Hostility and Increased Risk of Mortality and Acute Myocardial Infarction: The Mediating Role of Behavioral Risk Factors
Abstract
Cynical hostility has been associated with increased cardiovascular morbidity and mortality; yet few studies have investigated this relation in population-based samples, and little is known about underlying mechanisms. This study examined the association between hostility, measured by the eight-item Cynical Distrust Scale, and risk for all-cause and cardiovascular mortality and incident myocardial infarction. Subjects were 2,125 men, ages 42-60 years, from the Kuopio Ischemic Heart Disease Risk Factor Study, a longitudinal study of unestablished and traditional risk factors for ischemic heart disease, mortality, and other outcomes. There were 177 deaths (73 cardiovascular) in 9 years of follow-up. Men with hostility scores in the top quartile were at more than twice the risk of all-cause mortality (relative hazards (RH) 2.30, 95% confidence interval (CI) 1.47-3.59) and cardiovascular mortality (RH 2.70, 95% CI 1.27-5.76), relative to men with scores in the lowest quartile. Among 1,599 men without previous myocardial infarction or angina, high scorers also had an increased risk of myocardial infarction (RH 2.18, 95% CI 1.01-4.70). Biologic and socioeconomic risk factors, social support, and prevalent diseases had minimal impact on these associations, whereas adjustments for the behavioral risk factors of smoking, alcohol consumption, physical activity, and body mass index substantially weakened the relations. Simultaneous risk factor adjustment eliminated the observed associations. Results show that high levels of hostility are associated with increased risk of all-cause and cause-specific mortality and incident myocardial infarction and that these effects are mediated primarily through behavioral risk factors.
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When revised scales focusing on these components were utilized, they predicted all-cause and CVD mortality in other large cohorts.
“and all-cause and CVD mortality in other large cohorts [117, 177, 178].”
From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [177]
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“relation between hostility and incident myocardial infarction[10], and that the protective effect of gene CCR5 heterozygosity on clinical AIDS occurrence is completely mediated through an effect on CD4 cell count[11].”
Ditlevsen, S., Christensen, U., Lynch, J., Damsgaard, M. T., & Keiding, N. (2005) · Epidemiology · doi:10.1097/01.ede.0000147107.76079.07 · Cited by 246 · see citing works
Roy, B., Diez-Roux, A. V., Seeman, T., Ranjit, N., Shea, S., & Cushman, M. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181cb981b · Cited by 187 · see citing works
Anger Expression and Incident Hypertension
Everson‐Rose, S. A., Goldberg, D. E., Kaplan, G. A., Julkunen, J., & Salonen, J. T. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199811000-00014 · Cited by 186 · see citing works
“We previously have reported that the excess risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction associated with high levels of cynical hostility in the KIHD population is largely mediated through behavioral factors (38).”
BackgroundSelf-citationWood, D., Backer, G. D., Færgeman, O., Graham, I. M., Mancia, G., & Pyörälà, K. (1998) · Journal of Hypertension · doi:10.1097/00004872-199816100-00003 · Cited by 180 · see citing works
What's Wrong with Social Epidemiology, and How Can We Make It Better?
Kaplan, G. A. (2004) · Epidemiologic Reviews · doi:10.1093/epirev/mxh010 · Cited by 194 · see citing works
“As a counterexample, the maturing approach to the relation between cynical hostility and cardiovascular outcomes illustrates the value (43, 44) of identifying the role of both behavioral and psychophysiologic pathways in explaining this association.”
BackgroundSelf-citationNegative Affect and Mortality in Older Persons
Wilson, R. S. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg224 · Cited by 157 · see citing works
Everson‐Rose, S. A., Roetker, N. S., Lutsey, P. L., Kershaw, K. N., Longstreth, W. T., Jr., Sacco, R. L., Roux, A. V. D., & Alonso, Á. (2014) · Stroke · doi:10.1161/strokeaha.114.004815 · Cited by 151 · see citing works
“Hostility was measured only at visit 2 using 8 true/false items previously derived from the Cook–Medley Hostility Scale(18) that measures individuals’ hostile attitudes and cynical expectations regarding others’ motives.(19) All true responses were summed to create a hostility score (range, 0–8).”
