November 1, 1996Circulation308 citations
A Prospective Study of Anger and Coronary Heart Disease
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Key Result
Highest levels of anger in older men significantly increased the risk of combined incident coronary events compared to the lowest levels (RR 2.66; 95% CI 1.26-5.61; P=0.008 for trend).
Study Design
Type
Cohort (n=1,305)
Structured PICO
Do high levels of anger increase the risk of incident coronary heart disease in older men free of diagnosed CHD?
P
Population
1,305 older community-dwelling men (mean age 61 years) free of diagnosed CHD from the Veterans Administration Normative Aging Study
I
Intervention
Highest levels of anger (categorized by MMPI-2 Anger Content Scale)
C
Comparator
Lowest levels of anger
O
Outcome
Total CHD (nonfatal MI plus fatal CHD) and combined incident coronary events including angina pectoriscomposite
High levels of expressed anger are associated with a significantly increased risk of incident coronary heart disease in older men.
Main Result
Effect estimate: RR 2.66 (95% CI 1.26-5.61)
p-value: p=0.008 for trend
Abstract
BACKGROUND: Recent laboratory and epidemiological studies have suggested that high levels of anger may increase the risk of coronary heart disease (CHD). METHODS AND RESULTS: We examined prospectively the relationship of anger to CHD incidence in the Veterans Administration Normative Aging Study, an ongoing cohort of older (mean age, 61 years) community-dwelling men. A total of 1305 men who were free of diagnosed CHD completed the revised Minnesota Multiphasic Personality Inventory (MMPI-2) in 1986. Subjects were categorized according to their responses to the MMPI-2 Anger Content Scale, which measures the degree to which individuals have problems controlling their anger. During an average of 7 years of follow-up, 110 cases of incident CHD occurred, including 30 cases of nonfatal myocardial infarction hostility. (MI), 20 cases of fatal CHD, and 60 cases of angina pectoris. Compared with men reporting the lowest levels of anger, the multivariate-adjusted relative risks among men reporting the highest levels of anger were 3.15 (95% confidence interval) CI: 0.94 to 10.5) for total CHD (nonfatal MI plus fatal CHD) and 2.66 (95% CI: 1.26 to 5.61) for combined incident coronary events including angina pectoris. A dose-response relation was found between level of anger and overall CHD risk (P for trend, .008). CONCLUSIONS: These data suggest that high levels of expressed anger may be a risk factor for CHD among older men.
Cite This Study
Kawachi et al. (1996) conducted a cohort in Coronary Heart Disease (n=1,305). Highest levels of anger vs. Lowest levels of anger was evaluated on Combined incident coronary events including angina pectoris (RR 2.66, 95% CI 1.26-5.61, p=0.008 for trend). Highest levels of anger in older men significantly increased the risk of combined incident coronary events compared to the lowest levels (RR 2.66; 95% CI 1.26-5.61; P=0.008 for trend).