Anger and hostility predict the development of atrial fibrillation in men in the framingham offspring study

• Published in: Circulation (New York, N.Y.) Vol. 109; no. 10; pp. 1267 - 1271
• Main Authors: EAKER, Elaine D, SULLIVAN, Lisa M, KELLY-HAYES, Margaret, D'AGOSTINO, Ralph B, BENJAMIN, Emelia J
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 16.03.2004; American Heart Association, Inc
• Subjects: Adaptation, Psychological; Adolescent; Adult; Aged; Anger; Atrial Fibrillation - epidemiology; Atrial Fibrillation - psychology; Atrial Flutter - epidemiology; Atrial Flutter - psychology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cause of Death; Cohort Studies; Comorbidity; Coronary Disease - epidemiology; Coronary Disease - mortality; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Educational Status; Female; Hostility; Humans; Incidence; Male; Medical sciences; Middle Aged; Neoplasms - mortality; Personality Inventory; Proportional Hazards Models; Prospective Studies; Risk Factors; Stroke - mortality; Type A Personality; Human; coronary disease; Arrhythmia; Heart disease; Atrial fibrillation; Mortality; men; Cardiovascular disease; Hostility; Excitability disorder; fibrillation
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.cir.0000118535.15205.8f

Conflicting findings in the literature with regard to the ability of type A behavior, expressions of anger, or hostility to predict incident coronary heart disease (CHD) have created controversy. In addition, there are no prospective studies relating these characteristics to the development of atrial fibrillation (AF). From 1984 to 1987, 3873 men and women, 18 to 77 years of age, participating in the Framingham Offspring Study, were examined and monitored for 10 years for the incidence of CHD, AF, and total mortality. Measures of type A behavior, anger, hostility, and risk factors for CHD and AF were collected at the baseline examination. After controlling for age, diabetes, hypertension, history of myocardial infarction, history of congestive heart failure, and valvular heart disease in Cox proportional hazards models, trait-anger (RR=1.1; 95% CI, 1.0 to 1.4; P=0.04), symptoms of anger (RR=1.2; 95% CI, 1.0 to 1.4; P=0.008), and hostility (RR=1.3; 95% CI, 1.1 to 1.5; P=0.003) were predictive of 10-year incidence of AF in men. After controlling for risk factors for CHD, none of the measures of anger, type A behavior, or hostility were related to incident CHD; however, trait-anger (RR=1.2; 95% CI, 1.1 to 1.4; P<0.01) was related to total mortality in men. None of the psychosocial variables were related to the 3 outcomes in women. This is the first study to examine and demonstrate a predictive relation between measures of anger and hostility to the development of AF in men. As opposed to type A behavior, measures of anger and hostility may be more productive avenues for research in studying the risk of arrhythmias and total mortality in men.