MethodSkrabski, Á., Kopp, M., & Kawachi, I. I. (2003) · Journal of Epidemiology & Community Health · doi:10.1136/jech.57.2.114 · Cited by 145 · see citing works
Anger in Young Men and Subsequent Premature Cardiovascular Disease
Chang, P. P., Ford, D. E., Meoni, L. A., Wang, N., & Klag, M. J. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.8.901
Virtanen, R., Jula, A., Salminen, J. K., Voipio‐Pulkki, L., Helenius, H. Y. M., Kuusela, T., & Airaksinen, J. K. E. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000088760.65046.cf · Cited by 140 · see citing works
Marsland, A. L., Prather, A. A., Petersen, K. L., Cohen, S., & Manuck, S. B. (2008) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2007.11.008 · Cited by 138 · see citing works
“(2008), doi:10.1016/j.bbi.2007.11.008 ity (NA) have been associated with lifestyle risk factors, including smoking, poor diet, sedentary lifestyle, obesity, and alcoholism (e.g., Everson et al., 1997; Kawachi et al., 1996).”
InfluentialIribarren, C., Markovitz, J. H., Jacobs, D. R., Schreiner, P. J., Daviglus, M. L., & Hibbeln, J. R. (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601739 · Cited by 125 · see citing works
“…anxiety and chronic life stress, has been shown to be associated with heightened sympathetic tone (Suarez et al, 1998) and with increased risk of clinical (Koskenvuo et al, 1988; Barefoot et al, 1995; Everson et al, 1997) and sub- clinical (Iribarren et al, 2000) cardiovascular disease.”
BackgroundMacleod, J., Smith, G. D., Heslop, P., Metcalfe, C. D., Carroll, D., & Hart, C. (2001) · Journal of Epidemiology & Community Health · doi:10.1136/jech.55.12.878 · Cited by 125 · see citing works
“We have illustrated difficulties caused by confounding, in the interpretation of observed associations between psychosocial exposures and health. We have also shown how the traditional approach to this issue, adjustment for the confounding factor by including a measure of it in multivariate models, may not be fully su…”
BackgroundAngerer, P., Siebert, U., Kothny, W., Mühlbauer, D., Mudra, H. G., & von Schacky, C. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00944-x · Cited by 124 · see citing works
“Second, it was recently demonstrated that increased risk for all-cause mortality, cardiovascular mortality and nonfatal myocardial infarction of highly cynical hostile men is primarily mediated through coronary risk factors (29).”
BackgroundIntegrating Positive Psychology Into Counseling: Why and (When Appropriate) How
Harris, A. H. S., Thoresen, C. E., & Lopez, S. J. (2007) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2007.tb00438.x · Cited by 122 · see citing works
Grossardt, B. R., Bower, J. H., Geda, Y. E., Colligan, R. C., & Rocca, W. A. (2009) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31819e67db · Cited by 121 · see citing works
“These risk factors may, in turn, trigger disease processes leading to functional impairments or lesions in specific tissues or organs (Figure 2, C) (43).”
BackgroundPsychological risk factors for HIV pathogenesis: mediation by the autonomic nervous system
Cole, S. W., Kemeny, M. E., Fahey, J. L., Zack, J. A., & Naliboff, B. D. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01888-7 · Cited by 116 · see citing works
“…several such relationships, including a heightened risk of myocardial infarct among depressed individuals (Denollet et al 1996, 2000; Frasure-Smith et al 1993; Rozanski et al 1999) and an increased risk of all-cause mortality in chronically hostile people (Barefoot et al 1989; Everson et al 1997).”
