Gender differences in the relation between interview-derived hostility scores and resting blood pressure

The Metabolic Syndrome Mediates the Relationship Between Cynical Hostility and Cardiovascular Disease

The objective of this work was to test the clustering of classic Cardiovascular disease (CVD) risk factors, known as the metabolic syndrome (e.g., increased blood pressure, insulin resistance, hypercholesterolemia combined with low levels of high-density lipoprotein, and abdominal fatness), as a mediator of the association between cynicism and CVD. Data were used from the Swedish Adoption/Twin Study of Aging (SATSA) (n = 1944 individuals, average age 62 years, 58% female). The cross-sectional association of cynicism with CVD was significant (standardized beta = 0.08, p <.01). In a longitudinal model, cynicism measured in 1984 was associated with CVD measured in 1987 (standardized beta = 0.06, p <.01). In a third model, a latent construct "metabolic syndrome" significantly partially mediated this relationship. Cynicism (measured 1984) predicted the metabolic syndrome (measured 1986-1988) (standardized beta = 0.20, p <.05) and the metabolic syndrome predicted CVD (measured 1987) (standardized beta = 0.18, p <.001); cynicism no longer significantly predicted CVD. Results were adjusted for baseline CVD, smoking, and age. These findings suggest that a clustering of CVD risk factors partially mediate the association between cynicism and CVD in an older population.

Psychosocial and reported inflammatory disease correlates of self-reported heart disease in women from South of Israel

BACKGROUND

Past and recent research suggests that psychological and biological factors may increase women's risk of coronary heart disease (CHD). This study examined the prevalence and correlates of self-reported heart disease among Jewish women from the Negev, a socio-economically and culturally unique region in south of Israel.

METHOD

A cross-sectional design was used. We interviewed over the phone 526 randomly-selected women (mean age: 44.3+/-14.2 years) about background variables (e.g., education), biomedical risk factors (e.g., body mass index or BMI), self-reported inflammatory diseases (rheumatoid arthritis or RA, urinary infections), psychosocial factors (depression, hopelessness, self-esteem, social-support) and self-rated health and heart disease.

RESULTS

Prior physician diagnosis of heart disease was reported by 8.2% of women. Age, economic difficulties, diabetes, hypertension, BMI, physical exercise, RA and urinary infections were significantly associated with reported heart disease. Of all psychosocial factors considered, hopelessness and self-esteem significantly distinguished heart disease cases from non-cases. In a multiple logistic regression, poor self-esteem, RA and hypertension were significant independent correlates of self-reported heart disease.

CONCLUSIONS

Pending replication with objective measures of heart disease and a prospective design, poor self-esteem and RA may prove to be new CHD risk factors in women.

Hostility differentially predicts cardiovascular risk factors in African American and White young adults

OBJECTIVE

Hostility may influence racial disparities in cardiovascular disease through differential associations with cardiovascular risk factors. This study explored racial variations in relations between hostility and selected cardiovascular risk factors.

METHODS

Cook-Medley Hostility (Ho) scores and 11 risk factors were examined among 66 healthy, White and African American young adults.

RESULTS

Controlling for age, gender, and body mass index, the interaction of hostility and race yielded significant (or marginal) associations with resting systolic and diastolic blood pressure (SBP, DBP), cardiac index (CI; i.e. cardiac output adjusted for body size), total peripheral resistance (TPR), insulin (INS), triglycerides (TG) and percent body fat (PBF). Contributing substantial variance, hostility was positively associated with SBP, DBP, TPR, TG and INS, and negatively associated with CI among African Americans. Conversely, hostility was negatively associated with TPR and PBF among Whites.

CONCLUSION

Hostility may confer greater cardiovascular risk among young African Americans than Whites.

Type D personality is related to cardiovascular and neuroendocrine reactivity to acute stress

OBJECTIVE

The relationship between Type D personality (the joint tendency towards negative affectivity [NA] and social inhibition [SI]) and laboratory indices of cardiovascular health was examined.

METHOD

173 undergraduates (86 male) completed a stress protocol involving a mental arithmetic task with harassment. Blood pressure, heart rate (HR), and salivary cortisol were measured both prior to and during the task.

RESULTS

The relationships between personality and both resting and reactivity levels were examined. Results indicated that socially inhibited men demonstrated heightened blood pressure reactivity. NA was related to dampened HR change during the stress task in men. Correlational analyses indicated that both Type D dimensions were associated with greater cortisol reactivity to stress; however, results no longer remained significant in more stringent regression analyses.

CONCLUSION

Findings are consistent with the noted relationship between Type D and cardiovascular disease (CVD), and suggest a possible pathway to disease via an association with physiological hyperreactivity.

Defense mechanisms and physiological reactivity to stress

The relation between the use of defense mechanisms and autonomic nervous system reactivity, under conditions of laboratory stress, was studied in 78 men and women. Both diastolic blood pressure (DBP) and skin conductance level (SCL) were monitored during exposure to ten stress tasks; concurrently, the use of three defense mechanisms was assessed by coding Thematic Apperception Test stories. Autonomic reactivity was found to be related to defenses; the nature of that relation differed across the defenses. DBP, typically found to be associated with cognitive work, was higher in those individuals who used more Identification, a defense that requires greater cognitive activity. The use of Projection, on the other hand, was associated with lower DBP. In addition, the use of Identification showed a tendency to be associated with lower SCL.

Hostility and the cardiovascular reactivity of women during interpersonal confrontation

In order to explore the association between hostility and women's health, this study examined the relationship of hostility to cardiovascular reactivity during stressful, interpersonal confrontations. Prior to the task, each participant's level of hostility, methods of coping with stress, and perceived social support were evaluated. Blood pressure and heart rate were monitored in ninety females during two discussions with a disagreeing confederate. In one discussion, participants were given positive feedback concerning their performance, while in a second discussion, participants were given non-positive feedback concerning their effectiveness in expressing their viewpoint. The results indicate that low hostile women displayed greater systolic blood pressure and heart rate increases than high hostile women during the discussions. In addition, participants exhibited greater systolic blood pressure and diastolic blood pressure reactivity during the positive feedback condition than during the non-positive feedback condition. However, for diastolic blood pressure, these results were qualified by an interaction, such that low hostile women displayed greater reactivity during the positive feedback condition than during the non-positive feedback condition, while high hostile women were equally reactive in both feedback conditions. State assessment of coping styles indicated that high hostile women may be less reactive due to withdrawal and lack of engagement during the task, while low hostile women may show greater engagement, especially when encouraged by positive feedback.

Development and cross-cultural and clinical validation of a brief comprehensive scale for assessing hostility in medical settings

This study presents the development and validation of a brief comprehensive hostility scale. Two items of each subscale from the Buss-Perry (1992) Aggression Questionnaire, most strongly correlated with their subscale score, were selected, yielding the eight-item New-Buss. Internal reliability was .66 to .81, and full and brief scales correlated r = .92 to .94. In Study 1 (95 Israeli students), New-Buss scores were significantly higher in self-rated deviant or speeding drivers than nondeviant or nonspeeding drivers, respectively. In Study 2 (279 American students), New-Buss scores correlated significantly with Barefoot's Ho, Anger-Out, Anger-In, and Agreeableness. In Study 3 (79 Israeli patients undergoing angiography), New-Buss scores were significantly correlated with coronary artery disease severity independent of SBP in men below age 60 alone but not in women. Our findings support the cross-cultural feasibility, reliability, and concurrent, construct, and criterion validity of the New-Buss.