Hostility and serum homocysteine as cardiovascular risk factors in Korean patients with coronary artery disease

AIMS: The aim of this study is to determine the relationships between hostility and serum homocysteine in Korean patients with coronary artery disease and to identify their effects on the occurrence of coronary artery disease. BACKGROUND: Recently, hostility as a psychosocial factor and serum homocysteine as a biochemical risk factor are gradually accepted as independent risk factors of coronary artery disease but research on the relationship between hostility and homocysteine is rare. DESIGN: This is a descriptive and correlative study conducted in the single teaching hospital located in South Korea. METHODS: Eighty-four patients with coronary artery disease participated. Semi-structured interviews were used to measure the level of hostility and the characteristics of participants. Hostility was measured by the Cynical Hostility Scale and fasting blood samples from venous vein was used to measure serum homocysteine level. RESULTS: Mean scores for hostility of men were higher than women. The difference was statistically significant (p = 0.001). The serum homocysteine level (11.51 SD 5.43 micromol/l) in patients with coronary artery disease was higher than the normal reference value. Findings of this study indicate that serum homocysteine increased in a statistically consistent pattern with the level of hostility (F = 8.37, p < 0.01). CONCLUSIONS: This result suggests that high level of hostility may increase cardiovascular risk by elevated serum homocysteine concentration. RELEVANCE TO CLINICAL PRACTICE: The development and applications of nursing interventions for hostility can contribute to reducing the prevalence and mortality rate of coronary artery disease.