BackgroundSurtees, P. G., Wainwright, N. W. J., Luben, R., Khaw, K.-T., & Day, N. E. (2006) · Health Psychology · doi:10.1037/0278-6133.25.1.102 · Cited by 115 · see citing works
Cardiac Autonomic Control Buffers Blood Pressure Variability Responses to Challenge
Sloan, R., Shapiro, P. A., Bagiella, E., Myers, M. M., & Gorman, J. M. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199901000-00010 · Cited by 114 · see citing works
The Association Between Trait Anger and Incident Stroke Risk
Williams, J. E., Nieto, F. J., Sanford, C. P., Couper, D. J., & Tyroler, H. A. (2002) · Stroke · doi:10.1161/hs0102.101625 · Cited by 111 · see citing works
Routledge, F. S., & McFetridge-Durdle, J. (2007) · European Journal of Cardiovascular Nursing · doi:10.1016/j.ejcnurse.2006.05.001 · Cited by 105 · see citing works
Wang, H., Schlesinger, M. J., Wang, H., & Hsiao, W. C. L. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.09.038 · Cited by 102 · see citing works
“Mistrust measured by the Cynical Distrust Scale is associated with increased risk of all-cause and cause-specific mortality (Everson et al., 1997) and self-reported symptom load (Christensen et al.”
Kauhanen, L., Lakka, H., Lynch, J. W., & Kauhanen, J. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyl046 · Cited by 101 · see citing works
Self-citationBarrett, B. P., Muller, D., Rakel, D. P., Rabago, D., Marchand, L. R., & Scheder, J. C. (2006) · Perspectives in biology and medicine · doi:10.1353/pbm.2006.0019 · Cited by 95 · see citing works
Neumann, S. A., Waldstein, S. R., Sellers, J. J., Thayer, J. F., & Sorkin, J. D. (2004) · Health Psychology · doi:10.1037/0278-6133.23.6.631 · Cited by 96 · see citing works
Siegler, I. C., Costa, P. T., Brummett, B. H., Helms, M. J., Barefoot, J. C., Williams, R. B., Dahlstrom, W. G., Kaplan, B. H., VITALIANO, P. P., Nichaman, M. Z., et al. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000088583.25140.9c · Cited by 93 · see citing works
“It is associated with the development of CHD (18–20), recurrent CHD (21), coronary artery calcification (22), CHD risk factors (23–27) and all-cause mortality (18, 19, 28), especially in prospective studies started on older samples (29, 30).”
BackgroundOverweight and Depressive Symptoms among African-American Women
Siegel, J. M., Yancey, A. K., & McCarthy, W. J. (2000) · Preventive Medicine · doi:10.1006/pmed.2000.0712 · Cited by 92 · see citing works
Hostility, Anger Control, and Anger Expression as Predictors of Cardiovascular Disease
Haukkala, A., Konttinen, H. M., Laatikainen, T. K., Kawachi, I. I., & Uutela, A. K. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181dbab87 · Cited by 90 · see citing works
“In another study conducted among males, cynical distrust was related to a higher risk for CVD mortality and acute MI incident, but this was explained mostly by other risk factors (24).”
BackgroundPulkki-Råbäck, L., Elovainio, M. J., Mika Kivimaki, B., Raitakari, O. T., & Keltikangas‐Järvinen, L. (2005) · Health Psychology · doi:10.1037/0278-6133.24.3.307 · Cited by 88 · see citing works
Anger Expression and Incident Stroke
Everson‐Rose, S. A., Kaplan, G. A., Goldberg, D. E., Lakka, T. A., Sivenius, J., & Salonen, J. T. (1999) · Stroke · doi:10.1161/01.str.30.3.523 · Cited by 88 · see citing works
Self-citationLlabre, M. M., Spitzer, S. B., Siegel, S. D., Saab, P. G., & Schneiderman, N. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000107886.51781.9c · Cited by 86 · see citing works
Lemogne, C., Nabi, H., Zins, M., Cordier, S., Ducimetière, P., Goldberg, M., & Consoli, S. M. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000286961 · Cited by 85 · see citing works
“In the present study, cognitive hostility was assessed in a relatively young and working population, which is likely [ 15 38 ] to contain a lower proportion of ill individuals compared with the general population.”
BackgroundHostility Predicts Recurrent Events among Postmenopausal Women with Coronary Heart Disease
Chaput, L. A. (2002) · American Journal of Epidemiology · doi:10.1093/aje/kwf158 · Cited by 83 · see citing works
“In one study of middle-aged men (21), associations between cynicism and cardiovascular mortality were mediated by adverse health practices related to CHD outcomes (e.”
