January 1, 1995
View Full PaperDefensive hostility: Relationship to multiple markers of cardiac ischemia in patients with coronary disease.
Structured PICO
Is the defensive hostile personality trait associated with more severe cardiac ischemia in patients with CAD?
P
Population
Patients with coronary artery disease (CAD)
I
Intervention
Defensive hostile personality trait (high hostility, high defensiveness)
C
Comparator
Low hostile, high hostile, and defensive personality traits
O
Outcome
Severity of cardiac ischemia measured by exercise thallium scintigraphy, ambulatory electrocardiographic monitoring, and mental stress echocardiographysurrogate
The combination of high hostility and high defensiveness in CAD patients is associated with more functionally severe ischemia across multiple testing modalities.
Abstract
Three studies assessed whether the combined traits of hostility and defensiveness identify a group of hostile individuals with functionally severe coronary artery disease (CAD). CAD patients completed the Cook-Medley Hostility Inventory (Ho) and the Marlowe-Crowne Social Desirability Scale (MC). Patients were classified into 4 groups: defensive hostile (DH: high Ho, high MC), low hostile (LH: low Ho, low MC), high hostile (HH: high Ho, low MC), and defensive (Def: low Ho, high MC). DH in comparison to HH, LH, and Def CAD patients demonstrate the greatest perfusion defects as measured by exercise thallium scintigraphy; DH patients exhibit the most frequent ischemic episodes during ambulatory electrocardiographic monitoring; and in a laboratory study, DH patients exhibit the most severe mental stress-induced ischemia assessed by echocardiography. Thus, the combination of high hostility and high defensiveness are associated with more functionally severe CAD and may predispose CAD patients to a more adverse prognosis.