HOSTILITY, AGGRESSION AND THE ASSOCIATION WITH HYPERTENSION IN POSTMENOPAUSAL WOMEN

In order to determine whether a hostile attitude is associated with hy pertension in post-menopausal women, we conducted a cross-sectional st udy of a sample of post-menopausal women enrollees from the Group Heal th Cooperative (Seattle, Washington). Outpatient medical records were reviewed for all subjects, Hypertension was defined as a recorded diag nosis of hypertension and treatment with an anti-hypertensive drug. Bo rderline hypertensives were excluded. Women were interviewed by teleph one and asked the 14 questions comprising the Hostile-Affect (HOS) and Aggressive-Responding (AGGR) factors of the Cook-Medley hostility sca le, Scores were grouped into high vs low HOS and AGGR. The AGGR score was available for 430 hypertensives and 628 normotensives. The HOS sco re was available for 436 hypertensives and 616 normotensives. High AGG R scores had a borderline association with hypertension (Odds Ratio (O R) = 1.26; 95% Confidence interval (CI) = 0.97-1.62). HOS was not asso ciated with hypertension. Adjusting for age, physical activity, diabet es mellitus, cholesterol level, tobacco and alcohol use, weight and ra ce, changed the association of AGGR with hypertension only slightly (O R = 1.22; CI = 0.92-1.63). We found a weak association between the pre valence of treated hypertension and AGGR in post-menopausal women, The re was no association between the HOS component and hypertension. The results of this study support the need for prospective studies of the role of psychological factors in the development of hypertension in po st-menopausal women, If this association is confirmed, AGGR measures m ay help identify women at high-risk who are most likely to benefit fro m hypertension screening and primary prevention.