Public Release: 

High hostility may predict heart disease more than other risk factors such as cholesterol

American Psychological Association

WASHINGTON -- Hostility may predict heart disease more often than traditional coronary heart disease (CHD) risk factors like high cholesterol, cigarette smoking and weight, according to research reported on in the November issue of Health Psychology, published by the American Psychological Association (APA).

Using a sample of 774 older White men (average age was 60) from the Normative Aging Study, lead researcher Raymond Niaura, Ph.D., and colleagues sought to determine whether hostility was an independent influence or a contributing factor in CHD development. Hostility levels, blood lipids, fasting insulin, blood pressure, body measurement index (BMI), weight-hip ratio (WHR), diet, alcohol intake, smoking and education attainment were assessed over a three year period beginning in 1986.

Incidences of CHD were more common in those with higher levels of hostility then those with other risk factors such as high cholesterol, alcohol intake or smoking tobacco, said Dr. Niaura. In this sample of older men with high levels of hostility, 5.8 percent (45) experienced at least one episode of CHD during their involvement with the NAS study. According to the authors, hostility is associated with and predicts incidents of coronary heart disease above and beyond the influence of known risk factors that include blood lipid profiles, sociodemographic characteristics, alcohol consumption and smoking. Specifically, HDL-cholesterol levels did significantly protect against CHD but hostility levels predicted incidences of CHD independent of the protective effect of HDL.

"Furthermore, older men with the highest levels of hostility were at the greatest risk for developing CHD, independent of the effects of fasting insulin, BMI, WHR, triglcyride levels and blood pressure," said the authors. It could be that high hostility levels predisposes an individual to CHD through other mechanisms not measured in this study, like cardiac arrhythmia, imbalances in the nervous system or cardiovascular and endocrine-neuroendocrine responses to stress. But these findings, said Dr. Niaura, suggests that mental health and health providers should continue to look at the effectiveness of providing psychological interventions for those individuals with high hostility levels.


Article: "Hostility, the Metabolic Syndrome, and Incident Coronary Heart Disease," Raymond Niaura, Ph.D., John F. Todaro, Ph.D., and Laura Stroud, Ph.D., Brown Medical School and The Miriam Hospital; Avron Spiro III, Ph.D., Boston University School of Public Health and Boston Veterans Affairs Healthcare System; Kenneth D. Ward, Ph.D., University of Memphis; Scott Weiss, M.D., Brigham and Women's Hospital and Harvard Medical School; Health Psychology, Vol 21, No. 6.

(Full text of the article is available from the APA Public Affairs Office or at

Raymond Niaura, PhD can be reached by telephone at 401-793-8002 or by email at

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 155,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

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