The mix of concepts: Hostility, anger, aggression and other negative affectOver the past decades, a large number of studies have investigated the association between negative affect and coronary heart disease (CHD). Many were cross-sectional case-control studies, which have been criticized for the recall bias of the CHD diagnosis and for the memory distortion (Chida and Steptoe 2009). More recently, several prospective longitudinal studies with more rigorous methodology have also been developed. Notwithstanding, results from this studies are not homogeneous, with both positive and negative results. Although more rigorous in their methodology, the prospective studies use www.intechopen.com Recent Advances in Cardiovascular Risk Factors 416 diverse and partially overlapping concepts to define negative affect associated with CHD (Table 1). Since each study analyzes only a single psychological construct at a time and since these concepts are only partially overlapping, it is not surprising to note the conflicting results in the literature. In addition, the single-factor approach ignores the clustering of psychosocial risk factors for physical disease, which may act synergistically (Suls and Bunde 2005). Another view, from a twin-designed study, is that some of this negative affect concepts may have a single common genetic factor and a nonshared environmental factor, i.e., enviroments uncorrelated between twins, such as accidents. (Raynor, Pogue-Geile et al. 2002). Type Some authors have proposed that anger, hostility and aggression should be considered a syndrome and other include anger and hostility in the concept of aggression. For others, hostility is characterized by interrelated elements of cynical beliefs and attributions, angry emotional states, and aggressive or antagonistic behaviors. Martin et al. advocate for the standardization of these concepts emphasizing that anger corresponds to affect, aggression to behavior, and hostility (or cynicism) to cognition. Together the three constructs form a three-factor "ABC" model of trait anger (Martin, Watson et al. 2000).Aside from hostility, anger and aggression, VE and distressed personality are more complex concepts. Although they overlap partially, these constructs include specific patterns and aspects not captured by general scales for hostility, anger and aggression. Last but not least, the concept of negative affectivity posits that these symptoms represent markers of a trait www.intechopen.com Anger, Hostility and Other Forms of Negative Affect: Relation to Cardiovascular Disease 417 characterized by hypersensitivity to negative stimuli (Watson and Clark 1984) and the concept of negative emotions postulate the existence of a continuum across these affective states. Depression: The mix beyond the negative affectsBeyond negative affect, depression and, secondarily, anxiety have the strongest evidence for associations with CHD, even after controlling for traditional CHD risk factors, such as serum cholesterol, blood pressure, and smoking. Intriguingly, as it ...