Ethnic and Gender Differences in the Relationship Between Hostility and Metabolic and Autonomic Risk Factors for Coronary Heart Disease

OBJECTIVE: To examine the relationship between hostility and biological risk factors for coronary heart disease (CHD) in a population of white European and South Asian men and women living in the United Kingdom. METHODS: This cross-sectional study involved a community-based sample of 1,757 healthy white and South Asian men and women aged between 35 years and 75 years from West London. Participants completed the Cook-Medley Hostility Scale, together with measures of standard biological risk factors and heart rate variability. Associations between hostility and CHD risk factors were evaluated, controlling for age, education, smoking, physical activity, body mass index, and waist/hip ratio, using regression models. RESULTS: In white men, hostility was associated positively with fasting glucose, glycosylated hemoglobin, and negatively with high-density lipoprotein cholesterol. High levels of hostility were also related to increased prevalence of diabetes and the metabolic syndrome in white men. Hostility in South Asian men was associated with impaired autonomic function. Hostility was not related to any biological CHD risk factors in South Asian or white women. CONCLUSIONS: Our results showed that hostility was independently associated with glucose metabolism and dyslipidemia in white men, and with autonomic dysfunction in South Asian men. Hostility was found not to be relevant for measured CHD risk factors in females. Longitudinal data are required to establish whether the impact of hostility on CHD risk in men is mediated through metabolic and autonomic processes.