Key result
Being in the lowest Anger Control tertile was associated with a higher risk of first nonfatal and fatal CVD incidence compared to the highest tertile (RR 1.35; 95% CI 1.06-1.73).
Why the study?
Do different hostility measures, such as low anger control, predict incident cardiovascular disease in adults without prior CVD?
Cohort (n=7,933)
Do different hostility measures, such as low anger control, predict incident cardiovascular disease in adults without prior CVD?
Relative Risk: 1.35 (95% CI 1.06–1.73)
Low anger control is an independent predictor of incident cardiovascular disease events in adults without prior CVD.
Supports anger control assessment in primary CVD prevention; extends hostility research but remains hypothesis-generating without trial confirmation.
Objective: To examine in a prospective setting whether different hostility measures, including Cynical Distrust, Trait Anger, Anger Out, Anger In, and Anger Control, are related to cardiovascular disease (CVD) and ischemic heart disease (IHD). Methods: Participants comprised 25- to 74-year-old men (n = 3850) and women (n = 4083), followed up for 10 to 15 years. Trait Anger, Anger Out, Anger In, and Anger Control were assessed with the Spielberger State-Trait Anger Expression Inventory and Cynical Hostility with the Cynical Distrust Scale. Incident CVD and IHD were derived from hospital records/death certificates. Subjects with a history of CVD or IHD at baseline were excluded. Results: Subjects in the lowest Anger Control tertile had a higher risk of first nonfatal and fatal CVD incidence (relative risk [RR], 1.35; 95% confidence interval [CI], 1.06-1.73) than subjects in the highest tertile after adjustment for age, gender, education, marital status, smoking, body mass index, blood pressure, cholesterol, alcohol consumption, and depressive symptoms. Higher Cynical Distrust scores predicted nonfatal and fatal CVD (RR, 1.31; 95% CI, 1.09-1.56) and IHD (RR, 1.37; 95% CI, 1.08-1.74) events after adjustment for age, but these associations disappeared after further adjustment for gender, education, and marital status. Other hostility measures, i.e., Trait Anger, Anger Out, or Anger In, were not related to CVD or IHD outcomes. Conclusions: This is the first study to show that compared with four other hostility dimensions, low Anger Control predicts CVD events. Further studies should examine whether Anger Control is specific to anger or reflects more general psychosocial factors. BDI = Beck Depression Inventory; BMI = body mass index; CAD = coronary artery disease; CHD = coronary heart disease; CI = confidence interval; CVD = cardiovascular disease; ICD = International Classification of Diseases and Related Health Problems; IHD = ischemic heart disease; IMT = intima medial thickness; MI = myocardial infarction; RR = relative risk.
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Haukkala et al. (2010) conducted a cohort in Cardiovascular disease (n=7,933). Lowest Anger Control tertile vs. Highest Anger Control tertile was evaluated on first nonfatal and fatal CVD incidence (RR 1.35, 95% CI 1.06-1.73). Being in the lowest Anger Control tertile was associated with a higher risk of first nonfatal and fatal CVD incidence compared to the highest tertile (RR 1.35; 95% CI 1.06-1.73).
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