May 16, 2000 -- Young adults who score high on a test of hostility are more likely to have calcium deposits in their heart arteries, and that's a potential sign of early heart disease, a study in this week's issue of the Journal of the American Medical Association reports.
"This study raises the very intriguing possibility that high hostility levels in young adults are contributing to early atherosclerosis," which is hardening of the arteries, Diane Bild, MD, MPH, tells WebMD. Basically, the higher the level of hostility, the higher the prevalence of calcium deposits in the heart arteries, she says. Bild is former director of the CARDIA study, from which this study was generated, and a medical officer at the National Heart, Lung, and Blood Institute in Bethesda, Md., as well as one of the study's authors.
The CARDIA study is a large national investigation of risk factors for cardiovascular disease that has been going on since 1985. It has been following about 5,000 young adults aged 18 to 30, and includes both men and women. The 374 members of the group included in this analysis had approximately equal numbers of men and women and black and white participants.
All study participants have been evaluated for many of the known risk factors for cardiovascular disease, including smoking, level of physical activity, and weight. Participants also filled out a questionnaire specially designed to assess their level of hostility, and they were examined using a technique that identifies areas in the heart's blood vessels that have calcium deposits.
Bild says the findings of this study need to be confirmed, but adds, "It's kind of like motherhood and apple pie to suggest that people need to be calmer and to take a better attitude toward life, but studies to do that kind of intervention would be interesting."
"I'm not at all surprised by these results, and I think its time we started to acknowledge that chronic stresses affect [brain-hormone] pathways and are part of the cardiovascular risk equation," says Sarah Knox, PhD, who reviewed the study for WebMD. "There are two possible pathways where hostility can lead to cardiovascular disease. One of them is health behaviors, such as smoking or not exercising. These are definitely behaviors found more often in hostile people. The other is ... psychosocial behaviors, where things like chronic stress or hostility affect the body."
Many doctors already recognize that assessing someone's cardiovascular risk requires looking at psychosocial risk factors, as well as health behaviors and familial background, Knox says. This study, as well as many others, suggests that treatment of psychosocial factors also is important, and needs to take place earlier, she says.
"My own research has shown that people who are chronically irritable are as prone to cardiovascular disease as those who are always angry and ready to explode," says Aron Seigmen, PhD, professor of psychology at the University of Maryland in Baltimore County.
"It's hard to define what different researchers mean by hostility, but in my research, I've seen that the outward expression of anger seems to be the most toxic," Seigmen says. "People who respond in this way need to relearn their responses and to change their view of situations to defuse the toxic effect of their emotions on their cardiovascular health."
Willem Kop, PhD, research assistant professor at the Uniformed Services University of the Health Sciences in Bethesda, Md., also reviewed the study for WebMD.
"Unfortunately, hostility is a trait that's very resistant to change," Kop says. "It's necessary to alter the person's coping strategy, not attempt to change the trait itself. We've had success with behavioral medicine interventions, in addition to relaxation training."
- According to a new study, people who are hostile are more likely to show signs of early heart disease.
- The higher the level of hostility a person exhibits, the greater prevalence of calcium in the arteries, a condition that contributes to the hardening of the arteries.
- People who are hostile can relearn how to respond to situations and diffuse the negative effects of these emotions on their health.