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Hostility Can Hurt the Heartbeat

Study finds increased risk of atrial fibrillation in angry men

MONDAY, March 1, 2004 (HealthDayNews) -- Men who are angry at the world and hostile to those around them are more likely to develop the dangerous heartbeat abnormality called atrial fibrillation than those who possess a more benevolent outlook, a new study finds.

The risk of atrial fibrillation was 30 percent higher in men with high scores on a standard test for hostility and anger, says a report from the Framingham Offspring Study in the March 1 online issue of Circulation.

No such relationship was found for women in the study, "but that may be because women develop heart disease later than men, and our population was fairly young," says study author Elaine D. Eaker, an epidemiologist formerly with the Framingham study.

In atrial fibrillation, the two upper chambers of the heart quiver feebly instead of pumping blood forcefully. Clots can form in the stagnant blood, increasing the risk of stroke and other cardiovascular problems. An estimated 2 million Americans have atrial fibrillation.

The latest report includes data on 1,769 men and 1,913 women in the Framingham Heart Study, which began in 1948. All took the Minneapolis Multiphasic Personality Inventory, which measures traits such as anger, at an average age of 48.5 years.

The incidence of atrial fibrillation was 30 percent greater in men with high hostility scores, measured by whether they agreed with statements such as "I have often met people who were supposed to be experts and who were no better than me," and "Some of my family members have habits that bother me and annoy me very much."

The incidence was 10 percent higher for men who described themselves as quick-tempered, hotheaded, furious when criticized, and likely to hit someone when frustrated. The death rate for these men during the study was 20 percent higher than for calmer men.

By contrast, no increased risk was found for men who rated high on Type A behavior, which is a sense of urgency that keeps a person constantly in a rush or always in a state of competitiveness.

The study was not designed to determine why anger and hostility can affect heart rhythm, Eaker says.

"Something is obviously going on here, but the paper does not address the mechanism," she says.

But she notes "there is some other evidence, mostly from animal studies, that social stress can lead to atrial fibrillation."

The increased risk took into account known physical risk factors, such as high blood pressure. "In our society, we don't tend to think about social risk factors," Eaker says.

It might be helpful to include measures of personality traits when assessing cardiovascular risk, she says.

"We are not doing anything about it now, but we can," Eaker says. "People can self-identify themselves as being hostile and angry, and they can be referred for counseling and anger management. All kinds of programs are available."

"This is an interesting finding, since it is the first reported association of hostility, anger variables, and atrial fibrillation," says Catherine Stoney, a professor of psychology at Ohio State University, who has done research in the field.

The finding "is in keeping with other data, some of it ours, demonstrating a stronger association of cardiovascular risk among men than women," she says.

More research is needed on the mechanisms that link anger and hostility with cardiovascular disease, Stoney says. "Only through this broader understanding will we be able to formulate meaningful interventions to decrease cardiovascular disease risk," she says.

More information

A rundown on atrial fibrillation is offered by the American Heart Association. Get tips on anger management from the American Psychological Association.

SOURCES: Elaine D. Eaker, Sc.D., president, Eaker Epidemiology Enterprises, Chili, Wisc.; Catherine Stoney, Ph.D., professor of psychology, Ohio State University, Columbus; March 1, 2004, online issue, Circulation
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