Cited by 559Cardiac Health and Mental HealthCardiovascular Health and Risk FactorsHeart Rate Variability and Autonomic Control

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Hostility, Risk of Coronary Heart Disease, and Mortality

Shekelle, Richard B., Gale, Meryl, Ostfeld, Adrian M., Paul, Oglesby·1983·Psychosomatic Medicine

DOI 10.1097/00006842-198305000-00003

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Abstract

Level of hostility (Ho) was assessed by a 50-item subscale of the Minnesota Multiphasic Personality Inventory at the initial examination of 1877 employed middle-aged men who were free of coronary heart disease (CHD). Ten-year incidence of major CHD events (myocardial infarction and CHD death) was lowest in the first quintile of the Ho scale's distribution, highest in the middle quintile, and intermediate in the other three quintiles. After adjustment for age, blood pressure, serum cholesterol level, cigarette smoking, and intake of ethanol, the relative odds of a major CHD event was 0.68 for men with Ho scores less than or equal to 10 points in comparison to men with higher scores. The Ho scale was positively associated with crude 20-year mortality from CHD, malignant neoplasms, and causes other than cardiovascular--renal diseases and malignant neoplasms. After adjustment for the risk factors listed above, the Ho scale had a statistically significant, positive, monotonic association with 20-year risk of death from all causes combined. A difference of 23 points on the Ho scale, i.e., the difference between the means of the first and the fifth quintiles, was associated with a 42% increase in the risk of death. These results support the previous findings of Williams et al. with respect to the Ho scale and coronary atherosclerosis, and also suggest that the Ho scale may be associated with factors having broad effects on survival.

