Anger Proneness, Gender, and the Risk of Heart Failure

Kucharska‐Newton, Anna; Williams, Janice E.; Chang, Patricia P.; Stearns, Sally C.; Blecker, Saul; Mosley, Thomas H.

doi:10.1016/j.cardfail.2014.09.010

Cited by 16 publications

(9 citation statements)

References 44 publications

(45 reference statements)

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“…Anxiety has also been examined in association with incident heart failure, with mixed results, and anger has been modestly associated with incident heart failure in one study. 10, 11, 13 Lack of social support has also been associated with greater incident HF risk, 3, 14 though as noted in a recent meta-analysis several studies had short follow-up periods and the majority were composed mostly of men. 4 Whether psychosocial factors such as chronic stress and hostility are associated with HF incidence is presently unknown.…”

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confidence: 99%

Psychosocial Factors and Risk of Incident Heart Failure

Ogilvie

Everson‐Rose

Longstreth

et al. 2016

Circ: Heart Failure

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Background Heart failure is a major source of morbidity and mortality in the United States. Psychosocial factors have frequently been studied as risk factors for coronary heart disease, but not for heart failure. Methods and Results We examined the relationship between psychological status and incident heart failure among 6,782 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA). Anger, anxiety, chronic stress, depressive symptoms, and hostility were measured using validated scales and physician reviewers adjudicated incident heart failure events. Cox proportional hazards models were used to adjust for relevant demographic, behavioral, and physiological covariates. Interactions by age, race, sex, and self-reported health were examined in exploratory analyses. During a mean follow up of 9.3 years, 242 participants developed incident heart failure. There was no association between psychosocial factors and heart failure hazard ratios (95% CI) for highest vs. lowest quartile: anger=1.14 (0.81-1.60), anxiety=0.74 (0.51-1.07), chronic stress=1.25 (0.90-1.72), depressive symptoms=1.19 (0.76-1.85), and hostility=0.95 (0.62-1.42). In exploratory analysis, among the participants reporting fair/poor health at baseline, those reporting high vs. low levels of anxiety, chronic stress, and depressive symptoms had 2-fold higher risk of incident heart failure, but there was no association for those with good/very good/excellent self-reported health. Conclusions Overall these psychosocial factors were not significantly associated with incident heart failure. However, for participants reporting poor health at baseline, there was evidence that anxiety, chronic stress, and depressive symptoms were associated with increased risk of heart failure. Future research with greater statistical power is necessary to replicate these findings and seek explanations.

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confidence: 99%

Psychosocial Factors and Risk of Incident Heart Failure

Ogilvie

Everson‐Rose

Longstreth

et al. 2016

Circ: Heart Failure

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“…No evidence of the association of anger-proneness and risk of HF was observed in women in this study. 9 In contrast, a multiethnic population-based study of 6782 initially healthy individuals (242 total incident HF cases) did not find an association of anger and other psychosocial factors with risk of incident HF. 11 The observed inconsistency of these findings with the others could be related to the smaller sample size and relatively small number of cases in the latter study.…”

Section: Discussionmentioning

confidence: 93%

“… 4 While there is evidence that strong anger may trigger acute cardiovascular events, the long-term influence of anger on CVD events has scarcely been investigated and the scarce available data are inconsistent. Several cohort studies have indicated that anger (higher anger expression, frequent episodes of anger, or trait anger) is linked to higher risk of total CVD, 5 atrial fibrillation (AF), 6 coronary heart disease (CHD), 7 , 8 heart failure (HF), 9 and CVD mortality, 10 but other cohort studies and meta-analyses showed no such associations 11 , 12 or demonstrated an inverse relationship with some CVDs such as MI and stroke. 13 There appear to be no cohort studies of anger and the incidence of aortic valve stenosis (AVS) or abdominal aortic aneurysm (AAA).…”

Section: Introductionmentioning

confidence: 99%

Anger frequency and risk of cardiovascular morbidity and mortality

Titova

Baron

Michaëlsson

et al. 2022

European Heart Journal Open

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Aims Anger may increase the risk of cardiovascular diseases (CVDs) but previous findings are inconclusive and large prospective studies are needed. We investigated whether frequency of strong anger is associated with the incidence of specific CVDs and CVD mortality, and if sex, age, and cardiometabolic risk factors modifies these associations. Methods and Results We used data from a population-based cohort of 47,077 Swedish adults (56-94 years of age) who completed questionnaires regarding their experience of anger, lifestyle habits and health characteristics. Participants were followed for incident cardiovascular outcomes and death up to 9 years through linkage to the Swedish National Patient and Death Registers. Hazard ratios and confidence intervals adjusted for potential confounders were assessed. In multivariable analyses, frequent episodes of strong anger were associated with an increased risk of heart failure, atrial fibrillation, and CVD mortality (hazard ratios [95% confidence intervals] 1.19 [1.04-1.37], 1.16 [1.06-1.28], and 1.23 [1.09-1.40], respectively). The link between anger frequency and heart failure was more pronounced in men and participants with a history of diabetes. No evidence of an independent association of anger frequency with risk of myocardial infarction, aortic valve stenosis, and abdominal aortic aneurysm was found. Conclusions Our findings indicate that anger may contribute to the development of specific CVDs and CVD mortality, especially heart failure in men and in those with diabetes.

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“…in HF patients and not necessarily on hospitalizations alone (Kop, Synowski, & Gottlieb, 2011b; Rutledge, Reis, Linke, Greenberg, & Millis, 2006). With respect to incident HF, traits related to “anger proneness” predict HF events, with the latter determined, in part, by HF hospitalizations (Kucharska-Newton et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

Anger, hostility, and hospitalizations in patients with heart failure.

Keith¹,

Krantz²,

Chen³

et al. 2017

Health Psychology

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Objective Heart failure patients have a high hospitalization rate, and anger and hostility are associated with coronary heart disease morbidity and mortality. Using structural equation modeling, this prospective study assessed the predictive validity of anger and hostility traits for cardiovascular and all-cause re-hospitalizations in patients with heart failure. Methods 146 heart failure patients were administered the STAXI and Cook-Medley Hostility Inventory to measure anger, hostility, and their component traits. Hospitalizations were recorded for up to 3 years following baseline. Causes of hospitalizations were categorized as heart failure, total cardiac, non-cardiac, and all-cause (sum of cardiac and non-cardiac). Results Measurement models were separately fit for Anger and Hostility, followed by a Confirmatory Factor Analysis to estimate the relationship between the Anger and Hostility constructs. An Anger model consisted of State Anger, Trait Anger, Anger Expression Out, and Anger Expression In, and a Hostility model included Cynicism, Hostile Affect, Aggressive Responding, and Hostile Attribution. The latent construct of Anger did not predict any of the hospitalization outcomes, but Hostility significantly predicted all-cause hospitalizations. Analyses of individual trait components of each of the two models indicated that Anger Expression Out predicted all-cause and non-cardiac hospitalizations, and Trait Anger predicted non-cardiac hospitalizations. None of the individual components of Hostility were related to re-hospitalizations or death. Conclusion The construct of Hostility and several components of Anger are predictive of hospitalizations that were not specific to cardiac causes. Mechanisms common to a variety of health problems, such as self-care and risky health behaviors, may be involved in these associations.

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Anger Proneness, Gender, and the Risk of Heart Failure

Cited by 16 publications

References 44 publications

Psychosocial Factors and Risk of Incident Heart Failure

Psychosocial Factors and Risk of Incident Heart Failure

Anger frequency and risk of cardiovascular morbidity and mortality

Anger, hostility, and hospitalizations in patients with heart failure.

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