BackgroundSense of coherence as a mediator between hostility and health
Mika Kivimaki, B., Elovainio, M. J., Vahtera, J., Nurmi, J., Feldt, T., Keltikangas‐Järvinen, L., & Pentti, J. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00305-1 · Cited by 91 · see citing works
“play a role in the pathogenesis of coronary heart disease [22,23].”
BackgroundProspective cohort study of hostility and the risk of cardiovascular disease mortality
Surtees, P. G., Wainwright, N. W. J., Luben, R., Day, N. E., & Khaw, K.-T. (2005) · International Journal of Cardiology · doi:10.1016/j.ijcard.2005.01.014 · Cited by 80 · see citing works
Taylor‐Piliae, R. E., Fair, J. M., Haskell, W. L., Varady, A. N., Iribarren, C., Hlatky, M. A., Go, A. S., & Fortmann, S. P. (2010) · Journal of Physical Activity and Health · doi:10.1123/jpah.7.1.87 · Cited by 78 · see citing works
Anger and the Heart: Perspectives on Cardiac Risk, Mechanisms and Interventions
Suls, J. (2013) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2013.03.002 · Cited by 93 · see citing works
Christensen, U., Lund, R., Damsgaard, M. T., Holstein, B. E., Ditlevsen, S., Diderichsen, F., Due, P., Iversen, L., & Lynch, J. W. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000126206.35683.d1 · Cited by 78 · see citing works
“(10) showed that high levels of cynical hostility were associated with an increased risk of all-cause and cardiovascular mortality and incident myocardial infarction.”
BackgroundInfluentialJulkunen, J., & Ahlström, R. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2005.12.005 · Cited by 77 · see citing works
“[8,9]).”
MethodSelf-citationHostility, gender, and cardiac autonomic control
Sloan, R. P., Bagiella, E., Shapiro, P. A., Kuhl, J. P., Chernikhova, D., Berg, J., & Myers, M. M. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200105000-00012 · Cited by 107 · see citing works
“(4) showed that hostility is associated with an increased risk of all-cause mortality and MI but that this risk is mediated primarily by behavioral risk factors.”
BackgroundMomeni, J., Omidi, A., Raygan, F., & Akbari, H. (2016) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2016.07.007 · Cited by 71 · see citing works
“Studies on patients of different age, gender, and race groups have shown that the risk for tobacco use, obesity, drug abuse, unhealthy eating style, and limited physical activity is greater among people with higher levels of psychological stress (46, 47).”
BackgroundHostility and physiological responses to laboratory stress in acute coronary syndrome patients
Brydon, L., Strike, P. C., Bhattacharyya, M. R., Whitehead, D. L., McEwan, J. R., Zachary, I. C., & Steptoe, A. (2009) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.06.007 · Cited by 73 · see citing works
“Hostility is an enduring personality trait that includes emotional (anger) as well as attitudinal (cynicism and mistrust of others) and behavioral (overt and repressed aggression) components [6], and numerous cross-sectional and prospective studies have highlighted hostility as a robust independent risk factor for cor…”
BackgroundBunde, J., & Suls, J. (2006) · Health Psychology · doi:10.1037/0278-6133.25.4.493 · Cited by 139 · see citing works
Cynical beliefs about human nature and income: Longitudinal and cross-cultural analyses.
Stavrova, O., & Ehlebracht, D. (2015) · Journal of Personality and Social Psychology · doi:10.1037/pspp0000050 · Cited by 74 · see citing works
“…obesity and insulin resistance (Bunde & Suls, 2006), coronary heart disease (Nelson, Palmer, & Pedersen, 2004; Niaura et al., 2002; Smith, 1992; Smith et al., 2004), dementia (Neuvonen et al., 2014), and increased mortality (Everson et al., 1997; Miller, Smith, Turner, Guijarro, & Hallet, 1996).”
