Curbing Hostility May Help your Heart

Hostility may be a risk factor for heart disease.

A driver cuts Harry off, so he swears and starts tailgating the offending motorist. As the grocery clerk tosses a loaf of bread in the bottom of a bag, Sharon feels her blood boil. But she doesn’t say anything.

Jerry’s boss berates him for failing to communicate some important information. Humiliated, Jerry goes home and picks a fight with his wife for buying a new blouse.

Hostility—it makes you feel rotten. Mistrust and ill humor blacken your days. The slightest mishap—misplaced keys, oversleeping, spilled coffee—sets you off. The upshot? You alienate friends and family, have difficulty at work and end up isolated.

And that may be just the tip of the iceberg. Since the 1950s, when Drs. Meyer Friedman and Ray Rosenman declared hostility one of the hallmarks of "Type A (or coronary-prone) personality," it’s been singled out as a possible risk factor for heart disease.

How does hostility hurt?

As research findings linking hostility to heart disease continue to mount, the question remains, How does hostility do damage?

One theory contends that hostility is simply a marker for smoking, drinking alcohol and obesity.

Another maintains that hostile persons have an exaggerated physical response to stress. Study after study has shown that when facing a demanding task, like taking an exam, hostile people experience higher blood pressure and heart rates than easygoing types facing the same task. It also takes longer for a hostile person’s system to return to normal.

What’s worse, hostile people tend to be "hot reactors." That means they’re likely to blow their tops over events others would consider trivial. Over time, this frequent, strong response to stress may take a toll on the heart and blood vessels.

Burden of Proof

Although its role in cardiovascular disease has been a matter of debate in the ensuing decades, findings suggest that hostility can indeed hurt:

  • As part of the decades-long Veterans Administration Normative Aging Study, Harvard researchers looked at the link between anger and the development of coronary artery disease in 1,305 men who were heart-disease free in 1986. Over the next seven years, those who scored highest on the hostility portion of a personality test given at the start of the study were three times more likely to develop heart disease than those who scored lowest.
  • By using Holter monitors to record patients’ heart activity around the clock, doctors have found that bouts of anger often precede angina attacks (chest pain caused by reduced blood flow to the heart) as well as silent ischemia (reduced blood flow to the heart that produces no symptoms and so may be even more dangerous). What’s more, when researchers interviewed 1,623 heart attack patients within four days of their heart attacks, they found that an angry episode more than doubled the risk of heart attack during the next two hours.
  • Hostility may not help a heart patient’s recovery, either. Of 41 patients who had angioplasty to clear clogged arteries, those who scored high on the hostility scale were two-and-a-half times more likely to have their arteries clog up again within the next year.
  • A Scottish study suggests that hostility is dangerous simply because it’s closely associated with smoking and drinking. Researchers determined the relationship between hostility, cigarette smoking and alcohol consumption by studying nearly 6,000 men and women who took a personality test. It turned out that hostility emerged as a significant predictor of both behaviors. A more recent Berkeley, Calif., study reached a similar conclusion, adding obesity and lack of physical activity—notorious risk factors in their own right—to the list of behaviors linked to hostility.

Quieting the Rage

There happens to be good news on the hostility front. Research by Dr. Friedman and others suggests that counseling at-risk heart patients to curb hostility can help reduce the incidence of silent ischemia and future heart attacks.

If you have a low hostility threshold, these steps may help you find some calm:

  • When you feel yourself overreacting to an event, pause for a moment and ask yourself these questions:
    • Is my anger justified? (Is the driver really going too slowly, or am I mad because he or she is obeying the speed limit?)
    • Is my anger getting me anywhere? (Is the anger motivating me to act constructively, or is it just making me feel lousy?)
    • Do I want to be right, or do I want to be happy?
  • Figure out which people or events "press your buttons," and learn to avoid or adapt, as needed.
  • Assert yourself in a calm manner when something bothers you instead of exploding or holding it in.
  • Turn around your thinking. For example, allow for the possibility that a rude waiter may be having a bad day instead of concluding that he’s out to get you.

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