Anger and hostility predict the development of atrial fibrillation in men in the Framingham offspring study
Open accessAbstract
BACKGROUND: Conflicting findings in the literature with regard to the ability of type A behavior, expressions of anger, or hostility to predict incident coronary heart disease (CHD) have created controversy. In addition, there are no prospective studies relating these characteristics to the development of atrial fibrillation (AF). METHODS AND RESULTS: From 1984 to 1987, 3873 men and women, 18 to 77 years of age, participating in the Framingham Offspring Study, were examined and monitored for 10 years for the incidence of CHD, AF, and total mortality. Measures of type A behavior, anger, hostility, and risk factors for CHD and AF were collected at the baseline examination. After controlling for age, diabetes, hypertension, history of myocardial infarction, history of congestive heart failure, and valvular heart disease in Cox proportional hazards models, trait-anger (RR=1.1; 95% CI, 1.0 to 1.4; P=0.04), symptoms of anger (RR=1.2; 95% CI, 1.0 to 1.4; P=0.008), and hostility (RR=1.3; 95% CI, 1.1 to 1.5; P=0.003) were predictive of 10-year incidence of AF in men. After controlling for risk factors for CHD, none of the measures of anger, type A behavior, or hostility were related to incident CHD; however, trait-anger (RR=1.2; 95% CI, 1.1 to 1.4; P<0.01) was related to total mortality in men. None of the psychosocial variables were related to the 3 outcomes in women. CONCLUSIONS: This is the first study to examine and demonstrate a predictive relation between measures of anger and hostility to the development of AF in men. As opposed to type A behavior, measures of anger and hostility may be more productive avenues for research in studying the risk of arrhythmias and total mortality in men.
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The adrenergic hyperactivation connected with intense emotions and anxiety can, in itself, predispose the patient to supraventricular and/or ventricular arrhythmias.
“In addition, the adrenergic hyperactivation connected with intense emotions and anxiety can, in itself, predispose the patient to supraventricular and/or ventricular arrhythmias.25 -27”
From Management of patients with palpitations: a position paper from the European Heart Rhythm Association (2011) · cites this paper as [27]
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- Authors
- Eaker, E. D., Sullivan, L. M., Kelly-Hayes, M., D’Agostino, R. B., & Benjamin, E. J.
- Affiliations
- Boston University (US)
- From Eaker Epidemiology Enterprises, LLC, Chili, Wis (E.D.E.); the Department of Mathematics and Statistics, Boston University School of Public Health, Boston, Mass (L.M.S., R.B.D.); the Departments of Neurology and Cardiology, Boston University School of Medicine, Boston, Mass (M.K.-H.); and the National Heart, Lung, and Blood Institutes’ Framingham Heart Study (L.M.S., M.K.-H., R.B.D., E.J.B.), Bethesda, Md.
- Venue
- Circulation
- Published
- 2004-03-16
- Volume
- 109
- Issue
- 10
- Pages
- 1267-1271
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2101390840
- Cited by
- 184
- References
- 37
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 3 · 2022: 9 · 2021: 5 · 2020: 15 · 2019: 9 · 2018: 6 · 2017: 7 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 9 · 2012: 11
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r03hl067426-02, n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (HC25195, N01‐HC25195, 1 R03 HL 67426-01, N01-HC)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- atrial fibrillation, anger, hostility, Type A behavior pattern, coronary artery disease, all-cause mortality, arrhythmia risk, psychosocial risk factors, men, Framingham Offspring Study
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Aged, Anger, Atrial Fibrillation, Atrial Flutter, Cause of Death, Coronary Disease, Educational Status, Female, Hostility, Humans, Male, Middle Aged, Neoplasms, Personality Inventory, Prospective Studies, Risk Factors, Type A Personality, Cohort Studies, Comorbidity, Incidence, Proportional Hazards Models, Stroke
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