American Journal of Epidemiology Vol. 154, No. 3 : 230-235
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Effects of an Angry Temperament on Coronary Heart Disease Risk
The Atherosclerosis Risk in Communities Study
1 Cardiovascular Health Branch, Centers for Disease Control and Prevention, Atlanta, GA.
2 Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
3 Injury and Violence Prevention Unit, North Carolina Department of Health and Human Services, Raleigh, NC.
4 Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC.
The objective of the study was to determine which component of an anger-prone personality more strongly predicts coronary heart disease (CHD) risk. Proneness to anger, as assessed by the Spielberger Trait Anger Scale, is composed of two distinct subcomponents—anger-temperament and anger-reaction. Participants were 12,990 middle-aged Black men and women and White men and women from the Atherosclerosis Risk in Communities Study who were followed for the occurrence of acute myocardial infarction (MI)/fatal CHD, silent MI, or cardiac revascularization procedures (average = 53 months; maximum = 72 months) through December 31, 1995. Among normotensive persons, a strong, angry temperament (tendency toward quick, minimally provoked, or unprovoked anger) was associated with combined CHD (acute MI/fatal CHD, silent MI, or cardiac revascularization procedures) (multivariate-adjusted hazard ratio = 2.10, 95% confidence interval: 1.34, 3.29) and with ‘hard" events (acute MI/fatal CHD) (multivariate adjusted hazard ratio = 2.28, 95% confidence interval: 1.29, 4.02). CHD event-free survival among normotensives who had a strong, angry temperament was not significantly different from that of hypertensives at either level of anger. These data suggest that a strong, angry temperament rather than anger in reaction to criticism, frustration, or unfair treatment places normotensive, middle-aged persons at increased risk for cardiac events and may confer a CHD risk similar to that of hypertension.
coronary disease; prospective studies; stress; survival analysis
Abbreviations: ARIC, Atherosclerosis Risk in Communities; CHD, coronary heart disease; MI, myocardial infarction.
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