Antagonistic Behavior, Dominance, Hostility, and Coronary Heart Disease
Siegman, A. W., Townsend, S. T., Civelek, A., & Blumenthal, R. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200003000-00017 · Cited by 68 · see citing works
“(23) found that hostility was an independent risk factor for carotid artery atherosclerosis, and in this study, the abbreviated Ho scores were associated with an increased risk of essential hypertension, even after adjusting for SES and the other traditional risk factors (b 5 0.”
BackgroundHarris, A. H. S., & Thoresen, C. E. (2005) · The Journal of Positive Psychology · doi:10.1080/17439760500380930 · Cited by 65 · see citing works
Racial and ethnic health disparities: evidence of discrimination's effects across the SEP spectrum
D’Anna, L. H., Ponce, N. A., & Siegel, J. M. (2010) · Ethnicity and Health · doi:10.1080/13557850903490298 · Cited by 62 · see citing works
Does personality explain social inequalities in mortality? The French GAZEL cohort study
Nabi, H., Kivimaki, M., Marmot, M. G., Ferrie, J., Zins, M., Ducimetiere, P., Consoli, S. M., & Singh-Manoux, A. (2008) · International Journal of Epidemiology · doi:10.1093/ije/dyn021 · Cited by 63 · see citing works
Does personality predict mortality? Results from the GAZEL French prospective cohort study
Nabi, H., Kivimaki, M., Zins, M., Elovainio, M., Consoli, S. M., Cordier, S., Ducimetiere, P., Goldberg, M., & Singh-Manoux, A. (2008) · International Journal of Epidemiology · doi:10.1093/ije/dyn013 · Cited by 62 · see citing works
“This stands in contrast with the Kuopio Ischemic Heart Disease Risk factor (KIHD) Study (15) which concluded that behavioural risk factor were important mediating factors in the associations between cynical hostility and mortality and myocardial infarction.”
InfluentialEarly manifestations of personality and adult health: A life course perspective.
Kubzansky, L. D., Martin, L. T., & Buka, S. L. (2009) · Health Psychology · doi:10.1037/a0014428 · Cited by 63 · see citing works
“In addition, hostile individuals are more likely to engage in more health-damaging behaviors (Everson et al., 1997), and are more likely to be exposed to interpersonal stress and poorer social support, factors that have consistently been linked with poor health (Smith, Glazer, Ruiz, & Gallo, 2004).”
BackgroundSocial Support and Health Behavior in Hostile Black and White Men and Women in CARDIA
Allen, J., Markovitz, J. H., Jacobs, D. R., & Knox, S. S. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200107000-00014 · Cited by 61 · see citing works
“Concerning health behavior, high hostility has been associated with higher smoking rates (21), salt consumption (22), alcohol consumption (11), and body mass index (23) than low hostility.”
BackgroundEverson‐Rose, S. A., Lewis, T. T., Karavolos, K., Matthews, K. A., Sutton-Tyrrell, K., & Powell, L. H. (2006) · American Heart Journal · doi:10.1016/j.ahj.2006.08.010 · Cited by 59 · see citing works
El-Gabalawy, R. M., Mackenzie, C. S., Pietrzak, R. H., & Sareen, J. (2014) · Experimental Gerontology · doi:10.1016/j.exger.2014.09.012 · Cited by 59 · see citing works
Rutledge, T., Reís, S. E., Olson, M. B., Owens, J. F., Kelsey, S. F., Pepine, C. J., Reichek, N., Rogers, W. J., Merz, C. N. B., Sopko, G. S., et al. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200103000-00014 · Cited by 58 · see citing works
“In light of evidence from male patient groups suggesting that psychosocial effects on cardiovascular disease may be in part mediated by atherosclerosis risk factors (19), it is important to examine this issue in women.”
BackgroundIs Type A Behavior Really a Trigger for Coronary Heart Disease Events?
Gallacher, J., Sweetnam, P. M., YARNELL, J. W. G., Elwood, P. C., & Stansfeld, S. A. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000041608.55974.a8 · Cited by 57 · see citing works
Dimensions of Anger and CHD in Men and Women: Self-Ratings Versus Spouse Ratings
Siegman, A. W., Townsend, S. T., Blumenthal, R. S., Sorkin, J. D., & Civelek, A. C. (1998) · Journal of Behavioral Medicine · doi:10.1023/a:1018725212562 · Cited by 56 · see citing works
“Similar results obtained in a recent large-scale population-based study ( Everson et al., 1997 ).”
