Angry women at higher risk for heart disease

While previous studies have shown that anger and hostility in and of themselves can increase risk of heart disease in men, little of the research has included women.

But the results of a new study conducted with only women suggests that women who outwardly express anger may be at increased risk if they also have several other risk factors: age (risk increases as women get older), and history of diabetes and unhealthy levels of fats (lipids) in the blood.

Researchers analyzed a variety of measures related to anger, including cynicism, hostile temperament, aggression and suppressed anger. Only expressed anger had predictive value and only when the age, diabetes or dyslipidemia risk factors also were present.

The overt expression of anger toward other persons or objects appears to be the most toxic aspect of hostility in women, said cardiologist C. Noel Bairey Merz, MD, medical director of the Preventative and Rehabilitative Cardiac Center and medical director of Women's Health at CedarsSinai Medical Center.

"Our results appear to differ from the literature on males, particularly young males, in which hostility scores are found to be associated with coronary artery disease. However, the new data . . . indicate that anger and hostility in women, as in men, do tend to cluster with adverse risk factors," said Bairey Merz, one of the authors of an article in the December 2006 issue of the Journal of Women's Health.

In the article, the research team showed that hostility and anger are related to coronary artery disease and are predictive of heart-related "events" in women. The study concluded that the outward expression of anger and hostility is higher in, and may be a risk factor for, women with suspected coronary artery disease.

But the study also found that anger and hostility are associated with atypical cardiac symptoms in women who do not have angiographic evidence of heart disease. The researchers hypothesized that women who have symptoms but no definitive diagnosis or potential treatment may manifest their frustration in increased aggression and anger.

"By beginning to understand the psychosocial factors that play a role in the development of heart disease in women, we hope to develop more effective diagnostic tools," said Bairey Merz.

This story is provided by Cedars-Sinai Medical Center.