DEFENSIVE HOSTILITY - RELATIONSHIP TO MULTIPLE MARKERS OF CARDIAC ISCHEMIA IN PATIENTS WITH CORONARY-DISEASE

Three studies assessed whether the combined traits of hostility and de fensiveness identify a group of hostile individuals with functionally severe coronary artery disease (CAD). CAD patients completed the Cook- Medley Hostility Inventory (He) and the Marlowe-Crowne Social Desirabi lity Scale (MC). Patients were classified into 4 groups: defensive hos tile (DH: high Ho, high MC), low hostile (LH: low Ho, low MC), high ho stile (HH: high Ho, low MC), and defensive (Def: low Ho, high MC). DH in comparison to HH, LH, and Def CAD patients demonstrate the greatest perfusion defects as measured by exercise thallium scintigraphy; DH p atients exhibit the most frequent ischemic episodes during ambulatory electrocardiographic monitoring; and in a laboratory study, DH patient s exhibit the most severe mental stress-induced ischemia assessed by e chocardiography. Thus, the combination of high hostility and high defe nsiveness are associated with more functionally severe CAD and may pre dispose CAD patients to a more adverse prognosis.