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“The CMHS and its subscales have been associated with coronary calcification (2), coronary heart disease (CHD) morbidity and mortality (3–6), and all-cause mortality (3,4,6,7) in prospective studies of healthy subjects.”
Background
Hostility and the Metabolic Syndrome in Older Males: The Normative Aging Study
NIAURA, R. S., Banks, S. M., Ward, K. D., Stoney, C. M., Spiro, A., Aldwin, C. M., Landsberg, L., & Weiss, S. T. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200001000-00002 · Cited by 125
“However, longitudinal studies that did control for CHD risk factors (eg, lipids) nevertheless found positive associations between Ho and CHD morbidity and mortality (4, 5, 8).”
BackgroundInfluential
A Link between Hostility and Disease: Poor Health Habits?
Leiker, M., & Hailey, B. J. (1988) · Behavioral Medicine · doi:10.1080/08964289.1988.9935136 · Cited by 120
Anxiety and Anger in Patients with Ventricular Tachyarrhythmias. Responses after Automatic Internal Cardioverter Defibrillator Implantation
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Inability to predict cardiovascular disease from hostility scores or MMPI items related to Type A behavior.
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Everyday Discrimination Prospectively Predicts Inflammation across 7‐Years in Racially Diverse Midlife Women: Study of Women's Health across the Nation
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DEATH TAKES A HOLIDAY: MORTALITY SURROUNDING MAJOR SOCIAL OCCASIONS
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Stress and Health
Kasl, S. V. (1984) · Annual Review of Public Health · doi:10.1146/annurev.pu.05.050184.001535 · Cited by 113
Blood-pressure responses during social interaction in high- and low-cynically hostile males
Smith, T. W., & Allred, K. D. (1989) · Journal of Behavioral Medicine · doi:10.1007/bf00846547 · Cited by 110
Hostility, Social Support, and Ambulatory Cardiovascular Activity
Benotsch, E. G., Christensen, A. J., & McKelvey, L. (1997) · Journal of Behavioral Medicine · doi:10.1023/a:1025530711432 · Cited by 109
Psychosocial factors associated with cardiovascular reactivity in older adults.
VITALIANO, P. P., Russo, J. E., Bailey, S. L., Young, H. M., & McCann, B. S. (1993) · Psychosomatic Medicine · doi:10.1097/00006842-199303000-00005 · Cited by 107
“, Type A or B (7), as well as hostility (8-10).”
Background
Physiological, psychological, and behavioral factors and white coat hypertension.
Siegel, W. C., Blumenthal, J. A., & Divine, G. (1990) · Hypertension · doi:10.1161/01.hyp.16.2.140 · Cited by 109
Social Support and Hostility as Predictors of Depressive Symptoms in Cardiac Patients One Month After Hospitalization
Brummett, B. H., Babyak, M. A., Barefoot, J. C., Bosworth, H. B., Clapp‐Channing, N. E., Siegler, I. C., Williams, R. B., & Mark, D. B. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199811000-00008 · Cited by 108
“The 50-item scale has been shown to predict all-cause mortality and coronary events (20, 21, 34), as well as several other health outcomes (33).”
Method
Lipids in psychological research: The last decade
NIAURA, R. S., Stoney, C. M., & Herbert, P. N. (1992) · Biological Psychology · doi:10.1016/0301-0511(92)90022-m · Cited by 104
Neurobiology, cellular and molecular biology, and psychosomatic medicine.
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“Equal numbers of studies reporting a significant association between Ho scores and subsequent health (Barefoot et al., 1983, 1989; Shekelle et al., 1983) and failing to find such an association (Hearn et al., 1989; Leon et al., 1988; McCranie et al., 1986) have appeared in recent years.”
Background
Hostility, Interpersonal Interactions, and Ambulatory Blood Pressure
Brondolo, E. N., Rieppi, R., Erickson, S. A., Bagiella, E., Shapiro, P. A., McKinley, P. S., & Sloan, R. P. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000097329.53585.a1 · Cited by 98
“research (12,43), with the scale demonstrating good internal consistency and”
Background
Hostility, the metabolic syndrome, and incident coronary heart disease.
NIAURA, R. S., Todaro, J. F., Stroud, L. R., Spiro, A., Ward, K. D., & Weiss, S. T. (2002) · Health Psychology · doi:10.1037/0278-6133.21.6.588 · Cited by 104
“Results of the present study are consistent with other studies demonstrating that Ho is associated with and predicts incident CHD above and beyond the influence of traditionally assessed CHD risk factors, including blood lipid profiles, sociodemographic characteristics, and certain behavioral factors, such as alcohol…”
BackgroundResultInfluential
What does the Cook and Medley Hostility scale measure? Affect, behavior, and attributions in the marital context.
Smith, T. W., Sanders, J. D., & Alexander, J. F. (1990) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.58.4.699 · Cited by 113
Depression and Related Psychological Factors in Heart Disease
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Associations of blood pressure with self-report measures of anger and hostility among Black and White men and women.
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The Role of Episodic Memories in Current and Future Well-Being
Philippe, F. L., Koestner, R., Beaulieu‐Pelletier, G., Lecours, S., & Lekes, N. (2011) · Personality and Social Psychology Bulletin · doi:10.1177/0146167211429805 · Cited by 89
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

Authors: Shekelle, R. B., Gale, M., Ostfeld, A. M., & Paul, O.
Affiliations: Rush University Medical Center (US)
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1983-05
Volume: 45
Issue: 2
Pages: 109-114
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/00006842-198305000-00003
OpenAlex: W2076459336
Cited by: 554
References: 0
Citations by year: 2025: 1 · 2024: 3 · 2019: 2 · 2018: 1 · 2017: 5 · 2016: 5 · 2015: 4 · 2014: 11 · 2013: 7 · 2012: 3
FWCI: 16.79
Type: journal article
Language: en
Open access: closed
Locations: Psychosomatic Medicine (publishedVersion)
PubMed (publishedVersion)
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
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
Keywords: hostility, coronary artery disease, myocardial infarction, coronary heart disease mortality, MMPI, middle-aged men, personality traits, cardiovascular risk factors, all-cause mortality, cancer
MeSH terms: Adult, Alcohol Drinking, Chicago, Coronary Disease, Hostility, Humans, Male, Middle Aged, MMPI, Myocardial Infarction, Risk, Smoking

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Hostility, Risk of Coronary Heart Disease, and Mortality

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