Key result
Moderate anger expression was associated with a reduced risk of nonfatal myocardial infarction (RR 0.56; 95% CI 0.32-0.97) and stroke (RR 0.42; 95% CI 0.20-0.88) compared to lower expression.
Why the study?
Does moderate anger expression reduce the risk of cardiovascular disease in older male health professionals?
Cohort (n=23,522)
Does moderate anger expression reduce the risk of cardiovascular disease in older male health professionals?
Relative Risk: 0.56 (95% CI 0.32–0.97)
In older male health professionals, moderate anger expression appears to be protective against nonfatal myocardial infarction and stroke over a 2-year period.
Moderate anger expression was associated with lower CVD incidence; leaves open whether coping style affects risk or reflects confounders.
OBJECTIVE: Anger expression is a dimension of anger that may be strongly related to coronary heart disease and stroke. To date few cohort studies have evaluated the role of anger coping style in the development of cardiovascular disease. This study prospectively examined the effects of anger expression on incidence of cardiovascular disease. METHODS: Participants were male health professionals (N = 23,522), aged 50 to 85 years old and without previous cardiovascular disease, who responded to a mailed questionnaire incorporating the Spielberger Anger-Out Expression Scale in 1996. The cohort was followed for 2 years (1996-1998). RESULTS: Men with moderate levels of anger expression had a reduced risk of nonfatal myocardial infarction compared with those with lower levels of expression (relative risk: 0.56; 95% confidence interval: 0.32-0.97), controlling for coronary risk factors, health behaviors, use of psychotropic medication, employment status, and social integration. Anger expression was also inversely associated with risk of stroke. The multivariate relative risk of stroke was 0.42 (95% confidence interval: 0.20-0.88), comparing men with higher anger-out scores to men with lower scores. A protective dose-response relationship was observed between anger-out score and risk of stroke (p for multivariate trend test: 0.04). CONCLUSIONS: Among this cohort of older men with high socioeconomic status and relatively low level of anger expression on average, moderate anger expression seemed to be protective against cardiovascular disease over a limited follow-up period.
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Eng et al. (2003) conducted a cohort in Cardiovascular disease (n=23,522). Moderate or higher levels of anger expression vs. Lower levels of anger expression was evaluated on Nonfatal myocardial infarction (RR 0.56, 95% CI 0.32-0.97). Moderate anger expression was associated with a reduced risk of nonfatal myocardial infarction (RR 0.56; 95% CI 0.32-0.97) and stroke (RR 0.42; 95% CI 0.20-0.88) compared to lower expression.