. In cross-sectional analyses, high hostility was associated with higher body mass index, more physical activity at work, and poorer pulmonary function. These results constitute a rigorous test of the relation between hostility and health and increase the known generality of the phenomenon across sexes, age groups, and cultures.