Effects of an angry temperament on coronary heart disease risk - The Atherosclerosis Risk in Communities study

The objective of the study was to determine which component of an anger-pro ne personality more strongly predicts coronary heart disease (CHD) risk. Pr oneness to anger, as assessed by the Spielberger Trait Anger Scale, is comp osed of two distinct subcomponents-anger-temperament and anger-reaction. Pa rticipants were 12,990 middle-aged Black men and women and White men and wo men from the Atherosclerosis Risk in Communities Study who were followed fo r the occurrence of acute myocardial infarction (Ml)/fatal CHID, silent MI, or cardiac revascularization procedures (average = 53 months; maximum = 72 months) through December 31, 1995. Among normotensive persons, a strong, a ngry temperament (tendency toward quick, minimally provoked, or unprovoked anger) was associated with combined CHID (acute MI/fatal CHID, silent Ml, o r 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 i nterval: 1.29, 4.02). CHID event-free survival among normotensives who had a strong, angry temperament was not significantly different from that of hy pertensives at either level of anger. These data suggest that a strong, ang ry 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 hypertensi on.