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American Journal of Epidemiology Vol. 124, No. 2: 220-233
Copyright © 1986 by The Johns Hopkins University School of Hygiene and Public Health


research-article

ANGER-COPING TYPES, BLOOD PRESSURE, AND ALL-CAUSE MORTALITY: A FOLLOW-UP IN TECUMSEH, MICHIGAN (1971–1983)

MARA JULIUS1,, EARNEST HARBURG1,2, ERIC M. COTTINGTON3 and ERNEST H. JOHNSON4

1 The University of Michigan, School of Public Health, Department of Epidemiology Ann Arbor, MI 48109–2029
2 The University of Michigan, College of Literature, Science, and the Arts Department of Psychology Ann Arbor, MI
3 Allegheny-Singer Research Institute Pittsburgh, PA
4 The University of Michigan, Medical School, Division of Hypertension Ann Arbor, MI

Reprint requests to Dr. Mara Julius

This study examined prospectively (1971–1983) the relationship between an ger-coping types, blood pressure, and all-cause mortality in a sample of men and women aged 30–69 (n=696) of the Tecumseh Community Health Study. Subjects who indicated that they were likely to suppress their anger in response to two hypothetical anger-provoking situations had 1.7 times the mortality risk of those who expressed their anger (95% confidence interval (Cl)=1.03–3.05). Subjects who suppressed their anger when unjustifiably confronted by their spouse had twice the mortality risk of those who expressed their anger (95% Cl=1.13–3.38). For high vs. low suppressed anger towards a policeman, the mortality risk was 1.24 (95% Cl=0.72–2.14). These relationships were invariant across age, sex, and education groups, even when medical risk factors were adjusted for, i.e., smoking, relative weight, blood pressure, coronary heart disease status, forced expiratory volume at one second (FEV1), and chronic bronchitis. However, suppressed anger measures significantly interacted with elevated blood pressure to predict the highest mortality risk. These results suggest that persons with high mortality risk can be identified in part by how they cope with anger, and by the joint effect of anger-coping type (a behavioral trait) and elevated blood pressure (a biologic trait).

anger; blood pressure; follow-up studies; mortality


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