ResultEverson‐Rose, S. A., Skarupski, K. A., Barnes, L. L., Beck, T. L., Evans, D. A., & de Leon, C. F. M. (2011) · Health & Place · doi:10.1016/j.healthplace.2011.02.007 · Cited by 55 · see citing works
“Hostility was measured by 8 items from the Cook–Medley Hostility Scale (Cook and Medley, 1954), a commonly used measure of distrustful, suspicious attitudes that has been associated with excess CVD risk (Barefoot et al., 1983; Everson et al., 1997; Smith et al., 2004).”
MethodPsychological factors affecting a medical condition
Ketterer, M. W., Mahr, G., & Goldberg, A. D. (2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(00)00099-4 · Cited by 53 · see citing works
Anger-Related Personality Traits and Carotid Artery Atherosclerosis in Untreated Hypertensive Men
Bleil, M. E., McCaffery, J. M., Muldoon, M. F., Sutton‐Tyrrell, K., & Manuck, S. B. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000138128.68838.50 · Cited by 53 · see citing works
“For instance, hostile people tend to have other cardiovascular risk factors and may be more likely to engage in health-impairing behaviors (41,42).”
BackgroundCerebral activation, hostility, and cardiovascular control during mental stress
Shapiro, P. A., Sloan, R. P., Bagiella, E., et al. (2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(00)00100-8 · Cited by 53 · see citing works
Angry breathing: a prospective study of hostility and lung function in the Normative Aging Study
Kubzansky, L. D. (2006) · Thorax · doi:10.1136/thx.2005.050971 · Cited by 52 · see citing works
Ituarte, P. H. G., Kamarck, T. W., Thompson, H. S., & Bacanu, S. (1999) · Health Psychology · doi:10.1037/0278-6133.18.4.393 · Cited by 52 · see citing works
The Cynical Genius Illusion: Exploring and Debunking Lay Beliefs About Cynicism and Competence
Stavrova, O., & Ehlebracht, D. (2018) · Personality and Social Psychology Bulletin · doi:10.1177/0146167218783195 · Cited by 52 · see citing works
“Holding a cynical view of human nature has been associated with bad health outcomes and increased mortality risks, lower psychological well-being, diminished self-esteem, and reduced economic well-being (Chen et al., 2016; Everson et al., 1997; Haukkala & Uutela, 2000; Smith, 1992; Stavrova & Ehlebracht, 2016).”
BackgroundBuselli, E. F., & Stuart‐Shor, E. (1999) · The Journal of Cardiovascular Nursing · doi:10.1097/00005082-199904000-00006 · Cited by 51 · see citing works
Exercise Counteracts the Cardiotoxicity of Psychosocial Stress
O’Keefe, E. L., O’Keefe, J. H., & Lavie, C. J. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2019.02.022 · Cited by 51 · see citing works
“Indeed, hostility has been linked to poor diet, obesity, sleep disturbances, and abuse of alcohol, tobacco, and other addictive substances, and it can lead to unhealthy levels of social isolation.(71,72) Hostility has been associated with elevated risks of HTN, coronary artery calcification,(73) coronary atheroscleros…”
BackgroundSykes, D. H., Arveiler, D., Salters, C., Ferrières, J., McCrum, E. E., Amouyel, P., Bingham, A., Montaye, M., Ruidavets, J., Haas, B., et al. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.6.1227 · Cited by 50 · see citing works
Pollitt, R. A., Daniel, M., Kaufman, J. S., Lynch, J. W., Salonen, J. T., & Kaplan, G. A. (2005) · Journal of Behavioral Medicine · doi:10.1007/s10865-005-2563-y · Cited by 50 · see citing works
“…0 to 8, divided into three levels: “Low hopelessness” (scores of 0, 1, or 2, including 58.3% of all scores), “moderate hopelessness” (scores of 3, 4, or 5, representing 32.9% of the sample), and “high hopelessness” (scores of 6, 7, or 8, accounting for 8.8% of the sample) (Everson et al., 1997a).”
