A PROSPECTIVE-STUDY OF ANGER AND CORONARY HEART-DISEASE - THE NORMATIVE AGING STUDY

Background Recent laboratory and epidemiological studies have suggeste d that high levels of anger may increase the risk of coronary heart di sease (CHD). Methods and Results We examined prospectively the relatio nship of anger to CHD incidence in the Veterans Administration Normati ve Aging Study, an ongoing cohort of older (mean age, 61 years) commun ity-dwelling men. A total of 1305 men who were free of diagnosed CHD c ompleted the revised Minnesota Multiphasic Personality inventory (MMPI -2) in 1986. Subjects were categorized according to their responses to the MMPI-2 Anger Content Scale, which measures the degree to which in dividuals have problems controlling their anger. During an average of 7 years of follow-up, 110 cases of incident CHD occurred including 30 cases of nonfatal myocardial infarction hostility (MI), 20 cases of fa tal CHD, and 60 cases of angina pectoris. Compared with men reporting the lowest levels of anger, the multivariate-adjusted relative risks a mong men reporting the highest levels of anger were 3.15 (95% confiden ce interval [CI]: 0.94 to 10.5) for total CHD (nonfatal MI plus fatal CHD) and 2.66 (95% CI: 1.26 to 5.61) for combined incident coronary ev ents including angina pectoris. A dose-response relation was found bet ween level of anger and overall CHD risk (P for trend, .008). Conclusi ons These data suggest that high levels of expressed anger may be a ri sk factor for CHD among older men.