Wednesday, September 26, 2007

Anger and stress increase risk for hypertension and CHD in men

Anger and stress increase risk for hypertension and CHD in men

By Sara Carrillo de Albornoz

26 September 2007

Ann Fam Med 2007; 5: 403-411

MedWire News: Prehypertensive men with high levels of trait anger and stress are at high risk for hypertension and coronary heart disease (CHD), research shows.

Marty Player and colleagues from the Medical University of South Carolina in Charleston, USA, examined data from the prospective population-based Atherosclerosis risk in communities (ARIC) study on 2334 men and women aged 45-64 years who had prehypertension but were free of heart disease or stroke.

They then investigated whether psychosocial factors were associated with progression from prehypertension to hypertension and to CHD during the follow-up period from 1987 to 1998.

The researchers measured trait anger - a stable personality trait characterized by the frequency, intensity, and duration of anger - using the Spielberger trait anger scale. Psychological stress was assessed using the Maastricht questionnaire.

After adjusting for age, gender, ethnic background, and cardiovascular risk factors, patients with high levels of trait anger were significantly more likely to progress from prehypertension to hypertension than patients with low/moderate levels (odds ratio [OR]=1.53).

High trait anger scores were also significantly associated with CHD risk (OR=1.71), compared with low trait anger scores.

Nevertheless, stratification by gender revealed that high trait anger was only a risk factor for hypertension and CHD in men, at ORs of 1.71 and 1.92, respectively.

Both men and women with high levels of stress were significantly more likely to develop CHD than those with low/moderate levels (OR=1.68). However, long-term stress did not significantly increase the likelihood of prehypertension progressing to hypertension.

Player et al conclude in the Annals of Family Medicine: "This study adds to the growing evidence of the role of psychological factors in the development of cardiovascular disease."

They add: "Further studies may help determine whether treatment of anger by counseling, medication, or other means will have a beneficial effect on slowing progression from prehypertension to CHD."

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