BackgroundMethodResultInfluentialSelf-citationPersonality and all cause mortality: Evidence for indirect links
Ploubidis, G. B., & Grundy, E. (2009) · Personality and Individual Differences · doi:10.1016/j.paid.2009.02.022 · Cited by 49 · see citing works
The Association Between Generalized Trust and Physical and Psychological Health Across Societies
Hamamura, T., Li, L. M. W., & Chan, D. K. C. (2016) · Social Indicators Research · doi:10.1007/s11205-016-1428-9 · Cited by 48 · see citing works
Trust and all-cause mortality: a multilevel study of US General Social Survey data (1978–2010)
Giordano, G. N., Mewes, J., & Miething, A. (2018) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2018-211250 · Cited by 48 · see citing works
Pulkki, L. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg204 · Cited by 48 · see citing works
Hakulinen, C., Jokela, M., Hintsanen, M., Merjonen, P., Pulkki-Råback, L., Seppälä, I., Lyytikäinen, L.-P., Lehtimäki, T., Kähönen, M., Viikari, J., et al. (2013) · Journal of Behavioral Medicine · doi:10.1007/s10865-012-9452-y · Cited by 47 · see citing works
“Both hostility (Barefoot et al., 1983; Everson et al., 1997; Koskenvuo et al., 1988) and anger (Gallacher et al., 1999; Kubzansky et al., 2006; Williams et al., 2001) have been repeatedly associated with coronary heart disease (CHD) risk and there is some evidence for an association of…”
BackgroundTrust, happiness and mortality: Findings from a prospective US population-based survey
Miething, A., Mewes, J., & Giordano, G. N. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.112809 · Cited by 48 · see citing works
Smith, T. W., Gallo, L. C., & Ruiz, J. M. (2003) · Wiley eBooks · doi:10.1002/9780470753552.ch13 · Cited by 45 · see citing works
Bai, M., Tomenson, B., Creed, F. H., Mantis, D., Tsifetaki, N., Voulgari, P. V., Drosos, A. A., & Hyphantis, T. N. (2009) · Scandinavian Journal of Rheumatology · doi:10.3109/03009740903015135 · Cited by 45 · see citing works
“Finally, hostility has been shown to be a risk factor for ill health (14, 15), but its impact on HRQOL was found to be mediated through sense of coherence (14, 16).”
BackgroundSensitivity to depression or anxiety and subclinical cardiovascular disease
Seldenrijk, A., van Hout, H. P. J., van Marwijk, H., de Groot, E., Gort, J., Rustemeijer, C., Diamant, M., & Penninx, B. W. J. H. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.06.026 · Cited by 45 · see citing works
- Authors
- Everson, S. A., Kauhanen, J., Kaplan, G. A., Goldberg, D. E., Julkunen, J., Tuomilehto, J., & Salonen, J. T.
- Affiliations
- University of Oulu (FI)
- Department of Health Services (US)
- Public Health Institute (US)
- University of Helsinki (FI)
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1997-07-15
- Volume
- 146
- Issue
- 2
- Pages
- 142-152
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2151070440
- Cited by
- 301
- References
- 67
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 3 · 2021: 3 · 2020: 8 · 2019: 8 · 2018: 8 · 2017: 7 · 2016: 10 · 2015: 10 · 2014: 12 · 2013: 11 · 2012: 21
- FWCI
- 6.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- Academy of Finland
- National Heart, Lung, and Blood Institute (HL-44199, R01HL044199)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- cynicism, hostility, cardiovascular mortality, all-cause mortality, myocardial infarction, behavioral risk factors, mediation, smoking, alcohol consumption, physical activity, body mass index, men, ischemic heart disease
- MeSH terms
- Adult, Cardiovascular Diseases, Cause of Death, Finland, Health Status, Hostility, Humans, Male, Middle Aged, Myocardial Infarction, Risk, Risk Factors, Social Support, Socioeconomic Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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