Components of the Anger–hostility Complex as Risk Factors for Coronary Artery Disease Severity: A Multi-measure Study

Different forms of anger and hostility have been implicated in the pathogenesis of coronary artery disease (CAD), though previous research has not measured all of these in one sample. To assess their relative predictive utility, a multi-measure study was undertaken of three adult outpatient groups: 97 men identified angiographically with stenosed coronary arteries; 28 men with valvular heart disorders in the absence of CAD; and 28 men attending a fracture clinic with no CAD present. Questionnaires measured: anger expression; anger experience; cynical hostility; 'Ho' hostility; neurotic hostility; neurotic disagreeableness; resentment; and suspiciousness. The pre-eminent anger-hostility correlate of CAD was found to be expressed anger, with years as a smoker and age also being independently related to disease severity. Thus, seven of these anger/hostility variables do not warrant similar attention as anger expression in CAD aetiology. Further research should identify coronary toxic components of anger expression and of socio-occupational environments that afford or constrain their occurrence.