Hostility Adds to Heart-attack Risk Factors

NEW YORK (Reuters Health) - Men with the metabolic syndrome -- a cluster of disorders such as high blood pressure, high blood sugar and a large waistline -- run an increased risk of developing heart disease. High hostility levels boost the risk even further, according to researchers.

Dr. John F. Todaro, of Brown Medical School in Providence, Rhode Island, and colleagues examined the combined effect of the metabolic syndrome and hostility on the rate of heart attacks in 754 men (almost 60 years of age, on average) who participated in the Normative Aging Study.

A total of 208 participants (28 percent) met the definition for having the metabolic syndrome. The subjects were categorized as having high or low hostility levels using a standard scale.

As reported in the American Journal of Cardiology, the men were followed for an average of nearly 14 years. During that time, 85 patients (11 percent) had a heart attack.

On analysis of the data, subjects with high hostility levels and the metabolic syndrome had a four-fold higher likelihood of a heart attack.

"Psychological factors need to be assessed by primary care doctors and cardiologists, since hostility and other negative emotions (e.g., depression) seem to play a role in the development of heart disease in otherwise healthy individuals," Todaro said in an interview.

"Individuals who notice that they experience feelings of anger and hostility often, should mention these feelings to their doctor and seek help," he advised.

In addition, he underscored the need to test the effect of behavioral and medical treatments known to reduce hostility on the development and progression of heart disease. "We know we can reduce hostility through established treatment methods, but we don't know whether that makes a difference in someone's chances of having a future heart attack," Todaro explained.

"This study was conducted in older males, so we are not sure these results will generalize to women," he added. "Future studies should look at these relationships in women."

SOURCE: American Journal of Cardiology, July 2005.